Vieira Maria Luisa, Gama-Simões Maria Jacinta, Collares-Pereira Margarida
Unidade de Leptospirose e Borreliose de Lyme, Instituto de Higiene e Medicina Tropical, Universidade Nova de Lisboa, Lisboa, Portugal.
Int J Infect Dis. 2006 Sep;10(5):378-86. doi: 10.1016/j.ijid.2005.07.006.
Leptospirosis, an under-recognized public health problem, needs to be confirmed through specific laboratory diagnosis.
We describe herein a series of 4618 symptomatic patients for whom a microagglutination test (MAT) serology was available, representing a unique picture of human leptospirosis in central mainland Portugal and the Azores islands of São Miguel and Terceira, over eighteen- and twelve-year periods, respectively.
The distribution of the 1024 (22%) cases identified was an average 57 cases per year, with higher frequency in males (67%). These represent the majority of leptospirosis notifications in Portugal, with a higher annual incidence rate in the islands, compared to the central mainland (11.1 and 1.7/100,000 population, respectively). Middle-aged adults (25-54 years) were most frequently infected (45%). Cases occurred mainly in December and January. Serovars from nine presumptive serogroups caused infection, with a predominance of Icterohaemorrhagiae, Pomona, and Ballum, accounting for 66% of cases.
Seropositivity was associated with both anicteric and icteric leptospirosis. Several risk factors and a higher transmission risk in certain areas were emphasized. Leptospirosis was confirmed as a steadily increasing public health problem; good surveillance, communication, and laboratory support are thus necessary to reduce the impact of leptospirosis in areas at risk.
钩端螺旋体病是一个未得到充分认识的公共卫生问题，需要通过特定的实验室诊断来确诊。
我们在此描述了一系列4618例有症状患者，他们均进行了显微凝集试验（MAT）血清学检测，分别呈现了葡萄牙大陆中部以及亚速尔群岛圣米格尔岛和特塞拉岛在18年和12年期间人类钩端螺旋体病的独特情况。
确诊的1024例（22%）病例平均每年57例，男性发病率更高（67%）。这些病例占葡萄牙钩端螺旋体病通报病例的大部分，与大陆中部相比，岛屿地区的年发病率更高（分别为每10万人11.1例和1.7例）。中年成年人（25 - 54岁）感染最为频繁（45%）。病例主要发生在12月和1月。来自9个假定血清群的血清型导致了感染，其中出血性黄疸型、波摩那型和巴伦型占主导，占病例的66%。
血清阳性与无黄疸型和黄疸型钩端螺旋体病均有关。强调了几个危险因素以及某些地区更高的传播风险。钩端螺旋体病被确认为一个持续增加的公共卫生问题；因此，需要良好的监测、沟通和实验室支持，以减少钩端螺旋体病对高危地区的影响。
