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      Seasonality of Human Leptospirosis in Reunion Island (Indian Ocean) and Its Association with Meteorological Data

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          Abstract

          Background

          Leptospirosis is a disease which occurs worldwide but particularly affects tropical areas. Transmission of the disease is dependent on its excretion by reservoir animals and the presence of moist environment which allows the survival of the bacteria.

          Methods and Findings

          A retrospective study was undertaken to describe seasonal patterns of human leptospirosis cases reported by the Centre National de Références des Leptospiroses (CNRL, Pasteur Institute, Paris) between 1998 and 2008, to determine if there was an association between the occurrence of diagnosed cases and rainfall, temperature and global solar radiation (GSR). Meteorological data were recorded in the town of Saint-Benoît (Météo France “Beaufonds-Miria” station), located on the windward (East) coast. Time-series analysis was used to identify the variables that best described and predicted the occurrence of cases of leptospirosis on the island. Six hundred and thirteen cases were reported during the 11-year study period, and 359 cases (58.56%) were diagnosed between February and May. A significant correlation was identified between the number of cases in a given month and the associated cumulated rainfall as well as the mean monthly temperature recorded 2 months prior to diagnosis ( r = 0.28 and r = 0.23 respectively). The predictive model includes the number of cases of leptospirosis recorded 1 month prior to diagnosis ( b = 0.193), the cumulated monthly rainfall recorded 2 months prior to diagnosis ( b = 0.145), the average monthly temperature recorded 0 month prior to diagnosis ( b = 3.836), and the average monthly GSR recorded 0 month prior to diagnosis ( b = −1.293).

          Conclusions

          Leptospirosis has a seasonal distribution in Reunion Island. Meteorological data can be used to predict the occurrence of the disease and our statistical model can help to implement seasonal prevention measures.

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          Most cited references50

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          Leptospirosis in “Eco-Challenge” Athletes, Malaysian Borneo, 2000

          Adventure travel is becoming more popular, increasing the likelihood of contact with unusual pathogens. We investigated an outbreak of leptospirosis in “Eco-Challenge” multisport race athletes to determine illness etiology and implement public health measures. Of 304 athletes, we contacted 189 (62%) from the United States and 26 other countries. Eighty (42%) athletes met our case definition. Twenty-nine (36%) case-patients were hospitalized; none died. Logistic regression showed swimming in the Segama River (relative risk [RR]=2.0; 95% confidence interval [CI]=1.3 to 3.1) to be an independent risk factor. Twenty-six (68%) of 38 case-patients tested positive for leptospiral antibodies. Taking doxycycline before or during the race was protective (RR=0.4, 95% CI=0.2 to 1.2) for the 20 athletes who reported using it. Increased adventure travel may lead to more frequent exposure to leptospires, and preexposure chemoprophylaxis for leptospirosis (200 mg oral doxycycline/week) may decrease illness risk. Efforts are needed to inform adventure travel participants of unique infections such as leptospirosis.
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            Outbreak of leptospirosis among triathlon participants and community residents in Springfield, Illinois, 1998.

            We investigated an outbreak of leptospirosis among athletes and community residents after a triathlon was held in Springfield, Illinois. A telephone survey was conducted to collect clinical information and data on possible risk factors, community surveillance was established, and animal specimens and lake water samples were collected to determine the source of the leptospiral contamination. A total of 834 of 876 triathletes were contacted; 98 (12%) reported being ill. Serum samples obtained from 474 athletes were tested; 52 of these samples (11%) tested positive for leptospirosis. Fourteen (6%) of 248 symptomatic community residents tested positive for leptospirosis. Heavy rains that preceded the triathlon are likely to have increased leptospiral contamination of Lake Springfield. Among athletes, ingestion of 1 or more swallows of lake water was a predominant risk factor for illness. This is the largest outbreak of leptospirosis that has been reported in the United States. Health care providers and occupational and recreational users of bodies of freshwater in the United States should be aware of the risk of contracting leptospirosis, particularly after heavy rains.
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              Carriage of Leptospira interrogans among domestic rats from an urban setting highly endemic for leptospirosis in Brazil.

              A survey was conducted to identify reservoirs for urban leptospirosis in the city of Salvador, Brazil. Sampling protocols were performed in the vicinity of households of severe leptospirosis cases identified during active hospital-based surveillance. Among a total of 142 captured Rattus norvegicus (Norwegian brown rat), 80.3% had a positive culture isolate from urine or kidney specimens and 68.1% had a positive serum sample by microscopic agglutination test (MAT) titre of > or = 1:100. Monoclonal antibody-based typing of isolates identified that the agent carried by rats was Leptospira interrogans serovar Copenhageni, which was the same serovar isolated from patients during hospital-based surveillance. Leptospira spp. were not isolated from 8 captured Didelphis marsupialis (Opossum), while 5/7 had a positive MAT titre against a saprophytic serogroup. R. rattus were not captured during the survey. The study findings indicate that the brown rat is a major rodent reservoir for leptospirosis in this urban setting. Furthermore, the high carriage rates of L. interrogans serovar Copenhageni in captured rats suggest that there is a significant degree of environmental contamination with this agent in the household environment of high risk areas, which in turn is a cause of transmission during urban epidemics.
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                Author and article information

                Contributors
                Role: Editor
                Journal
                PLoS One
                plos
                plosone
                PLoS ONE
                Public Library of Science (San Francisco, USA )
                1932-6203
                2011
                31 May 2011
                : 6
                : 5
                : e20377
                Affiliations
                [1 ]Unité Mixte de Recherche Contrôle des Maladies Animales Exotiques et Emergentes (UMR CMAEE), Centre de Coopération Internationale en Recherche Agronomique pour le Développement (CIRAD), Sainte-Clotilde, La Réunion, France
                [2 ]Centre Régional de Recherche et de Veille sur les Maladies Emergentes de l'Océan Indien (CRVOI), Sainte-Clotilde, La Réunion, France
                [3 ]UMR Peuplement Végétaux et Bioagresseurs en Milieu Tropical (PVBMT), CIRAD, Saint-Pierre, La Réunion, France
                [4 ]Institut Pasteur, Centre National de Référence des Leptospiroses, Unité Postulante de Biologie des Spirochètes, Paris, France
                [5 ]Laboratoire de Bactériologie-Parasitologie-Virologie-Hygiène, Groupe Hospitalier Sud Réunion (GHSR), Centre Hospitalier de La Réunion (CHR), Saint-Pierre, La Réunion, France
                University of California Merced, United States of America
                Author notes

                Conceived and designed the experiments: AD. Performed the experiments: AD SJ. Analyzed the data: SJ. Contributed reagents/materials/analysis tools: FC PB. Wrote the paper: AD SJ AM. Provided data: AM PB. Helped in the epidemiological interpretation of data: AM EC. Helped with the statistical analysis: FC.

                Article
                11-PONE-RA-21771
                10.1371/journal.pone.0020377
                3105052
                21655257
                4a3ba77f-9586-414a-b221-c96979caff2c
                Desvars et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
                History
                : 25 January 2011
                : 30 April 2011
                Page count
                Pages: 10
                Categories
                Research Article
                Medicine
                Epidemiology
                Infectious Disease Epidemiology
                Infectious Diseases
                Bacterial Diseases
                Leptospirosis
                Infectious Disease Modeling

                Uncategorized
                Uncategorized

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