Sehgal S C, Murhekar M V, Sugunan A P
Regional Medical Research Centre (ICMR), Port Blair, Andaman Island.
Indian J Med Res. 1995 Jul;102:9-12.
An outbreak of acute febrile illness with haemorrhagic manifestations and pulmonary involvement occurred in Diglipur of North Andaman during October-November 1993. Investigations were carried out to see whether leptospires were responsible for this outbreak. Serum samples were collected from suspected cases and tested for presence of antibodies to leptospires by microscopic agglutination test (MAT) using a battery of 19 antigens representing 16 serogroups. 66.7 per cent of the specimens showed significant titres of antibodies against leptospires, 18 of 23 paired sera (78.3%) showed sero-conversion or four-fold rise in antibody titres. The commonest serovar involved was Leptospira grippotyphosa followed by L. canicola and L. JEZ bratislava. In 7 patients L. grippotyphosa was the sole serovar against which antibodies were detected. Clinical and epidemiological observations of this outbreak were similar with that of earlier seasonal outbreaks of acute febrile illness with haemorrhagic manifestations occurring in the same area, indicating that the past outbreaks may also have been due to leptospires. This is the first report of pulmonary leptospirosis from India.
1993年10月至11月期间,北安达曼岛的迪格利普尔爆发了伴有出血表现和肺部受累的急性发热性疾病。开展了调查以确定钩端螺旋体是否为此疫情的病因。从疑似病例中采集血清样本,并通过显微镜凝集试验(MAT)使用代表16个血清群的19种抗原检测针对钩端螺旋体的抗体。66.7%的标本显示出针对钩端螺旋体的显著抗体效价,23对配对血清中的18份(78.3%)显示血清转化或抗体效价呈四倍升高。最常见的血清型是犬型钩端螺旋体,其次是犬黄疸出血群钩端螺旋体和布拉迪斯拉发群钩端螺旋体。在7名患者中,犬型钩端螺旋体是唯一检测到抗体的血清型。此次疫情的临床和流行病学观察结果与该地区早期季节性爆发的伴有出血表现的急性发热性疾病相似,表明过去的疫情可能也由钩端螺旋体引起。这是印度关于肺钩端螺旋体病的首次报告。