Leptospirosis in Hawaii, 1974-1998: Epidemiologic analysis of 353 laboratory-confirmed cases

Department of Public Health Sciences and Epidemiology, John A. Burns School of Medicine, University of Hawaii, Honolulu 96822, USA.
The American journal of tropical medicine and hygiene (Impact Factor: 2.74). 02/2002; 66(1):61-70.
Source: PubMed

ABSTRACT The epidemiologic characterization of leptospirosis in the United States has been limited by difficulties associated with both case detection and confirmation. In addition, leptospirosis was eliminated from the list of National Notifiable Diseases in 1995. From 1974 until the cessation of national surveillance, Hawaii consistently had the highest reported annual incidence rate in the United States. From 1974 through 1998, 752 leptospirosis cases were reported in the State of Hawaii. Of these, 353 had exposures within the state and were laboratory confirmed. The mean annual incidence rate was 1.29 per 100,000. Cases were predominately male. Rates were highest in rural areas. Occupational exposures diminished over time while recreational exposures increased. This series represents the first large U.S. leptospirosis surveillance report since 1979. With leptospirosis recently being identified as a re-emerging zoonosis, continued national surveillance and case reporting should be reconsidered.

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    • "Leptospirosis is considered the most common zoonosis worldwide and is endemic in tropical environments (Katz et al., 2002). It has recently been classified as a re-emerging disease, largely because of increased recognition and recent rediscovery that it can present as a severe hemorrhagic illness, easily confused with some viral hemorrhagic fever (Monsuez et al., 1997). "
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    • "This disease is common in farmers and veterinarians, but can also be transmitted through contaminated water in flooded areas. In particular, leptospirosis is one of the most important infectious diseases contracted in waterlogging areas and rice paddies (Katz et al., 2002; Kariv et al., 2001; Kupek et al., 2000). Leptospira is divided into Leptospira interrogans and Leptospira biflexa. "
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    ABSTRACT: To determine the existence of genus-specific antigens in outer membrane proteins (OMPs) of leptospira with different virulence. Microscope agglutination test (MAT) was applied to detect the agglutination between commercial rabbit antiserum against leptospiral genus-specific TR/Patoc I antigen and 17 strains of Leptospira interrongans belonging to 15 serogroups and 2 strains of Leptospira biflexa belonging to 2 serogroups. The outer envelopes (OEs) of L.interrogans serogroup Icterohaemorrhagiae serovar lai strain lai (56601) with strong virulence and serogroup Pomona serovar pomona strain Luo (56608) with low virulence, and L.biflexa serogroup Semaranga serovar patoc strain Patoc I without virulence were prepared by using the method reported in Auran et al.(1972). OMPs in the OEs were obtained by treatment with sodium deoxycholate. SDS-PAGE and western blot were used for analyzing the features of the OMPs on electrophoretic pattern and the immunoreactivity to the antiserum against TR/Patoc I antigen, respectively. All the tested strains belonging to different leptospiral serogroups agglutinated to the antiserum against leptospiral genus-specific TR/Patoc I antigen with agglutination titers ranging from 1:256-1:512. A similar SDS-PAGE pattern of the OMPs from the three strains of leptospira with different virulence was shown and the molecular weight of a major protein fragment in the OMPs was found to be approximately 60 KDa. A positive protein fragment with approximately 32 KDa confirmed by Western blot, was able to react with the antiserum against leptospiral genus-specific TR/Patoc I antigen, and was found in each the OMPs of the three stains of leptospira. There are genus-specific antigens on the surface of L.interrogans and L.biflexa. The OMP with molecular weight of 32 KDa may be one of the genus-specific protein antigens of leptospira.
    Journal of Zhejiang University SCIENCE 05/2004; 5(4):462-6.
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    ABSTRACT: In Guilan province, near the end of spring and summer each year at the time of rice gathering, some of the farmers run high fevers. This disease is named as "Shaltook Fever" (Paddy or Husked rice fever) in the region. Review of literature showed outbreak of leptospirosis between rice farmers in Italy and Spain. We decided to measure antibody levels (IgM and IgG) against leptospirosis in patients with Shaltook fever. Samples were chosen from any patient who was diagnosed as Shaltook fever by health care clinics between end of spring and summer of 2002 in Guilan province. Patients should have fever above 38° C, with myalgia and history of recent work at rice fields. All other diagnosis for these patients should have been ruled out by clinical or laboratory investigations. Antibodies levels were measured by ELISA method. IgM was measured in 87 out of 100 serum samples and IgG was measured in 84 out of 87 of above serum samples. In 26 samples IgM anti Leptospira were positive (IgM > 20 u/ml), and 5 specimens were borderline (IgM = 15-20 u/ml). In measuring IgG, 10 samples were positive (IgG > 9 u/ml), and 13 samples were borderline (IgG = 5-9 u/ml). The above findings were suggestive of acute leptospirosis infection in 30% of Shaltook fever patients. It is of interest that in only 17 out of 26 positive samples for IgM positive IgG titers were observed. It could be concluded that these patients had, for the first time recently, encountered the disease. Acta Medica Iranica, 44(2): 131-134; 2006
    Acta medica Iranica 11/2005; 44(2).
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