Massenet Denis, Yvon Jean-François, Couteaux Clément, Goarant Cyrille
Agence de Santé des îles Wallis & Futuna, Laboratoire de biologie médicale/hôpital de SIA, BP 4G, 98 600 Mata'Utu, Wallis & Futuna.
Agence de Santé des îles Wallis & Futuna, Laboratoire de biologie médicale/hôpital de SIA, BP 4G, 98 600 Mata'Utu, Wallis & Futuna; Laboratoire de Ducos, BP 3931, 98846 Nouméa, New Caledonia.
PLoS One. 2015 Nov 3;10(11):e0142063. doi: 10.1371/journal.pone.0142063. eCollection 2015.
Futuna is a small Polynesian island in the South Pacific with a population of 3,612 in 2013. The first human leptospirosis case was confirmed in 1997. Active surveillance started in 2004. Cases were confirmed by PCR or real time PCR, or by serology using MAT or a combination of IgM-ELISA and MAT. A retrospective analysis of surveillance data shows that the disease was endemic with a mean annual incidence of 844 cases per 100,000 over an 11-year period from 2004 to 2014. An epidemic peak as high as 1,945 cases per 100,000 occurred in 2008. Serogroup Australis was predominant until 2007, Icterohaemorrhagiae was dominant afterwards. Cluster analysis revealed different hot spots over time. Lifestyle habits, such as walking barefoot in irrigated taro fields or pig pens probably contributed to contamination from the swine and rodent reservoirs to humans. Severe forms were rare, and the case fatality rate was 0.5%. The medical community and general population were aware of leptospirosis and rapid treatment with amoxycillin was the main treatment, probably contributing to this low fatality rate.
富图纳是南太平洋上一个小的波利尼西亚岛屿，2013年人口为3612人。1997年确诊了首例人类钩端螺旋体病病例。2004年开始进行主动监测。病例通过聚合酶链反应（PCR）或实时PCR确诊，或通过显微镜凝集试验（MAT）血清学检测，或采用IgM酶联免疫吸附测定（IgM-ELISA）和MAT联合检测确诊。对监测数据的回顾性分析表明，在2004年至2014年的11年期间，该病呈地方性流行，年平均发病率为每10万人844例。2008年出现了高达每10万人1945例的流行高峰。直到2007年，澳洲群血清型占主导地位，之后出血性黄疸型血清型占主导地位。聚类分析显示不同时期有不同的热点地区。生活习惯，如在灌溉的芋头田或猪圈里赤脚行走，可能导致了猪和啮齿动物宿主将病菌传播给人类。严重病例很少见，病死率为0.5%。医学界和普通民众都了解钩端螺旋体病，阿莫西林快速治疗是主要治疗方法，这可能是导致病死率较低的原因。
