Sohan Lal, Shyamal Biswas, Kumar Titti Shiv, Malini M, Ravi Kumnar, Venkatesh V, Veena Mittal, Lal Shiv
National Institute of Communicable Diseases, Plague Surveillance Unit, Bangalore.
J Commun Dis. 2008 Jun;40(2):127-32.
An outbreak of leptospirosis in Peddamandem Mandal, Chittoor district, Andhra Pradesh occurred during Aug to Oct 2005. Out of 86 single human sera samples of suspected cases collected during the investigation, 49 (56.97%) samples from seven villages were found positive for leptospirosis both by DGM tests and IgM antibodies. Out of total 49 positive cases 16 (47.05%) were male and 33 (69.46%) female patients. The mean age of the positive cases were 42.7 years. There was no significant differences in male and female ratio and age groups in affected population. The higher degree of seropositivity was observed in adult females as they were mainly engaged in both domestic and peridomestic works. Geographical clustering of cases was evident. All the 49 positive cases had fever (100%). Myalgia (42.9%), stiffness of calf muscles (55.1%) and headache (32.6%) were the other major clinical features observed. There was only 1 (2.04%) case with conjunctival suffusion. None of the case presented with jaundice. All the suspected cases were tested negative for malaria, typhoid and dengue fever. In Peddamandem, contaminated water stagnation due to heavy rainfall and frequent contact of barefooted villagers with the infected sources registered higher incidence of leptospirosis. Most of the cases were from the contaminated water logged areas of the affected villages. In the affected villages none of the individual occupational category showed a significant association with seropositivity. It indicated that the transmission was from the common single category source in the villages i.e. contaminated stagnant water. The villagers living with livestocks and rodents were significantly associated with seropositivity.
2005年8月至10月期间,印度安得拉邦奇图尔县佩达曼丹德乡爆发了钩端螺旋体病疫情。在调查期间收集的86份疑似病例的单人血清样本中,来自7个村庄的49份样本(56.97%)经暗视野显微镜检查(DGM)和IgM抗体检测,钩端螺旋体病呈阳性。在49例阳性病例中,男性患者16例(47.05%),女性患者33例(69.46%)。阳性病例的平均年龄为42.7岁。受影响人群的男女比例和年龄组之间没有显著差异。成年女性的血清阳性率较高,因为她们主要从事家务和居家周边工作。病例的地理聚集现象明显。49例阳性病例均有发热(100%)。其他主要临床特征包括肌痛(42.9%)、小腿肌肉僵硬(55.1%)和头痛(32.6%)。只有1例(2.04%)出现结膜充血。无一例出现黄疸。所有疑似病例的疟疾、伤寒和登革热检测均为阴性。在佩达曼丹德,暴雨导致污水滞留,且赤脚村民经常接触感染源,导致钩端螺旋体病发病率较高。大多数病例来自受影响村庄的污水积水区。在受影响村庄,没有任何个体职业类别与血清阳性呈显著关联。这表明传播源自村庄中常见的单一类别源头,即受污染的积水。与家畜和啮齿动物生活在一起的村民与血清阳性显著相关。