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PubMed2002

An urban outbreak of leptospirosis in Mumbai, India.

An outbreak of leptospirosis occurred during the rainy season in the city of Mumbai, India. Out of 169 suspected cases, 74 (43.7%) were determined serologically positive by microagglutination test (MAT) carried out with a battery of eight pathogenic serovars, while 78 (46.1%) were shown positive for IgM antibodies to leptospira by enzyme-linked immunosorbent assay. On the basis of MAT, serovar Copenhageni accounted for 66 (89.1%) out of the 74 cases admitted during the period of the outbreak. Myalgia, conjunctival suffusion, cough with hemoptysis, icterus, and oliguria were significantly more common in patients whose samples were determined positive by MAT. The presence of pulmonary signs and symptoms and renal failure were significantly associated with mortality in patients presumed to be suffering from leptospirosis.

Adult↗
PubMedDate not supplied

[Causes of leptospirosis morbidity in Krasnodar region].

The situation in leptospirosis morbidity in the Krasnodar Territory has been analyzed. The tendency towards a decrease in the number of water outbreaks and a growth in the number of sporadic cases has been noted. Antibodies to Leptospira ictrohaemorrhagiae, whose natural carriers are gray rats, are most often detected in the blood of patients. Among leptospirosis patients, persons engaged in fishing, work on plots of land adjoining their summer cottages, dog breeding are mostly registered. The detailed characterization of the outbreak of 1997, an outstanding outbreak among those observed in recent years, is given. This outbreak was caused by abundant precipitations and the subsequent flooding of vast areas, a growth in the number of Leptospira-infected rodents. In this connection attention is drawn to the necessity of greater efforts in carrying out deratization, as well as sanitary and veterinarian measures.

Adolescent↗
PubMed2003

[Pulmonary leptospirosis. Two cases].

Leptospirosis is a systemic infection transmitted to man by a variety of animals. Classical manifestations include fever, liver and renal involvement, meningoencephalitis and hemorrhage. Pulmonary involvement is less common, generally expressed by hemoptysis and bilateral reticulonodular infiltration on the chest x-ray. Pulmonary disease is one of the principal causes of mortality. We report the cases of two patients aged 22 and 32 years who were hospitalized for moderately abundant hemopysis and fever. The diagnosis of leptospirosis with pulmonary involvement, strongly suggested by the classical extrapulmonary signs and was confirmed later. The patients were given antibiotics (amoxicillin, cycline). Clinical, biological and radiological outcome was favorable.

Adult↗
PubMed1960

The distribution of leptospirosis in Latin America.

Although many factors combine to make Latin America an apparently suitable region for the spread of the leptospiroses, the prevalence of these infections has been studied in relatively few areas of this part of the American continent. Of the 60 Leptospira serotypes described in the world, only seven have so far been definitively demonstrated in Middle America and five in South America. However, there is evidence to suggest that other and perhaps new serotypes may be found, and recent serological surveys indicate that there are loci of multiple leptospirosis affecting a large percentage of human or animal populations in at least five Latin American territories.The true prevalence of leptospirosis can only be ascertained by the proper application of reliable laboratory diagnostic methods. The limited value of certain techniques used heretofore makes a number of reports on the presence of this disease subject to question.

Animals↗
PubMedDate not supplied

[Therapeutic considerations on severe leptospirosis].

The present paper reports on the results obtained by intravenous administration of furosemide which shortened the period of oliguria in the course of acute renal insufficiency in leptospirosis. The criteria of administration of heparin for preventing the intravascular disseminated coagulation syndrome in leptospirosis are discussed.

Acute Kidney Injury↗
PubMed1992

Enzyme-linked immunosorbent assay for leptospirosis immunoglobulin M specific antibody using surface antigen from a pathogenic Leptospira: a comparison with indirect hemagglutination and microagglutination tests.

A search for a sensitive and specific test for human leptospirosis was made by enzyme-linked immunosorbent assay for immunoglobulin M specific antibody (IgM ELISA) using a surface antigen from L.interrogans serovar bataviae, L. interrogans serovar pyrogenes and L.interogans serovar icterohaemorrhagiae. The IgM ELISA tests using each of the three antigens were evaluated in 103 sera primarily positive by microagglutination test (MA). Optical density of these IgM ELISA tests showed good correlation. The IgM ELISA using antigen from serovar bataviae was compared with MA and indirect hemagglutination (IHA) in 20 sera primarily positive by IHA, and 103 sera primarily positive by MA. IgM ELISA and IHA using antigen prepared from serovar bataviae in 103 sera positive for MA had a sensitivity of 98.06 and 92.23 per cent respectively. In 20 sera primarily positive by IHA, IgM ELISA and MA showed sensitivity of 80 and 45 per cent respectively. The surface antigen used in IgM ELISA is broadly specific making IgM ELISA a sensitive and specific test for human leptospirosis. IHA agreed more with IgM ELISA in comparison to MA. As MA is not sensitive for early infection, IHA and IgM ELISA should be in routine use in general laboratories.

