Ciceroni L, Stepan E, Pinto A, Pizzocaro P, Dettori G, Franzin L, Lupidi R, Mansueto S, Manera A, Ioli A, Marcuccio L, Grillo R, Ciarrocchi S, Cinco M
National Centre for Leptospirosis, Department of Bacteriology and Medical Mycology, Istituto Superiore di Sanità, Rome, Italy.
Eur J Epidemiol. 2000 Jan;16(1):79-86. doi: 10.1023/a:1007658607963.
In the three-year period 1994 1996, 222 reports on human cases of leptospirosis were received by the Italian Ministry of Health. The average annual number of reports was 29.2% lower than in the preceding eight years. In all cases but two the infections were thought to have been acquired in Italy. As in previous years, the majority of cases was observed in the northern regions of the country (83.8%), mostly in males (88.9%). Cases occurred in all age groups, but were more common in the working-age population (15-64 years). There was no common-source outbreaks. The typical leptospiral seasonal course, with a peak in August, was observed. During 1994, leptospirosis was the reported cause of death in 19 patients. Mortality was higher among males than females. The overall fatality rate was 22.6%. During the study period, a total of 126 cases of leptospirosis were confirmed by the National Centre for Leptospirosis or one of the 12 Regional Leptospira Laboratories. Of the 103 patients for whom information on place of residence, contact with animals, occupational and recreational activities was available, 98 (95.1%) were people who live in rural areas or devote themselves to occupational or recreational activities at risk. The likely source of infection and the mode of exposure were known for 55 patients. Forty-five patients (81.8%) were likely infected by contaminating water (43 cases) or soil (2 cases), ten (18.2%) by direct contact with animals or animal urine. Both running (51.2%) and stagnant water (27.9%) have been reported as a source of infection. Rodents were implicated in 50.0% of the 10 cases involving animals. In comparison with the preceding eight-year period, the risk of contracting leptospirosis was found to have increased for recreational activities (from 34.7 to 38.2%) and decreased for occupational activities (from 45.8 to 32.7%). A large number of infections, however, was ascribed to accidental events (25.5%). As in the previous period, besides fever, the involvement of the liver was the most frequent clinical manifestation (70.8%). Influenza-like symptoms were the only signs of illness in 15.1% of cases. Infections by 9 different serogroups were detected. The most frequent antibodies were those against serovars icterohaemorrhagiae, poi, copenhageni and brattislava. The presence of co-agglutinins against serovars belonging to different serogroups prevented the identification of the presumptive infecting serogroup in 19.8% of subjects.
在1994年至1996年的三年期间，意大利卫生部共收到222例人类钩端螺旋体病病例报告。报告的年均数量比前八年低29.2%。除两例之外，所有病例的感染都被认为是在意大利感染的。与往年一样，大多数病例出现在该国北部地区（83.8%），主要为男性（88.9%）。各年龄组均有病例发生，但在工作年龄人群（15 - 64岁）中更为常见。未出现共同来源的疫情暴发。观察到典型的钩端螺旋体季节性发病过程，8月达到高峰。1994年，有19例患者的死亡原因被报告为钩端螺旋体病。男性死亡率高于女性。总病死率为22.6%。在研究期间，国家钩端螺旋体病中心或12个地区钩端螺旋体实验室之一共确诊了126例钩端螺旋体病病例。在103例有居住地点、与动物接触情况、职业和娱乐活动信息的患者中，98例（95.1%）是居住在农村地区或从事有风险的职业或娱乐活动的人。55例患者的感染可能来源和暴露方式已知。45例患者（81.8%）可能因受污染的水（43例）或土壤（2例）感染，10例（18.2%）通过直接接触动物或动物尿液感染。流动水（51.2%）和积水（27.9%）均被报告为感染源。在涉及动物的10例病例中，50.0%与啮齿动物有关。与前八年相比，发现娱乐活动感染钩端螺旋体病的风险有所增加（从34.7%增至38.2%），职业活动感染风险有所降低（从45.8%降至32.7%）。然而，大量感染归因于意外事件（25.5%）。与上一时期一样，除发热外，肝脏受累是最常见的临床表现（70.8%）。15.1%的病例中，类似流感的症状是唯一的疾病体征。检测到9种不同血清群的感染。最常见的抗体是针对黄疸出血型、波摩那型、哥本哈根型和布拉迪斯拉发型血清型的抗体。在19.8%的受试者中，针对不同血清群血清型的协同凝集素的存在妨碍了推定感染血清群的鉴定。
