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PubMed2004

Human leptospirosis in Erode, South India: serology, isolation, and characterization of the isolates by randomly amplified polymorphic DNA (RAPD) fingerprinting.

The study describes the first attempt to record leptospirosis in Erode by isolation and serological tests such as the microscopic agglutination test and IgM-based enzyme-linked immunosorbent assay. Twenty-nine clinically suspected cases showing fever, headache, body ache associated with jaundice, decreased urine output, and conjunctival suffusion were included. The age of the patients ranged between 10-71 years and most of them were agricultural workers. Paired sera were possible among 12 cases. All the patients had fever and headache and other more common symptoms were myalgia and icterus. Leptospiral culture was positive in 7 (24.1%) patients. Out of 29 patients, 26 (89.7%) were diagnosed as having current leptospiral infection based on serology and isolation. The leptospiral isolates KSR 1-6 were further characterized by using randomly amplified polymorphic DNA fingerprinting shown genetic similarities with Leptospira interrogans spp. This study shows the presence of leptospirosis among the hospital cases of Erode and that this disease is a potential health hazard of agricultural workers in Cauvery basin.

Adolescent↗
PubMedDate not supplied

[Clinical and epidemiological behavior of human leptospirosis in Los Palacios municipality, Pinar del Rio, Cuba].

A descriptive-retrospective study was performed to find out some epidemiological aspects of leptospirosis in Los Palacios municipality in the period January 1996 to December 1998. Data were obtained from an epidemiological survey of leptospirosis cases, which was made y the Municipal Hygiene and Epidemiological Center. The results were 94% of cases were males; the most affected aged group was 14-19y (21,8%). Fever (100%), myalgia(84%) and arthralgia (62%) were the most common clinical findings. Rice harvesting work (87,5%) was significantly associated to the onset of disease.

Adolescent↗
PubMedDate not supplied

[Rats and dogs: important vectors of leptospirosis in agricultural areas in Cuidad Guzmán, Jalisco].

A study was conducted to determine how important rats and dogs are in the dissemination of leptospirosis in farms and stales located in Ciudad Guzmán, Jalisco. Thirteen of Leptospira interrograns serovarieties were used in microagglutination test of serogroups (MAT). Three hundred and fifty four rats (Rattus rattus and Rattus norvergicus) trapped in agricultural areas of the place were studied; 22 were positive (6,2%) and 34 suspected of leptospirosis (9,6%). Also four hundred and nineteen dogs from the region were tested; 22,6 % (95 dogs) were positive and 5,7%(24) suspected of L. Interrogans. These results showed that both species are important in the dissemination of the disease.

Agriculture↗
PubMedDate not supplied

[Reactogenecity and immunogenecity of Cuban trivalent inactivated vaccine against human leptospirosis in different vaccination schedules].

A controlled, randomized assay was performed to evaluate the reactogenecity and immunogenecity of Cuban trivalent vaccine against human leptospirosis (vax-SPIRAL) in healthy volunteers, using different vaccination schemes. A Russian-made vaccine was used as control. Adverse effects were local symptoms and signs (pain, rush, local infiltration, itching, necrosis and abscess) and general symptoms and signs(fever, low-grade fever, headache, lipotimia, nausea, vomiting, rash and general malaise). The results showed that the vaccine is innocuous since no serious adverse effects were observed. Low-grade fever and slight local pain were the symptoms and signs that occurred at acceptable levels. Fever was present in a small number of volunteers. Similar adverse reactions were reported in the groups immunized with Cuban vaccine under different vaccination schemes and in those immunized with the Russian-made vaccine. Most of the symptoms and signs disappeared after 72 hours. Seroconversion was similar to other bacterines against leptospirosis. The achieved results allowed concluding that the Cuban vaccine is safe and low reactogenic for human adults.

Bacterial Vaccines↗
PubMedDate not supplied

[Lepto-dipstick: results of its application to the fast diagnosis of human leptospirosis].

Forty one serum specimens from critical patients who were suspected of having human leptospirosis were studied by using simultaneously convencional test Lepto-dipstick and serogroup microagglutination test (MAT) with live antigens. Different reactivity levels were reached in 26 tested samples by Lepto-dipstick. This assay and MAT coincided in 85,4% of results. It was confirmed that Lepto-dipstick detects antibodies to various leptospiral serovars and that the degree of intensity of the band staining corresponded with the level of detected antibodies by MAT. The implementation of Lepto-dipstick in the diagnosis of human leptospirosis allows providing a rapid response to the medical staff in charge of the studied cases. This proved that Lepto-dipstick is a rapid method that is easy-to-read and interpret.

Agglutination Tests↗
PubMedDate not supplied

[Importance of the microbiological confirmation in an outbreak of human leptospirosis in the city of Villa Clara].