Agglutination Tests↗
PubMed1992

[Cluster and multiple regression analysis of leptospirosis epidemic factors].

Ten-year surveillance of Rice-field-typed leptospirosis was carried out in high-infected foci. Twenty two parameters of epidemic data were divided into 3 categories and cluster-analyzed. 5 typical variables were selected for multiple regression equation. The equation contained four factors, i.e. rodents density, carriage rates of main animal hosts, GMT of population antibody against leptospira and quantity of rainfall in August. The expected morbidity of leptospirosis calculated by the equation were roughly identical to the real morbidity.

Animals↗
PubMed2003

Leptospirosis in dogs: a serologic survey and case series 1996 to 2001.

All leptospirosis microscopic agglutination test titers for the Leptospira serovars icterohaemorrhagiae, canicola, grippotyphosa, bratislava, hardjo, and pomona conducted on 1,260 blood samples from dogs at the University of Illinois Veterinary Diagnostic Laboratory between March 1996 and March 2001 were evaluated. Low titers (1:100 to 1:400) were predominantly L. icterohaemorrhagiae and L. canicola, which represented the predominant serovars (65.4%) among all positive samples with low titers. L. grippotyphosa was the predominant serovar (72.1%) among samples with clinically significant titers (greater than 1:800). The medical records of 87 dogs with a titer greater than 1:800 that were patients at the Veterinary Teaching Hospital of the University of Illinois were reviewed. A clinical diagnosis of leptospirosis was made in 15 cases (17.2%) based on the elevated titer, appropriate clinical signs, lack of recent vaccination, and lack of concurrent disease that could explain the clinical signs present. Renal disease was present in 10 of the cases, concurrent renal and hepatic disease in two, and hepatic disease in three. In 12 cases, the predominant serovar was L. grippotyphosa; titers to L. grippotyphosa and L. bratislava were equal in magnitude in three cases.

Animals↗
PubMed2003

["Post traumatic" leptospirosis complicated by acute respiratory insufficiency].

INTRODUCTION: Leptospirosis is a rare cause of alveolar haemorrhage. The diagnosis is often delayed particularly when the mode of infection is atypical. These serious complications require prompt antibiotic treatment. CASE REPORT: A 21-year-old man was involved in a road accident and found lying unconscious in a roadside ditch containing stagnant water. Ten days later he presented with bilateral interstitial pneumonia and rapidly increasing hypoxaemia associated with cholestasis and liver cell necrosis. Broncho-alveolar lavage revealed alveolar haemorrhage. There was satisfactory resolution following antibiotic therapy. CONCLUSIONS: The diagnosis of leptospirosis was considered initially despite negative serology (Martin and Petit) and confirmed by sero-conversion 20 days after the onset of symptoms.

Accidents, Traffic↗
PubMedDate not supplied

[Leptospirosis outbreaks in the Ul'ianovsk region].

The paper presents the data of an epidemiological investigation on the outbreak incidence of leptospirosis in the Ulyanovsk Region. One hundred and forty-one recording forms under No. 171/y filled in for patients with leptospirosis have been examined. All the outbreaks have been found to be of seasonal nature (June to August) and to show an aqueous transmission of infection. The occupational nature of the disease was absent among the patients.

Adolescent↗
PubMed2003

Prognostic factors associated with severe leptospirosis.

To determine the prognostic factors associated with severity and death of leptospirosis, the authors conducted a hospital based cross sectional study by collecting data of adult patients that were admitted to Phrae Hospital for leptospirosis from 1998 to 2001. The serology was confirmed with a microscopic agglutination test (MAT). The variables obtained from the history, examination, behavioral risks, investigations, and initial treatment especially the data of the first day of admission were examined for association with severity. Of 362 patients, 214 were classed as nonsevere patients, 81 were severe with complications (serum creatinine > or = 3 mg/dl and/or patients with respiratory failure) and 67 died. Multivariate logistic regression demonstrated that five factors were independently associated with severity: hemoptysis, platelet count (Plt) < 100,000/mm3, total bilirubin > 2.5 mg/dl, white blood cell count > 13,000/mm3 and hematocrit (Hct) < 30 per cent. Five factors associated with mortality are: respiratory failure (or respiratory rate; RR > 24/min), hemoptysis, oliguria, metabolic acidosis (or bicarbonate < 20 mmol/l) and thrombocytopenia (or Plt < 100,000/mm3). Identification of these factors might provide useful selection criteria for patients who need early admission or transfer to the intensive care unit.

Adult↗
PubMed2003

Leptospirosis in children.

