Leptospirosis in Hawaii, 1974-1998: epidemiologic analysis of 353 laboratory-confirmed cases.

Abstract

Abstract. The epidemiologic characterization of leptospirosis in the United States has been limited by difficulties associated with both case detection and confirmation. In addition, leptospirosis was eliminated from the list of National Notifiable Diseases in 1995. From 1974 until the cessation of national surveillance, Hawaii consistently had the highest reported annual incidence rate in the United States. From 1974 through 1998, 752 leptospirosis cases were reported in the State of Hawaii. Of these, 353 had exposures within the state and were laboratory confirmed. The mean annual incidence rate was 1.29 per 100,000. Cases were predominately male. Rates were highest in rural areas. Occupational exposures diminished over time while recreational exposures increased. This series represents the first large U.S. leptospirosis surveillance report since 1979. With leptospirosis recently being identified as a re-emerging zoonosis, continued national surveillance and case reporting should be reconsidered.

Clinical presentation of leptospirosis: a retrospective study of 201 patients in a metropolitan city of Brazil

“…These are the most common findings reported in leptospirosis. 1,7,8,9,17,19 Hemorrhagic manifestations are characteristic of Weil disease, and are potentially fatal. Patients can develop important hemodynamic abnormalities, secondary to hypovolemia, which is caused by dehydration and direct effects of Leptospira toxins that damages vascular endothelium and increases permeability.…”

“…Fever, chills, headache, severe myalgia, conjunctival suffusion, anorexia, nausea, vomiting, and malaise usually characterizes acute leptospirosis. [7][8][9] Pulmonary involvement and acute kidney injury are the main causes of death in leptospirosis. [10][11][12] Renal involvement in leptospirosis is characterized by acute interstitial nephritis that may be associated with acute tubular necrosis.…”

Comportamiento de la vigilancia epidemiológica de la leptospirosis humana en Colombia, 2007-2011

“…La leptospirosis se considera una zoonosis emergente y reemergente de distribución mundial, causada por una bacteria perteneciente al género Leptospira, la cual se adquiere al tener contacto directo o indirecto con orina infectada de animales, suelos, aguas o alimentos contaminados (1)(2)(3)(4).…”

Risk Factors for an Outbreak of Leptospirosis in California Sea Lions (Zalophus Californianus) in California, 2004

“…The seasonal distribution of cases may reflect the temporal and spatial distribution of sea lions, as after the breeding season, most of the adult and subadult males leave the rookeries and move northward, while females remain nearer the rookeries (King, 1983). An increased number of cases in summer and autumn also have been found in dogs (Ward, 2002), cattle (Miller et al, 1991), horses (Barwick et al, 1997), and humans (Ferguson, 1993;Katz et al, 2002), during and immediately following periods of heavy rainfall. However, these studies, which were either not conducted in California, or focused on the entire country, showed no association of rainfall with leptospirosis in California.…”