Leptospirosis-associated hospitalizations, United States, 1998-2009 (original) (raw)
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F1000Research, 2020
Background: In Sri Lanka, the disease burden of leptospirosis is estimated based on a routine notification system, which is predominated by patients ill enough to be hospitalized. The notification system does not function well with ambulatory patients in outpatient departments (OPDs). The objective of this study was to determine the prevalence of leptospirosis in an OPD setting in a regional public hospital in Sri Lanka to provide further estimation of disease burden estimations Methods: This study was conducted in the OPD of the Rathnapura Provincial General Hospital from August to September 2017. Suspected leptospirosis patients were recruited based on standardized criteria and tested using the microscopic agglutination test and quantitative polymerase chain reaction. The number of OPD patients was compared with the reported patient numbers with leptospirosis from the hospital during the same period as the denominator, and the 95% confidence interval was calculated for the proportions using Poisson distribution. Results: During the study period, of 2,960 fever patients presenting to the OPD, 33 (1.1%) were suspected to have leptospirosis; 8/33 suspected (22.3%) cases were confirmed as being due to leptospirosis. There were 82 notifications of leptospirosis cases from hospital inpatients during the same period, none from the OPD. The total missing proportion from the surveillance system was 28.6% (95% CI,
PLoS ONE, 2013
Background: Leptospirosis is a global zoonotic disease. Although important for the assessment of the burden of leptospirosis, data on the duration of the illness and the occurrence of post-leptospirosis complaints are not well documented. Hence the main objective of this study was to estimate the occurrence of persistent complaints and duration of hospital stay in laboratory confirmed leptospirosis patients in the Netherlands during 1985 to 2010. Additionally, several risk factors potentially impacting on the occurrence of post-leptospirosis complaints were investigated.
F1000Research, 2020
Background: In Sri Lanka, the disease burden of leptospirosis is estimated based on a routine notification system, which is predominated by patients ill enough to be hospitalized. The notification system does not function well with ambulatory patients in outpatient departments (OPDs). The objective of this study was to determine the prevalence of leptospirosis in an OPD setting in a regional public hospital in Sri Lanka to provide further estimation of disease burden estimations Methods: This study was conducted in the OPD of the Rathnapura Provincial General Hospital from August to September 2017. Suspected leptospirosis patients were recruited based on standardized criteria and tested using the microscopic agglutination test and quantitative polymerase chain reaction. The number of OPD patients was compared with the reported patient numbers with leptospirosis from the hospital during the same period as the denominator, and the 95% confidence interval was calculated for the proport...
Family Medicine & Primary Care Review, 2020
A-Study Design, B-Data Collection, C-Statistical Analysis, D-Data Interpretation, E-Manuscript Preparation, F-literature Search, G-Funds Collection Background. Typically, doctors consider a diagnosis of probable leptospirosis when there is a history of fever with kidney or liver involvement and an elevated serum creatine phosphokinase level. However, there are increasing numbers of cases with atypical presentation, which renders the diagnosis challenging. Objectives. The aim of this study is to determine the presentation patterns of leptospirosis during an outbreak, in order to increase the understanding of this potentially complex disease. Material and methods. This is a retrospective, observational study of an outbreak that occurred in an army camp in 2012. The data were collected by retrieving the patients' medical records, including signs and symptoms, laboratory findings, and outcomes. Results. There were 47 cases of leptospirosis confirmed by a microscopic agglutination test (MAT). Of these, only 50% had a positive point-of-care serology test result at initial encounter in the emergency department. The majority (58%) presented with mild upper respiratory tract and gastrointestinal symptoms and 64% had no fever on presentation. Only five patients had leukocytosis (12%); 86% were within the normal range. Half of the patients (50%) had a normal platelet count and 60% had normal renal function. However, 74% had a creatine phosphokinase level over 200. Conclusions. Leptospirosis is difficult to diagnose due to its ambiguous clinical presentation. Most of the laboratory findings can be unhelpful in excluding the diagnosis. The point-of-care serology test done in the primary setting should not be relied on in highly suspicious cases. In a cluster where leptospirosis is endemic, the MAT might be warranted; otherwise, empirical antibiotics may be considered, even for mild symptoms.
