Current status of leptospirosis in Japan and Philippines
Current status of leptospirosis in Japan and Philippines
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DOI：
10.1016/j.cimid.2007.05.003
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发表时间：
2007-09-01
影响因子：
2
通讯作者：
Masuzawa, Toshiyuki
中科院分区：
文献类型：
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作者：
Yanagihara, Yasutake;Villanueva, Sharon Y. A. M.;Masuzawa, Toshiyuki
钩端螺旋体病是一种急性发热性疾病，具有多种临床表现，在世界各地都有发生，特别是在降雨量高的热带地区。本文回顾了日本和菲律宾两个亚洲国家的钩端螺旋体病现状，这两个国家在经济、环境、基础设施和流行传染病等方面存在较大差异。在日本，直到 1960 年，每年报告有 200 多人死于钩端螺旋体病。 1960年后，报告病例数迅速减少。现在，每年报告的钩端螺旋体病病例不足20例。20世纪60年代初以后，农业开始现代化，同时人类使用了钩端螺旋体灭活疫苗，自来水厂和污水处理系统等基础设施维护良好。另一方面，在菲律宾，钩端螺旋体病患者往往经常出现在城市环境中的洪水易发地区，例如马尼拉大都会，该地区被发现是钩端螺旋体病的流行病灶。农村地区（卡巴端、伊洛伊洛）的发病率为每 10 万人口 147 例。 1998年至2001年，菲律宾1200名疑似钩端螺旋体病患者中约70%血清学呈阳性。患者平均年龄为32岁，其中87%为男性，70%为户外工作者。病死率为 12-14%。马尼拉大都会和邻近省份估计的主要血清型是马尼拉、洛斯巴诺斯、塔拉索维、波伊和未知血清型。菲律宾钩端螺旋体病的爆发被认为与强降雨、快速城市化（人口急剧增加）、森林砍伐、洪水易发地区数量增加、基础设施落后等因素有关。 (C) 2007 年，爱思唯尔有限公司出版。
Leptospirosis is an acute febrile illness with a wide variety of clinical manifestations and is encountered throughout the world, prominently in tropical areas with high rainfall. In this paper, we review the current status of leptospirosis in two Asian countries, Japan and Philippines, which have quite different situations in terms of economy, environment, infrastructures and prevailing infectious diseases. In Japan, until 1960, more than 200 deaths due to leptospirosis had been reported yearly. After 1960, the number of reported cases had rapidly decreased. Now, leptospirosis cases notified every year were less than 20. After the early 1960s, modernization of agriculture was introduced, at the same time, inactivated vaccine against Leptospira was applied for humans and there was good maintenance of infrastructures such as water works and sewage systems. In Philippines, on the other hand, leptospirosis patients tend to be frequently found in flood-prone areas of urban setting such as Metro Manila, which was found to be the endemic foci of leptospirosis. Morbidity in a rural area (Cabatuan, Iloilo) was 147 cases per 100,000 populations. From 1998 to 2001, about 70% of 1200 suspected leptospirosis patients in Philippines were serologically positive. The average age of patients was 32 years old where 87% of the cases were males and 70% were outdoor workers. Case fatality rate was found to be 12-14%. The estimated major serovars in Metro Manila and neighboring provinces were Manilae, Losbanos, Tarassovi, Poi and an unknown serovar. Outbreaks of leptospirosis in the Philippines are thought to be associated with heavy rainfall, rapid urbanization (dramatic increase in populations), deforestation, increasing number of flood-prone areas, poor infrastructures and many others. (C) 2007 Published by Elsevier Ltd.