Aspectos clínicos y epidemiológicos de pacientes con leptospirosis en Cienfuegos. 2001 - 2010  <span class="so-article-trans-title" dir="auto"> Translated title: Clinical and Epidemiological Aspects of Leptospirosis Patients in Cienfuegos. 2001 - 2010 </span>

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Abstract

Fundamento: La leptospirosis es considerada históricamente la zoonosis de mayor repercusión a nivel mundial, lo que también se ha cumplido para la provincia y el municipio Cienfuegos. Objetivo: caracterizar clínica y epidemiológicamente a pacientes con leptospirosis. Métodos: se realizó un estudio descriptivo, retrospectivo, con los 83 pacientes notificados con leptospirosis en el municipio de Cienfuegos del 2001 al 2010. Las variables de estudio fueron: edad, sexo, grupo de riesgo, tiempo de exposición a labores de riesgo, uso de medios de protección, inmunización, quimioprofilaxis, signos y síntomas y resultado serológico. Resultados: para el sexo masculino se obtuvo una tasa de 76,0 x 100 000 habitantes; el 55,4 % eran trabajadores agrícolas. El 74,5 % del total de los enfermos expuestos temporalmente, usaron inadecuadamente los medios de protección. El 78,1 % de los diagnosticados y expuestos a riesgo permanente, no fue inmunizado y solo el 9,8 % de los expuestos a riesgos temporales, recibió quimioprofilaxis. La fiebre y la cefalea fueron los síntomas presentes en la totalidad de los casos. Conclusión: La permanencia en la ocupación con protección personal disminuyó la probabilidad de enfermar. Fueron síntomas predominantes la fiebre y cefalea, coincidiendo el alza de la morbilidad con los dos últimos trimestres del año, períodos de las principales cosechas.

Translated abstract

Background: leptospirosis has been historically considered the major zoonotic disease worldwide, which holds true for the municipality and province of Cienfuegos. Objective: to characterize patients with leptospirosis clinically and epidemiologically. Methods: a descriptive, retrospective study was conducted in 83 patients with leptospirosis reported in the municipality of Cienfuegos from 2001-2010. Variables analyzed included: age, sex, risk group, time of exposure to risk tasks, use of protective equipment, immunization, chemoprophylaxis, signs and symptoms and serology. Results: a rate of 76,0 per 100 000 inhabitants was obtained for males; 55.4% were agricultural workers. Seventy four point five percent of temporarily exposed patients improperly used the protective equipment. Seventy eight point one percent of those diagnosed and constantly exposed to risk was not immunized and only 9.8% of the patients temporarily exposed to risk received chemoprophylaxis. Fever and headache were the symptoms developed in all cases. Conclusion: using personal protection at work decreased the likelihood of contracting this disease. Predominant symptoms were fever and headache; the increase in morbidity coincided with the last two quarters of the year, which are the main harvest seasons.

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Leptospira and leptospirosis.

Ben Adler, Alejandro de la Peña Moctezuma (2010)

Leptospirosis is the most wide spread zoonosis worldwide; it is present in all continents except Antarctica and evidence for the carriage of Leptospira has been found in virtually all mammalian species examined. Humans most commonly become infected through occupational, recreational, or domestic contact with the urine of carrier animals, either directly or via contaminated water or soil. Leptospires are thin, helical bacteria classified into at least 12 pathogenic and 4 saprophytic species, with more than 250 pathogenic serovars. Immunity following infection is generally, but not exclusively, mediated by antibody against leptospiral LPS and restricted to antigenically related serovars. Vaccines currently available consist of killed whole cell bacterins which are used widely in animals, but less so in humans. Current work with recombinant protein antigens shows promise for the development of vaccines based on defined protective antigens. The cellular and molecular basis for virulence remains poorly understood, but comparative genomics of pathogenic and saprophytic species suggests that Leptospira expresses unique virulence determinants. However, the recent development of defined mutagenesis systems for Leptospira heralds the potential for gaining a much improved understanding of pathogenesis in leptospirosis. Copyright 2009 Elsevier B.V. All rights reserved.

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Leptospirosis

Paul N. Levett, Joseph Vinetz (2001)

Leptospirosis is a worldwide zoonotic infection with a much greater incidence in tropical regions and has now been identified as one of the emerging infectious diseases. The epidemiology of leptospirosis has been modified by changes in animal husbandry, climate, and human behavior. Resurgent interest in leptospirosis has resulted from large outbreaks that have received significant publicity. The development of simpler, rapid assays for diagnosis has been based largely on the recognition that early initiation of antibiotic therapy is important in acute disease but also on the need for assays which can be used more widely. In this review, the complex taxonomy of leptospires, previously based on serology and recently modified by a genotypic classification, is discussed, and the clinical and epidemiological value of molecular diagnosis and typing is also evaluated.