A multidisciplinary group was created to confirm the existance of human leptospirosis in the province of Villa Clara where by the end of June, 1977, there was a considerable increase of febrile cases with symptoms and signs consistent with diseases such as hemorrhagic dengue and human leptospirosis. The National Laboratory of Reference of Leptospires from "Pedro Kouri" Institute, organized a set of direct and indirect diagnostic techniques as a working strategy that would serve to confirm this health problem. As a final result, it was observed that the Ballum, Pomona, Canicola and icterohaemorrhagiae serogroups showed the highest percentage of appearance among the studied cases. A total of 7 cases had active infection, since they were positives by the passive hemoagglutination method. The four severe cases studied by passive hemoagglutination and microagglutination were positive. Sera from the 3 patients with febrile syndrome of unknown ethiology were negative by these 2 techniques. The 3 samples obtained from the autopsy of a dead were positive by direct exam in dark field and staining of immunoperoxidase. The monosera of the dead subjects were highly reactive by passive hemagglutination (titers from 1-10 and up to 1-640). 2 hemocultures were typified as Ballum; 2 urines and 1 hemoculture were positive by polymerase chain reaction. In this way, a fast answer was given to the health public authorities from the Viceministry of Hygiene and Epidemiology of Cuba on confirming microbiologically the existance of the disease. lt was sugggested to administer the Cuban vax SPIRAL vaccine in the affected area.

Cuba↗
PubMed2005

Leptospirosis in Guilan, a northern province of Iran: assessment of the clinical presentation of 74 cases.

BACKGROUND: This study was carried out to define the major clinical presentation and laboratory findings of leptospirosis in Guilan province, an agricultural and fishery area in the Caspian littoral. MATERIAL/METHODS: Cases with a clinically compatible illness and positive serology (immunofluorescence antibody method (IFA)), were included. Clinical information and other lab data were collected. RESULTS: Seventy-four cases, with a mean age of 47.3 +/- 12.4 years and of whom 52 (70.3%) were male, were recruited. All had had contact with stagnant water of a farm within the week prior to their admission. Fever and chills were the most frequent chief complaint in 47 (63.5%). Fever, headache, and myalgia were reported by 73 (98.6%), 69 (93.2%), and 57 (77%) cases, respectively. Increased serum creatinine was detected in 18 (27.3%). Only in 27% of patients did CPK rise to 3-fold or more above the Normal Upper Limit, and in 43% of patients its level was within the normal range. Thrombocytopenia was noticed in 87.3%, and 15.5% of cases had platelets less than 20,000/mm(3). Anemia was detected in 78.4%. ESR was more than 100 mm/hour in 28.3%. CONCLUSIONS: History of fever, headache, and myalgia in patients who have been in contact with the stagnant water of rice fields should raise the possibility of leptospirosis in Guilan province.

Adult↗
PubMedDate not supplied

[Leptospirosis in French Polynesia: 120 case reports].

Because of its clinical polymorphism and the difficulties to made a bacteriological and/or serological diagnosis, leptospirosis is an affection always non-detected. Nevertheless it is daily met affection in French Polynesia. Based on a homogenous series of 120 observations gathered from 1984 to 1990, all of them bacteriologically and/or serologically confirmed, we studied the different clinical and evolutive features of that disease. Fever is present in 91.6 p.c., cephalgia in 79.16 p.c. and myalgia in 70.83 p.c. Admission was necessary once out of four times. The four syndromes we observed in Tahiti are: infections syndrome, meningeal syndrome (30 p.c.) associated to an hyperproteinic grade in the C.S.F. (40 p.c.) and a lymphocytic reaction (60 p.c.). Liver syndrome, with hepatalgia (58.33 p.c.) and pain at the mass motion of liver (65 p.c.), that is an important sign in the local context; jaundice (28.33 p.c.) on the presence of which we must not based a diagnosis of leptospirosis: Biological renal syndrome displayed by transitory renal insufficiency with proteinuria, hematuria and leucocyturia. Neurological complications are mainly of encephalitic manifestations (5.8 p.c.). Hemorrhagic syndrome is expressed in digestive hemorrhage (8.33 p.c.) epistaxis (6.66 p.c.) and hemoptysis (6.66 p.c.). Cardiovascular manifestations are expressed in collapsus in 5.83 of the cases. Pulmonary abnormalities are frequent: cough (26.66 p.c.) and non specific X Ray image (19.16 p.c.). All patients are treated by Penicillin G (10 to 20 millions per day) by parenteral route with enteral alternative for an average of 10 days. Recovery was fast (7 to 10 days). In 65.8 p.c., slower in 15 p.c. (15 to 20 days); failure at first stage was observed in 10 p.c. of the cases, and relapse at medium or long term occurred under treatment in 8 cases (6.66 p.c.). Three dead were deplored (mortality 2.5 p.c.).

