A Comparative Study of the Epidemiology of Human Leptospirosis in Korea and Japan between 2006 and 2012

Clinical characteristics and prognosis of patient with leptospirosis: A multicenter retrospective analysis in south of China

Purpose

Leptospirosis is a zoonotic disease caused by pathogenic spirochetes of the genus Leptospira. However, there is currently no consensual definition or diagnostic criteria for severe and different forms of leptospirosis. Therefore, more insight on clinical manifestations, risk factors, and outcomes of leptospirosis is warranted. The identification of leptospirosis with distinct clinical manifestations and prognosis in our population.

Methods

Multiple correspondence analysis and hierarchical classification on principal components were presented to identify different clinical types of leptospirosis. The outcomes were clinical phenotypes, laboratory and imaging findings, and prognosis.

Results

The 95 enrolled patients had median values of 54.0 years (39.0-65.0) for age, 9.0 (7.0-14.0) for total hospital stay lengths, of whom 86.3% was male and 40.0% was transferred to ICU. Three clinical types were distinguished: mild leptospirosis (n=43, 45.3%) with less organ dysfunction and shorter hospital stays; respiratory leptospirosis (n=28, 29.5%) with hemoptysis, and respiratory and circulatory failure; and hepato-renal leptospirosis (n=24, 25.3%) with worst liver and kidney dysfunction. Total hospital mortality was 15.8% and was associated with dyspnea and high levels of neutrophil counts.

Conclusions

The identification of leptospirosis with distinct clinical manifestations and prognosis in our population may assist clinicians to distinguish leptospirosis-like disease. Moreover, dyspnea and neutrophil count were found to be independent risk factors for severe leptospirosis progression.

Seroprevalence of Leptospirosis among High-Risk Individuals in Morocco

Background

Leptospirosis is an anthropozoonotic reemerging neglected infectious disease underreported in most developing countries. A cross-sectional study was performed between 17 and 23 February 2014 to estimate the seroprevalence of leptospirosis among high-risk populations in Casablanca (Morocco).

Methods

A total of 490 human serum samples (97.6% males) were collected in 3 high-risk occupational sites including the biggest meat slaughterhouse (n = 208), a poultry market (n = 121), and the fish market (n = 161). A total of 125 human blood samples were also collected from the general population and used in this study as a control group. To detect the presence of anti-Leptospira, sera were screened with in-house IgG and IgM enzyme-linked immunosorbent assay (ELISA). Positive samples were tested by Microscopic Agglutination Technique (MAT) using a panel of 24 serovar cultures and cut point of 1 : 25.

Results

Seroprevalence of leptospirosis among the control group was 10.4% (13/125). A high seropositivity among the overall seroprevalence of 24.1% (118/490) was observed in the high-risk groups of which 7.3% (36/490), 13.7% (67/490), and 3.1% (15/490) were for anti-Leptospira IgM, IgG, and both IgG and IgM antibodies, respectively. Most of the positive individuals were occupationally involved in poultry (37.2%), followed by the market fish (26.1%) and the meat slaughterhouse (14.9%) workers. Among all ELISA-positive serum samples, 20.3% (n = 24) had positive MAT responses, of which the Icterohaemorrhagiae (n = 7) is the most common infecting serogroup followed by Javanica (4), Australis (2), and Sejroe, Mini, and Panama (one in each). In the remaining 8 MAT-positive sera, MAT showed equal titers against more than one serogroup.

Conclusion

Individuals engaged in risk activities are often exposed to leptospiral infection. Therefore, control and prevention policies toward these populations are necessary.

Leptospirosis trends in China, 2007-2018: A retrospective observational study

Leptospirosis is one of the most common and neglected tropical waterborne diseases in China, causing serious economic losses, and constituting a significant public health threat. Leptospirosis has recently received increased attention and is considered a re-emerging infectious disease in many countries. The incidence of leptospirosis among people suggests that occupation, age, season, sex and water recreational activities are significant risk factors. The aim of this study was to describe the epidemiological profiles of leptospirosis in China during the 2007-2018 period. The morbidity data of leptospirosis by age, season (month), gender, occupation and geographic location (different provinces) were obtained from the public health science data centre of China for subsequent epidemiological analysis. The results indicate that the incidence of leptospirosis has shown a slow downward trend from 2007 to 2018, but morbidity rates were still relatively high (0.0660-0.0113). The incidence of leptospirosis varied in different provinces of China; cases localized mainly to the Southern and Central provinces, areas with warm weather and ample rainfall. Older people (aged 60-75), males, farmers, students and field workers were high-risk populations. During the 2007-2018 observation period, morbidity rates increased beginning in May, remained at high levels in August and September and decreased after November. The present investigation highlights the re-emergence of leptospirosis in some provinces of China (especially in Yunnan and Fujian) and shows that leptospirosis remains a serious public health threat. The results of this study should enhance measures taken for the prevention, control, and surveillance of leptospirosis in China.

Severe leptospirosis in a patient with positive serological test for spotted fever rickettsiosis

Here, we report a case of a 64-year-old man with severe leptospirosis infected in an area in Japan that is non-endemic to leptospirosis. Initially, findings of high-grade fever, mild generalised arthralgia, rashes on the trunk, mild thrombocytopenia, elevated liver enzymes and renal dysfunction led to the suspicion of rickettsiosis, which was an endemic infectious disease in the area. Subsequently, leptospirosis was also considered after carefully reviewing patient history, which revealed that he may have been exposed to mice urine. Finally, leptospirosis was diagnosed after the serum indicated a positive PCR for leptospirosis. Furthermore, due to serum antibody positivity for Rickettsia japonica, false-positivity or coinfection of spotted fever rickettsiosis was suspected. Despite the delayed diagnosis, the patient recovered with antibiotic treatment. Thus, to prevent diagnostic errors, leptospirosis should be potentially considered with high suspicion in patients with acute undifferentiated fever, even in non-endemic areas of leptospirosis.