Department of General Pediatrics, Okinawa Prefectural Nanbu Medical Center & Children's Medical Center, Okinawa, Japan.
Department of Infectious Disease, Okinawa Prefectural Nanbu Medical Center & Children's Medical Center, Okinawa, Japan.
PLoS Negl Trop Dis. 2018 Mar 8;12(3):e0006294. doi: 10.1371/journal.pntd.0006294. eCollection 2018 Mar.
Leptospirosis is considered underdiagnosed because of its nonspecific presentation and lack of proper understanding of its epidemiology. Early diagnosis and treatment are crucial. However, few data are available on confirmed leptospirosis cases in children in industrialized countries. We therefore aimed to describe epidemiologic and clinical characteristics of laboratory-confirmed childhood leptospirosis in Okinawa, Japan. We reviewed the national surveillance data of pediatric leptospirosis in Okinawa, Japan from January 2003 through December 2015. The database included all of laboratory-confirmed leptospirosis diagnosed at the only central laboratory for leptospirosis in the region. There were 44 children (0-20 years of age) with laboratory-confirmed leptospirosis. Of these, 90% were male, 91% were 10-20 years of age, and 96% of cases occurred in August and September. The number of laboratory-confirmed patients ranged from 0 to 11 per year (mean: 3.3 per year), and the estimated annual rate was 1.0 per 100,000 pediatric populations. In all cases, the presumed infection route was recreational exposure to river water. Commonly observed manifestations include fever (95%), myalgia (52%), and conjunctival suffusion (52%). Childhood leptospirosis in Okinawa, Japan occurred predominantly in teenage boys after freshwater exposure in summer, and most patients had characteristic conjunctival suffusion. Cohort studies would be helpful to better understand more detailed clinical manifestations in association with prognosis.
钩端螺旋体病因其临床表现不具特异性且对其流行病学认识不足而被认为诊断不足。早期诊断和治疗至关重要。然而，关于工业化国家儿童确诊的钩端螺旋体病病例，数据很少。因此，我们旨在描述日本冲绳儿童实验室确诊钩端螺旋体病的流行病学和临床特征。我们回顾了 2003 年 1 月至 2015 年 12 月日本冲绳地区儿科钩端螺旋体病的国家监测数据。该数据库包括该地区唯一的钩端螺旋体病中央实验室诊断的所有实验室确诊的钩端螺旋体病。共有 44 例（0-20 岁）实验室确诊的钩端螺旋体病患儿。其中，90%为男性，91%为 10-20 岁，96%的病例发生在 8 月和 9 月。实验室确诊患者人数每年从 0 到 11 例不等（平均每年 3.3 例），估计年发病率为每 10 万儿童人口 1.0 例。在所有病例中，推测的感染途径是在河水中进行娱乐性暴露。常见的表现包括发热（95%）、肌痛（52%）和结膜充血（52%）。日本冲绳的儿童钩端螺旋体病主要发生在夏季接触淡水后 10-20 岁的青少年男孩中，大多数患者都有特征性的结膜充血。队列研究将有助于更好地了解与预后相关的更详细的临床表现。