Adult↗
PubMed2005

Leptospirosis--an overview.

One of the important causes of acute febrile illness in a country where malaria, typhoid and dengue are also not uncommon, leptospirosis, a zoonotic disease spread by rodents, is endemic in Tamil Nadu, Kerala and Andamans; and is now being increasingly reported from other parts of India, perhaps with better facility to diagnose the disease. Disease of profound importance in view of its grave outcome, in its icteric form (Weil's disease), may have a mortality of as high as 40%. Worst prognosticator is the presence of multi-organ failure (MOF), as in any other septicemia. Andaman hemorrhagic fever (AHF), a type peculiar to Andamans, is now being described elsewhere in the country also. IgM ELISA, Dot-ELISA, dip-stick method and slide agglutination test (SAT) are newer screening methods for diagnosis of leptospirosis, but are only genus-specific. Identifying specific serovar is possible by Micro-agglutination test (MAT) and culture method only. Anicteric type of disease, however, is easily treatable with penicillin and has a good prognosis. Oral doxycycline can be used for prophylaxis during the risk of exposure.

Humans↗
PubMed1992

Kayaking as a risk factor for leptospirosis.

Leptospirosis is a common zoonosis present throughout Missouri. Previously regarded as an occupational illness of farmers and sewer workers, it is now primarily acquired from exposure to water polluted with the bacteria Leptospira. We present a case report of leptospirosis acquired through kayaking and review both the disease and the risk factor associated with kayaking.

Adult↗
PubMedDate not supplied

LipL32, an outer membrane protein of Leptospira, as an antigen in a dipstick assay for diagnosis of leptospirosis.

Microscopic agglutination test (MAT), as well as other serological assays that aimed at detecting antibodies to Leptospira, supplements the leptospirosis diagnosis based on the clinical features. Nevertheless, false positive results have been occasionally reported when the crude antigen was used in those antibody-based tests due either to the presence of antibodies stimulated by other antigenically related pathogens in the patient's serum, or the antibodies in the serum may be stimulated by a previously unrecognized Leptospira infection, especially in the disease endemic areas. Thus, the more refined antigen should improve the serodiagnostic accuracy. Among Leptospira spp., LipL32, which is a pathogenic Leptospira outer membrane protein (OMP), expressed by the bacteria grown both in vitro and in vivo. In this study, recombinant LipL32 protein was tested by a dipstick method for its potential in serodiagnosis of leptospirosis. Preliminary results suggest that the recombinant LipL32 is a good diagnostic detection reagent for specific Leptospira IgG. Diagnostic sensitivity and specificity of the Lip32 dipstick assay, when compared to those of MAT, were 100% and 98.33%, respectively.

Agglutination Tests↗
PubMedDate not supplied

Nephropathy in leptospirosis.

Renal involvement is common in leptospirosis. Bacterial invasion, inflammatory process, haemodynamic alterations and direct toxicity of bacterial products are thought to be responsible for the development of nephropathy. Pathologically, all renal structures are involved. Interstitial nephritis is the basic lesion, and is observed even in patients without clinical renal manifestations. Tubular necrosis is the important pathological counterpart of acute renal failure. The clinical spectrum of renal manifestations includes mild urinary sediment change, hypokalemia, tubular dysfunction, decreased response to fluid load and acute renal failure (ARF). ARF reflects the severity of leptospirosis, is catabolic and is commonly associated with cholestatic jaundice. Severe renal failure may be complicated by multiple organ involvement. Renal failure with hyperbilirubinemia represents a severe form of renal dysfunction with oligo-anuria and prolonged clinical course. Mild renal failure is usually anicteric and non-oliguric and without complication. Besides antibiotic treatment, early and frequent dialysis is life saving. ARF with major organ failure has unfavorable outcome. Plasmapheresis and continuous venovenous hemofiltration improve hemodynamics and are beneficial for the patients with acute renal failure and multiorgan involvement. Recovery of renal function is usually complete in most patients.

Humans↗
PubMed2005

[Two leptospirosis cases and review of the national literature].

In this report, two cases of leptospirosis admitted to our clinic in the same periods, have been presented. The first patient was a 29 years old male farmer, and the other was a 44 years old male prisoner. Both of them were from Middle Anatolian Region with the similar clinical findings (subfebrile fever, gastrointestinal complaints, ichterus in sclera, leucocytosis, and increased levels of liver enzymes, urea and creatine). The diagnosis was based on the antibody positivities against Leptospira with microscopic agglutination test which performed in the Etlik Central Veterinary Control and Research Institute. The first case was positive for L. grippotyphosa, and the second was positive for L. australis serovar bratislava at the titers of 1/800. Both of the patients were given empirical antibiotic treatment (ceftriaxone 2 x 1 gr, and ampicillin-sulbactam 4 x 1 gr, respectively), and discharged with complete healing. These cases led us to review the other leptospirosis cases in our country.

