Abstract
BackgroundLeptospirosis is a zoonosis usually transmitted through contact with water or soil contaminated with urine from infected animals. Severe flooding can put individuals at greater risk for contracting leptospirosis in endemic areas. Rapid testing for the disease and large-scale interventions are necessary to identify and control infection. We describe a leptospirosis outbreak following severe flooding and a mass chemoprophylaxis campaign in Guyana.Methodology/Principal FindingsFrom January–March 2005, we collected data on suspected leptospirosis hospitalizations and deaths. Laboratory testing included anti-leptospiral dot enzyme immunoassay (DST), immunohistochemistry (IHC) staining, and microscopic agglutination testing (MAT). DST testing was conducted for 105 (44%) of 236 patients; 52 (50%) tested positive. Four (57%) paired serum samples tested by MAT were confirmed leptospirosis. Of 34 total deaths attributed to leptospirosis, postmortem samples from 10 (83%) of 12 patients were positive by IHC. Of 201 patients interviewed, 89% reported direct contact with flood waters. A 3-week doxycycline chemoprophylaxis campaign reached over 280,000 people.ConclusionsA confirmed leptospirosis outbreak in Guyana occurred after severe flooding, resulting in a massive chemoprophylaxis campaign to try to limit morbidity and mortality.
Highlights
Leptospirosis is a zoonosis caused by pathogenic species of Leptospira
A confirmed leptospirosis outbreak in Guyana occurred after severe flooding, resulting in a massive chemoprophylaxis campaign to try to limit morbidity and mortality
All organizations actively involved with the investigation, including the local hospitals, the Ministry of Health (MOH), the Pan American Health Organization (PAHO), and the Caribbean Epidemiology Centre (CAREC), agreed that Investigational Review Board (IRB) review was not necessary
Summary
Leptospirosis is a zoonosis caused by pathogenic species of Leptospira. It is usually transmitted through skin or mucus membrane contact with water or soil contaminated with urine from infected animals, or through contact with tissues from infected animals. Leptospirosis is considered to be widespread in many tropical countries, including the Caribbean region and Central and South America [4,5,6], and outbreaks have occurred after severe flooding due to increased contact with contaminated water [7,8,9]. Leptospirosis is a zoonosis usually transmitted through contact with water or soil contaminated with urine from infected animals. We describe a leptospirosis outbreak following severe flooding and a mass chemoprophylaxis campaign in Guyana
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