Atherstone Christine, Galloway Renee, Schafer Ilana, Artus Aileen, Rodriguez Melissa Marzan, Ryff Kyle, Rivera Abigail Medina, Slavinski Sally, Paladini Marc, Kemble Sarah K, Berreman Janet M, Kallas Grayson, Traxler Rita, Kharod Grishma, Guerra Marta, Stoddard Robyn A, Moore Hannah, Bower William A, Negron Maria E, DeBord Katherine
Bacterial Special Pathogens Branch, Division of High-Consequence Pathogens and Pathology, National Center for Emerging and Zoonotic Infectious Diseases, CDC, Atlanta, Georgia, United States of America.
Puerto Rico Department of Health, San Juan, Puerto Rico, United States of America.
PLoS Negl Trop Dis. 2025 Aug 22;19(8):e0013427. doi: 10.1371/journal.pntd.0013427. eCollection 2025 Aug.
Leptospirosis, caused by pathogenic Leptospira spp., is one of the most widespread zoonotic diseases globally. In 2014, leptospirosis was reinstated as a nationally notifiable condition due to evidence of increasing incidence and public health importance. We describe the epidemiological, temporal, and geographic trends of leptospirosis in the United States since reinstatement.
Analysis included confirmed and probable leptospirosis cases from jurisdictions reporting ≥ 1 case between 2014-2020. Analyzed data included reportable case surveillance and voluntarily submitted supplemental data.
Between 2014-2020, CDC received 1,053 case reports from 34 jurisdictions. The national incidence rate was 0.48 cases per 100,000 population. Since 2014, leptospirosis cases have been increasing, with an average annual gain of 13 cases (R2 = 0.69). Cases increased in summer, peaking in early fall, corresponding with warmer weather and hurricane season. Among cases with outcome data, 85% (n = 606/709) were hospitalized and 10% (n = 74) died. Seventy-seven percent of cases (n = 623) reported contact with animals or their bodily fluids while 71% (n = 578) of cases reported contact with freshwater or mud. More cases reported avocational activities (n = 413, [52%]) as the source of their animal or environmental exposure(s) than recreational or occupational activities (n = 203, [25%] vs n = 163, [20%], respectively). Only 13% of cases reported any international travel in the 30 days prior to symptom onset.
An increasing number of leptospirosis cases in the U.S. are being reported, mostly from domestic sources of infection. Changing epidemiological trends away from occupational exposures to avocational or recreational activities highlights the need for interventions mitigating these exposure risks. A high percentage of cases were hospitalized and died emphasizing the need to educate healthcare providers, public health professionals, and the public about early identification and treatment for leptospirosis to improve patient outcomes.
钩端螺旋体病由致病性钩端螺旋体属引起，是全球最广泛传播的人畜共患病之一。2014年，由于发病率上升及公共卫生重要性的证据，钩端螺旋体病重新被列为须全国通报的疾病。我们描述了自重新列为通报疾病以来美国钩端螺旋体病的流行病学、时间和地理趋势。
分析纳入了2014年至2020年期间报告≥1例确诊和可能钩端螺旋体病病例的辖区的数据。分析的数据包括应报告病例监测和自愿提交的补充数据。
2014年至2020年期间，美国疾病控制与预防中心（CDC）收到来自34个辖区的1053例病例报告。全国发病率为每10万人0.48例。自2014年以来，钩端螺旋体病病例数一直在增加，平均每年增加13例（R2 = 0.69）。病例在夏季增加，在初秋达到峰值，这与天气变暖和飓风季节相对应。在有结局数据的病例中，85%（n = 606/709）住院治疗，10%（n = 74）死亡。77%的病例（n = 623）报告与动物或其体液有接触，而71%的病例（n = 578）报告与淡水或泥浆有接触。报告业余活动（n = 413，[52%]）作为其动物或环境暴露源的病例多于娱乐或职业活动（分别为n = 203，[25%]和n = 163，[20%]）。只有13%的病例报告在症状出现前30天内有任何国际旅行。
美国报告的钩端螺旋体病病例数在增加，大多数来自国内感染源。流行病学趋势从职业暴露转向业余或娱乐活动，这凸显了采取干预措施降低这些暴露风险的必要性。高比例的病例住院治疗并死亡，这强调了有必要对医疗服务提供者、公共卫生专业人员和公众进行教育，使其了解钩端螺旋体病的早期识别和治疗方法，以改善患者预后。
