Leptospirosis Outbreak in Sri Lanka in 2008: Lessons for Assessing the Global Burden of Disease
Leptospirosis Outbreak in Sri Lanka in 2008: Lessons for Assessing the Global Burden of Disease
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DOI：
10.4269/ajtmh.2011.11-0276
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发表时间：
2011-09-01
影响因子：
3.3
通讯作者：
Vinetz, Joseph M.
中科院分区：
文献类型：
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作者：
Agampodi, Suneth B.;Peacock, Sharon J.;Vinetz, Joseph M.
全球钩端螺旋体病疾病负担估计数因缺乏来自可能高度流行和诊断能力有限的国家的科学可靠的数据而受到阻碍。我们描述了2008年斯里兰卡钩端螺旋体病爆发的血清流行病学和临床特征。采用世界卫生组织钩端螺旋体病流行病学参考小组提出的确诊/推定病例定义进行病例确认。在404宗可能个案中，155宗证实为端螺旋体病。患者浮渣样本的最高滴度与血清型Pyrogenes（28.7%）、Hardjo（18.8%）、Javanica（11.5%）和Hebdomadis（11.5%）反应。16 S核糖体DNA基因测序鉴定了6例感染：5例为问号钩端螺旋体感染，1例为钩端螺旋体感染。好极了。在该患者人群中，急性肾衰竭是主要并发症（14.8%），其次是心肌炎（7.1%）和心力衰竭（3.9%）。病死率为1.3%。本报告强调迫切需要提高实验室诊断能力，以确定斯里兰卡流行病和地方性传染病的原因，这一发现与其他热带地区有关。
Global leptospirosis disease burden estimates are hampered by the lack of scientifically sound data from countries with probable high endemicity and limited diagnostic capacities. We describe the seroepidemiologic and clinical characteristics of the leptospirosis outbreak in 2008 in Sri Lanka. Definitive/presumptive case definitions proposed by the World Health Organization Leptospirosis Epidemiology Reference Group were used for case confirmation. Of the 404 possible cases, 155 were confirmed to have leptospirosis. Highest titers of patient scum samples reacted with serovars Pyrogenes (28.7%), Hardjo (18.8%), Javanica (11.5%), and Hebdomadis (11.5%). Sequencing of the 16S ribosomal DNA gene identified six infections: five with Leptospira interrogans and one with L. weilli. In this patient population, acute renal failure was the main complication (14.8%), followed by myocarditis (7.1%) and heart failure (3.9%). The case-fatality rate was 1.3%. This report strengthens the urgent need for increasing laboratory diagnostic capabilities to determine the causes of epidemic and endemic infectious diseases in Sri Lanka, a finding relevant to other tropical regions.