Journal
AMERICAN JOURNAL OF TROPICAL MEDICINE AND HYGIENE
Volume 85, Issue 3, Pages 471-478Publisher
AMER SOC TROP MED & HYGIENE
DOI: 10.4269/ajtmh.2011.11-0276
Keywords
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Funding
- epidemiology unit
- World Health Organization through the epidemiology unit of Sri Lanka
- Welcome Trust through Oxford-Mahidol Medicine Research Unit, Bangkok, Thailand
- U.S. Public Health Service [K24AI068903, D43TW007120]
- University of California San Diego School of Medicine
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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.
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