The Center for Geographic Medicine, Chaim Sheba Medical Center, Tel Hashomer, Israel.
Am J Trop Med Hyg. 2010 Mar;82(3):459-63. doi: 10.4269/ajtmh.2010.09-0239.
Leptospirosis is re-emerging in developed countries as a travel-related infection. In this nationwide study of travel-related leptospirosis in Israel, all cases diagnosed at the Central Reference Laboratory for Leptospirosis, during 2002-2008 were retrospectively reviewed and only travel-related cases were included. During the study years, 20 (42%) of 48 leptospirosis cases in Israel were travel-related. Exposure occurred in Southeast Asia in 15 (75%) of 20 cases. The estimated yearly incidence of travel-related leptospirosis was 1.78/100,000 travelers compared with an incidence of endemic cases of 0.06/100,000 inhabitants (risk ratio = 29.6, 95% confidence interval = 16.7-52.4). Most patients (89%) were infected during water-related activities. Severe disease was present in 10 (55%) of 18 patients; 7 of them were presumptively infected with the Icterohaemorrhagiae serogroup. Thus, travel-related leptospirosis is becoming increasingly important in the epidemiology of leptospirosis in Israel. Leptospirosis should be suspected in any traveler with undifferentiated febrile illness, especially when water exposure is reported.
钩端螺旋体病作为一种与旅行相关的感染，在发达国家再次出现。在这项对以色列与旅行相关的钩端螺旋体病的全国性研究中，回顾性分析了 2002-2008 年期间中央钩端螺旋体病参考实验室诊断的所有病例，仅纳入与旅行相关的病例。在研究期间，以色列的 48 例钩端螺旋体病中有 20 例（42%）与旅行有关。15 例（75%）暴露于东南亚。与地方性病例的 0.06/100,000 居民发病率（风险比=29.6，95%置信区间=16.7-52.4）相比，与旅行相关的钩端螺旋体病的估计年发病率为 1.78/100,000 旅行者。大多数患者（89%）在与水有关的活动中感染。18 例患者中有 10 例（55%）出现严重疾病；其中 7 例被推定感染黄疸出血群。因此，与旅行相关的钩端螺旋体病在以色列的钩端螺旋体病流行病学中变得越来越重要。对于任何出现不明原因发热的旅行者，尤其是报告有水源暴露的旅行者，应怀疑钩端螺旋体病。