Adult↗
PubMed2005

Human leptospirosis in the Vicenza area (Italy) from 1990 to 2003: an epidemiological and clinical study.

All cases of human leptospirosis observed at the S. Bortolo Hospital, Vicenza, Italy, in the period from September 1990 to December 2003 were retrospectively reviewed. The aim of the study was to define the epidemiological, clinical, diagnostic, and therapeutic aspects of this infection and to compare these with an earlier local study (1979-1990) in order to assess if any changes have occurred over time. The screening test was made using macroscopic agglutination and the diagnosis was definitively confirmed using the microscopic agglutination test (MAT). The etiological serotype was identified in 13 patients (68%) and Leptospira poi was the most frequent serovar. Hepatic and renal involvements were present in a high percentage of patients (71% and 74%, respectively), cardiac involvement in 39%, and hypertriglyceridemia and hepatic steatosis were observed in 68% and 43% of cases, respectively. One patient died because of acute renal and respiratory failure. Intravenous penicillin was the treatment of choice. A consistent reduction in the prevalence was observed during the time period of this study (n = 38) compared with the previous period (n = 86); males were more affected than females in both time periods. In industrialized countries the prevalence of leptospirosis is decreasing; nevertheless, this infection is no longer limited to specific occupational groups and remains a potential fatal disease that should be included in the differential diagnosis of all the patients with unexplained fever.

Adult↗
PubMed2006

An outbreak of leptospirosis among Israeli troops near the Jordan River.

An outbreak of leptospirosis that involved 7 of a team of 27 Israeli troops occurred following a military exercise in northern Israel near the Jordan River. The organism implicated in the outbreak was Leptospira interrogans serovar Hardjo. The clinical course was uncomplicated and all patients fully recovered. There were no cases of asymptomatic infection. Military personnel should be recognized as having an occupational risk for contracting leptospirosis, especially when military activity takes place near natural water sources inhabited by cattle, taking into account the local epidemiology of this disease. Moreover, outbreaks among military personnel may serve as a sentinel for leptospiral illness in areas in which civilian exposure takes place, such as the Jordan River, which is an important site that involves immersion in the context of both pilgrimage and civilian recreational activities."Bathe and you will become clean. So he went down and immersed himself seven times in the Jordan, as Elisha had told him to do. And his flesh became clean once more like the flesh of a small child."II Kings 5:14.

Adult↗
PubMed2005

Surveillance of leptospirosis after flooding at Loei Province, Thailand by year 2002.

In this surveillance, suspected leptospirosis patients in Loei Hospital, Loei Province were studied by conventional methods of cultivation and microscopic agglutination test (MAT) during July-October, 2002. It was found that 63% of 64 admitted patients and 35% of 34 outpatients were found positive by leptospire cultivation. Antibodies determined by MAT were positive in 78% of 63 admitted patients. Particularly, the five most common agglutinating antibodies were reactive with serovars bratislava (57%), autumnalis (48%), new (38%), australis (37%) and bangkok (29%). The MAT results of 15 OPD patients were 67% positive with the following five serovars, including bratislava (47%), new (20%), bangkok (7%), ranarum (7%) and australis (7%). Accordingly, preventive strategies against leptospirosis outbreaks after flooding in Thailand should be undertaken, including the prompt treatment of the disease in this endemic area.

Agglutination Tests↗
PubMedDate not supplied

[Natural foci of leptospirosis in Moscow in 1995 - 2004].

The article deals with the results of the 10-year study of the synanthropic urban foci of leptospirosis on the territory of Moscow. Information on the manifestation of the activity of the foci under study, rodents serving as the reservoir of infection in these foci, the etiological structure of the leptospires among these rodents, the state of leptospirosis morbidity among humans is presented.

Agglutination↗
PubMed2006

Brief report: Leptospirosis after flooding of a university campus--Hawaii, 2004.

On November 19, 2004, the Hawaii Department of Health (HDOH) received a report that a University of Hawaii professor aged 56 years had been hospitalized with suspected leptospirosis after cleaning his flooded laboratory. On October 31, heavy rains had caused an adjacent stream to overflow its banks and flood the campus. Persons exposed to fresh water or mud contaminated by the urine of animals infected with the spirochete Leptospira interrogans can have systemic illness if the leptospires enter the body through broken skin or mucous membranes. This report describes the subsequent investigation by HDOH, assisted by CDC, which highlights the importance of maintaining clinical suspicion for leptospirosis after flooding in areas where the illness is endemic, even in well-developed urban settings.

Disasters↗