Leptospirosis Outbreak following Severe Flooding: A Rapid Assessment and Mass Prophylaxis Campaign; Guyana, January-February 2005
Leptospirosis Outbreak following Severe Flooding: A Rapid Assessment and Mass Prophylaxis Campaign; Guyana, January-February 2005
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DOI：
10.1371/journal.pone.0039672
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发表时间：
2012-07-09
期刊：
影响因子：
3.7
通讯作者：
Mintz, Eric D.
中科院分区：
文献类型：
--
作者：
Dechet, Amy M.;Parsons, Michele;Mintz, Eric D.
背景：钩端螺旋体病是一种人畜共患病，通常通过接触受感染动物尿液污染的水或土壤传播。在地方病流行地区，严重的洪水会使个人面临更大的感染钩端螺旋体病的风险。对疾病进行快速检测和大规模干预对于识别和控制感染是必要的。我们描述了一个钩端螺旋体病爆发后，严重的洪水和大规模的化学预防运动在Guyano.Methodology/主要调查结果：从2005年1月至3月，我们收集了疑似钩端螺旋体病住院和死亡的数据。实验室检测包括抗钩端螺旋体斑点酶免疫测定（DST）、免疫组织化学（IHC）染色和显微镜凝集试验（MAT）。对236名患者中的105名（44%）进行了DST检测; 52名（50%）检测呈阳性。四个（57%）配对血清样本测试MAT证实钩端螺旋体病。在34例归因于钩端螺旋体病的死亡病例中，12例患者中有10例（83%）的尸检样本经IHC检测呈阳性。在接受采访的201名患者中，89%报告直接接触过沃茨。为期3周的多西环素化学预防运动达到超过280，000 people.Conclusions：确认钩端螺旋体病爆发后，圭亚那发生严重的洪水，导致大规模的化学预防运动，试图限制发病率和死亡率。
Background: Leptospirosis is a zoonosis usually transmitted through contact with water or soil contaminated with urine from infected animals. Severe flooding can put individuals at greater risk for contracting leptospirosis in endemic areas. Rapid testing for the disease and large-scale interventions are necessary to identify and control infection. We describe a leptospirosis outbreak following severe flooding and a mass chemoprophylaxis campaign in Guyana.Methodology/Principal Findings: From January-March 2005, we collected data on suspected leptospirosis hospitalizations and deaths. Laboratory testing included anti-leptospiral dot enzyme immunoassay (DST), immunohistochemistry (IHC) staining, and microscopic agglutination testing (MAT). DST testing was conducted for 105 (44%) of 236 patients; 52 (50%) tested positive. Four (57%) paired serum samples tested by MAT were confirmed leptospirosis. Of 34 total deaths attributed to leptospirosis, postmortem samples from 10 (83%) of 12 patients were positive by IHC. Of 201 patients interviewed, 89% reported direct contact with flood waters. A 3-week doxycycline chemoprophylaxis campaign reached over 280,000 people.Conclusions: A confirmed leptospirosis outbreak in Guyana occurred after severe flooding, resulting in a massive chemoprophylaxis campaign to try to limit morbidity and mortality.