Vanasco N B, Fusco S, Zanuttini J C, Manattini S, Dalla Fontana M L, Prez J, Cerrano D, Sequeira M D
Instituto Nacional de Enfermedades Respiratorias E. Coni, ANLIS Dr. Carlos G. Malbrán, Argentina.
Rev Argent Microbiol. 2002 Jul-Sep;34(3):124-31.
Since April of 1998 a high number of leptospirosis cases were detected, coming from the area of Reconquista Central Hospital in Santa Fe province. Since January of that year a notable increase in rainfall and river levels was observed causing inundation. As screening test, macroscopic agglutination (MAT) using 10 serotypes of L. interrogans. Among the 122 patients studied 71 were TR positive and 52 were also ELISA positive, leptospirosis diagnosis being confirmed in 40 of them. Five infecting serogroups were identified: Icterohaemorrhagiae (7/40), Ballum (5/40), Sejroe (3/40), Pomona (3/40) and Canicola (2/40). In the remaining cases (20/40), co-agglutinins were found at the same titer against two or more serotypes of leptospires. Infection prevalence was higher in men and productive age (21 to 40 years). The clinical symptoms more frequently observed were headache, fever and myalgias. All cases occurred after the rains and in the period when the area was flooded. Their clinical presentation, time distribution, geographical localization and high frequency of contact with the risk factor inundation could indicate that, independently of search activities, there was an outbreak.
自1998年4月以来,在圣菲省雷孔基斯塔中心医院所在地区发现了大量钩端螺旋体病病例。自当年1月起,降雨量和河流水位显著增加,引发了洪水。作为筛查试验,采用10种问号钩端螺旋体血清型进行宏观凝集试验(MAT)。在研究的122例患者中,71例MAT阳性,52例酶联免疫吸附测定(ELISA)也呈阳性,其中40例确诊为钩端螺旋体病。鉴定出5个感染血清群:出血性黄疸型(7/40)、拜伦型(5/40)、赛罗型(3/40)、波摩那型(3/40)和犬型(2/40)。在其余病例(20/40)中,发现对两种或更多种钩端螺旋体血清型的协同凝集素效价相同。男性和生产年龄(21至40岁)的感染患病率较高。最常观察到的临床症状是头痛、发热和肌痛。所有病例均发生在降雨后以及该地区被洪水淹没的时期。它们的临床表现、时间分布、地理定位以及与危险因素洪水接触的高频率可能表明,无论搜索活动如何,都存在一次疫情爆发。