Olszyna D P, Jaspars R, Speelman P, van Elzakker E, Korver H, Hartskeerl R A
Academisch Medisch Centrum, afd. Inwendige Geneeskunde, onder-afd. Infectieziekten, Tropische Geneeskunde en Aids, Amsterdam.
Ned Tijdschr Geneeskd. 1998 May 30;142(22):1270-3.
To determine all cases of leptospirosis in the Netherlands in 1991-1995 that were confirmed by serological investigation or culturing.
Descriptive, retrospective.
Department of Biomedical Research, Royal Tropical Institute, Amsterdam, the Netherlands, and Department of Internal Medicine, Academic Medical Centre, Amsterdam, the Netherlands.
Using data of the Reference Laboratory for Leptospirosis, the number of leptospirosis cases in 1991-1995 was determined and compared with the data of 1986-1990. Additional information was obtained about patients with confirmed leptospirosis or who had been hospitalized because of leptospirosis.
The number of confirmed cases dropped from 229 in 1986-1990 to 159 in 1991-1995. This decrease could be attributed mainly to a marked decrease of the number of dairy farm fever (hardjo) cases. There was a clear increase of the number of infections acquired during travel in foreign countries, notably outside Europe. Thus, leptospirosis in the Netherlands shifted from an occupational disease towards a disease due to recreational activities. In about 10% of the patients the disease ran a severe course with Weil's syndrome (icterus, renal failure, and haemorrhages). Eight patients (5%) died. Clinical data of 5 of these 8 patients indicated that they had suffered from Weil's syndrome.
确定1991年至1995年在荷兰通过血清学调查或培养确诊的所有钩端螺旋体病病例。
描述性回顾研究。
荷兰阿姆斯特丹皇家热带研究所生物医学研究部以及荷兰阿姆斯特丹学术医疗中心内科。
利用钩端螺旋体病参考实验室的数据，确定1991年至1995年钩端螺旋体病病例数，并与1986年至1990年的数据进行比较。获取了确诊钩端螺旋体病患者或因钩端螺旋体病住院患者的更多信息。
确诊病例数从1986年至1990年的229例降至1991年至1995年的159例。这种下降主要归因于奶牛场热（哈焦型）病例数的显著减少。在国外旅行期间感染的病例数明显增加，尤其是在欧洲以外地区。因此，荷兰的钩端螺旋体病从一种职业病转变为一种因娱乐活动导致的疾病。约10%的患者病情严重，出现韦尔综合征（黄疸、肾衰竭和出血）。8名患者（5%）死亡。这8名患者中有5名的临床数据表明他们患有韦尔综合征。