Leptospirosis has a broad spectrum of clinical manifestations varying, from inapparent influenza like illness to fulminant fatal disease with hepato-renal dysfunction and hemorrhagic phenomena. Our cases had fever, puffiness, respiratory distress and bleeding diathesis as leading manifestations. Leptospirosis was suspected in view of epidemic situation prevailing in the city. We report four cases here, three of which survived and one died.

Anti-Bacterial Agents↗
PubMedDate not supplied

[Leptospirosis in the Southern Federal District of the Russian Federation].

The retrospective and operative epidemiological analysis of leptospirosis morbidity on the administrative territories of the Southern Federal District during the period of 1990-2002 was carried out. The dynamics and tendencies of morbidity in individual administrative units of the region were shown. Materials on the negative influence of the emergency situation arising in the region as the result of the natural calamity in summer 2002 were presented. As shown in this work, timely decisions on the stabilization of epidemiological situation taken at the period of high flood and inundation in summer 2002 in the Southern Federal District and their efficient execution made it possible to keep the epidemiological situation in leptospirosis under control.

Communicable Disease Control↗
PubMedDate not supplied

[Features of leptospirosis in the Krasnodar Territory].

The data on leptospirosis morbidity in the Krasnodar Territory, one of the most epidemiologically unsafe areas in this infectious disease in the Russian Federation, are presented. High morbidity registered in this territory greatly depends on the epidemic outbreaks appearing due to defects in the realization of a complex of sanitary and veterinary measures. The Krasnodar Territory is liable to be affected by natural calamities. In 1997 a severe outbreak of leptospirosis took place here in connection with the high flood. Due to timely prophylactic measures the epidemiological consequencies of the similar calamity occurring in 2002 were brought to a minimum.

Animals↗
PubMed1978

[Comparative study of the immunoglobulin content in persons from leptospirosis foci in different geographical zones of the RSFSR].

The authors carried out a comparative study of the content of serum immunoglobulins in persons from the leptospirosis foci of various geographical zones of the RSFSR: European part--the Centre (Moscow and Ryazan regions), the South (Checheno-Ingush ASSR and Krasnodar Territory), and Western Siberia (Altai territory), Leptospira of serological group Pomona, Grippotyphosa, and Hbedomadis served as the causative agents of the diseases. It appeared that the annual course of the climatic factors acted equally (inhibitory action) on the immuno-globulin metabolism in the residents of temperate and southern zones of the RSFSR at the warm period of the year (May-September), and in the Western Siberia- in winter. However, irrespective of the time of the year, the level of immunoglobulins G and A was greater in the residents of Western Siberia than in the native population of the European part. There proved to be no correlation between the levels of leptospirosis seropositivity in the foci of infection under study and the serum immunoglobulins in local residents of various geographical zones.

Adolescent↗
PubMed2003

Leptospirosis--a case report.

Outbreaks of Leptospirosis have been reported from various parts of India including Maharashtra. We report a case of leptospirosis from Wardha District, Maharashtra from where the disease has not been reported so far.

Adult↗
PubMed2003

Leptospirosis in dogs: a serologic survey and case series 1996 to 2001.

All leptospirosis microscopic agglutination test titers for the Leptospira serovars icterohaemorrhagiae, canicola, grippotyphosa, bratislava, hardjo, and pomona conducted on 1,260 blood samples from dogs at the University of Illinois Veterinary Diagnostic Laboratory between March 1996 and March 2001 were evaluated. Low titers (1:100 to 1:400) were predominantly L. icterohaemorrhagiae and L. canicola, which represented the predominant serovars (65.4%) among all positive samples with low titers. L. grippotyphosa was the predominant serovar (72.1%) among samples with clinically significant titers (greater than 1:800). The medical records of 87 dogs with a titer greater than 1:800 that were patients at the Veterinary Teaching Hospital of the University of Illinois were reviewed. A clinical diagnosis of leptospirosis was made in 15 cases (17.2%) based on the elevated titer, appropriate clinical signs, lack of recent vaccination, and lack of concurrent disease that could explain the clinical signs present. Renal disease was present in 10 of the cases, concurrent renal and hepatic disease in two, and hepatic disease in three. In 12 cases, the predominant serovar was L. grippotyphosa; titers to L. grippotyphosa and L. bratislava were equal in magnitude in three cases.

Animals↗
PubMed2004

[Epidemiologic analysis of human Leptospirosis in Poland in 1995-2002. I. Clinical features and laboratory diagnosis].

The aim of the study was to formulate the case definition of Leptospirosis for surveillance in Poland. There were also discussed the laboratory criteria appropriate for epidemiological situation of leptospirosis in our country. The study based on statistical data and information from 66 epidemiological investigation cards of leptospira cases reported in Poland between 1995 and 2002. We analyzed the course of the disease, clinical symptoms as well as the status of laboratory confirmation.

Diagnosis, Differential↗