Leptospirosis: A Neglected Zoonosis of Public Health Concern
Leptospirosis is an important emerging and re-emerging zoonotic disease that is spread worldwide by pathogenic species of the bacterium genus Leptospira. The disease is commonly reported especially in tropical and subtropical areas. Leptospirosis is a neglected tropical zoonotic disease that is rapidly becoming a major public health issue around the world. Leptospirosis has emerged as a prominent cause of acute febrile disease in many developing nations due to neglect, rapid, unplanned urbanization, and poor sanitation. Although it has been stated that leptospirosis is the most frequent zoonotic illness, it is thought to be underreported due to the non-specificity of clinical symptoms and the lack of laboratory confirmation in endemic areas. A wide range of clinical manifestations, ranging from asymptomatic infection to fulminant, deadly disease, is characteristic of the disease. Laboratory help is needed to confirm an unequivocal diagnosis of leptospirosis. Antibacterial antibiotics are used to treat the acute illness in the patient. This mini review includes all current information on leptospirosis, including its etiology, transmission, clinical symptoms, diagnosis, treatment, and preventative measures.
Family Medicine & Primary Care Review, 2020
Background. Typically, doctors consider a diagnosis of probable leptospirosis when there is a history of fever with kidney or liver involvement and an elevated serum creatine phosphokinase level. However, there are increasing numbers of cases with atypical presentation, which renders the diagnosis challenging. Objectives. The aim of this study is to determine the presentation patterns of leptospirosis during an outbreak, in order to increase the understanding of this potentially complex disease. Material and methods. This is a retrospective, observational study of an outbreak that occurred in an army camp in 2012. The data were collected by retrieving the patients’ medical records, including signs and symptoms, laboratory findings, and outcomes. Results. There were 47 cases of leptospirosis confirmed by a microscopic agglutination test (MAT). Of these, only 50% had a positive point-of-care serology test result at initial encounter in the emergency department. The majority (58%) pres...
A Step Toward Controlling the Havoc of Leptospirosis: Comprehensive and Combined Efforts
2013
Introduction: Leptospirosis is a globally important bacterial zoonotic disease occurring in rural areas of South Gujarat. Primary prevention of Leptospirosis is very difficult. This study was planned for early detection and timely referral of cases; increase awareness in high risk population regarding primary prevention and early treatment seeking; and establish and strengthen case suspicion and referral network in the community itself. Methodology: This intervention study was conducted in villages of Surat district with main focus on early recognition of symptoms of Leptospirosis and timely health care seeking. Multipronged approach including meeting with villages, local leader and local health functionaries were used as an intervention. Results: Mass campaign resulted in early health seeking behavior for suspected symptoms which is evident from gross increase in case reporting compare to previous year. These cases were reported early in their clinical course and timely treatment r...
A Systematic Review of the Mortality from Untreated Leptospirosis
PLoS neglected tropical diseases, 2015
Leptospirosis occurs worldwide, but the global incidence of human disease and its mortality are not well understood. Many patients are undiagnosed and untreated due to its non-specific symptoms and a lack of access to diagnostics. This study systematically reviews the literature to clarify the mortality from untreated leptospirosis. Results will help quantify the global burden of disease and guide health policies. A comprehensive literature search was performed to identify untreated patient series. Included patients were symptomatic, but asymptomatic patients and those who had received antibiotics, dialysis or who were treated on Intensive Care Units were excluded. Included patients had a confirmed laboratory diagnosis by culture, PCR, or serological tests. Data was extracted and individual patient series were assessed for bias. Thirty-five studies, comprising 41 patient series and 3,390 patients, were included in the study. A high degree of bias within studies was shown due to limi...
PLOS Neglected Tropical Diseases
Background In Ecuador, leptospirosis surveillance involves a mandatory notification of all cases and a hospitalization for severe illness. Morbidity and mortality are, nevertheless, underestimated and contribute directly to the status of leptospirosis as a neglected disease. Leptospira spp. is zoonotic in Ecuador with established endemic transmission in the Tropics. Here, we review retrospective national data within the country to aid in control strategies. Methodology/Principal findings In a population-based nationwide study, we analysed morbidity, mortality, and spatial distribution on confirmed hospital-discharged leptospirosis cases from 2000–2020 from a publicly accesible National Database, including males and females of all ages. We computed data for the 24 provinces across the four-geoclimatic regions of Ecuador based on seasonal and monthly variations and calculated rates according to age and sex. The spatial distribution was estimated at the level of ecoregions, provinces, ...