Urban epidemic of severe leptospirosis in Brazil. Salvador Leptospirosis Study Group

Detalhes bibliográficos
Autor(a) principal: Ko, Albert Icksang
Data de Publicação: 1999
Outros Autores: Reis, Mitermayer Galvão dos, Dourado, Cibele Maria Ribeiro, Johnson Junior, Warren D, Riley, Lee Woodland, Salvador Leptospirosis Study Group
Tipo de documento: Artigo
Idioma: eng
Título da fonte: Repositório Institucional da FIOCRUZ (ARCA)
Texto Completo: https://www.arca.fiocruz.br/handle/icict/7574
Resumo: Fundação Oswaldo Cruz. Centro de Pesquisa Gonçalo Moniz. Salvador, BA, Brasil / Division of International Medicine and Infectious Disease. Cornell University Medical College. New York, USA
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spelling Ko, Albert IcksangReis, Mitermayer Galvão dosDourado, Cibele Maria RibeiroJohnson Junior, Warren DRiley, Lee WoodlandSalvador Leptospirosis Study Group2014-05-05T12:29:57Z2014-05-05T12:29:57Z1999KO, A. I. et al. Urban epidemic of severe leptospirosis in Brazil. Lancet, v. 354, n. 9181, p. 820-825, 1999.0140-6736https://www.arca.fiocruz.br/handle/icict/7574engLancetUrban epidemic of severe leptospirosis in Brazil. Salvador Leptospirosis Study Groupinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleFundação Oswaldo Cruz. Centro de Pesquisa Gonçalo Moniz. Salvador, BA, Brasil / Division of International Medicine and Infectious Disease. Cornell University Medical College. New York, USAFundação Oswaldo Cruz. Centro de Pesquisa Gonçalo Moniz. Salvador, BA, BrasilHospital Couto Maia. Secretary of Health for the State of Bahia. Salvador, BA, BrasilDivision of International Medicine and Infectious Disease. Cornell University Medical College. New York, USASchool of Public Health. University of California. Berkeley, USABACKGROUND: Leptospirosis has, traditionally, been considered a sporadic rural disease. We describe a large urban outbreak of leptospirosis. METHODS: Active surveillance for leptospirosis was established in an infectious-disease referral hospital in Salvador, Brazil, between March 10 and Nov 2, 1996. Patients meeting case criteria for severe manifestations of leptospirosis were recruited into the study. The diagnosis was confirmed in the laboratory with the microagglutination test and identification of leptospires in blood or urine. Risk factors for death were examined by multivariate analyses. FINDINGS: Surveillance identified 326 cases of which 193 (59%) were laboratory-confirmed (133) or probable (60) cases. Leptospira interrogans serovar copenhageni was isolated from 87% of the cases with positive blood cultures. Most of the cases were adult (mean age 35.9 years [SD 15.9]), and 80% were male. Complications included jaundice (91%), oliguria (35%), and severe anaemia (26%). 50 cases died (case-fatality rate 15%) despite aggressive supportive care including dialysis (in 23%). Altered mental status was the strongest independent predictor of death (odds ratio 9.12 [95% CI 4.28-20.3]), age over 37 years, renal insufficiency, and respiratory insufficiency were also significant predictors of death. Before admission to hospital, 42% were misdiagnosed as having dengue fever in the outpatient clinic; an outbreak of dengue fever was taking place concurrently. INTERPRETATION: An epidemic of leptospirosis has become a major urban health problem, associated with high mortality. 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dc.title.pt_BR.fl_str_mv Urban epidemic of severe leptospirosis in Brazil. Salvador Leptospirosis Study Group
title Urban epidemic of severe leptospirosis in Brazil. Salvador Leptospirosis Study Group
spellingShingle Urban epidemic of severe leptospirosis in Brazil. Salvador Leptospirosis Study Group
Ko, Albert Icksang
Surtos de Doenças/estatística & dados numéricos
Saúde da População Urbana/estatística & dados numéricos
Doença de Weil/epidemiologia
Adulto
Brasil/epidemiologia
Dengue/diagnóstico
Diagnóstico Diferencial
Feminino
Humanos
Leptospira interrogans/isolamento & purificação
Masculino
Vigilância da População
Doença de Weil/diagnóstico
title_short Urban epidemic of severe leptospirosis in Brazil. Salvador Leptospirosis Study Group
title_full Urban epidemic of severe leptospirosis in Brazil. Salvador Leptospirosis Study Group
title_fullStr Urban epidemic of severe leptospirosis in Brazil. Salvador Leptospirosis Study Group
title_full_unstemmed Urban epidemic of severe leptospirosis in Brazil. Salvador Leptospirosis Study Group
title_sort Urban epidemic of severe leptospirosis in Brazil. Salvador Leptospirosis Study Group
author Ko, Albert Icksang
author_facet Ko, Albert Icksang
Reis, Mitermayer Galvão dos
Dourado, Cibele Maria Ribeiro
Johnson Junior, Warren D
Riley, Lee Woodland
Salvador Leptospirosis Study Group
author_role author
author2 Reis, Mitermayer Galvão dos
Dourado, Cibele Maria Ribeiro
Johnson Junior, Warren D
Riley, Lee Woodland
Salvador Leptospirosis Study Group
author2_role author
author
author
author
author
dc.contributor.author.fl_str_mv Ko, Albert Icksang
Reis, Mitermayer Galvão dos
Dourado, Cibele Maria Ribeiro
Johnson Junior, Warren D
Riley, Lee Woodland
Salvador Leptospirosis Study Group
dc.subject.decs.pt_BR.fl_str_mv Surtos de Doenças/estatística & dados numéricos
Saúde da População Urbana/estatística & dados numéricos
Doença de Weil/epidemiologia
Adulto
Brasil/epidemiologia
Dengue/diagnóstico
Diagnóstico Diferencial
Feminino
Humanos
Leptospira interrogans/isolamento & purificação
Masculino
Vigilância da População
Doença de Weil/diagnóstico
topic Surtos de Doenças/estatística & dados numéricos
Saúde da População Urbana/estatística & dados numéricos
Doença de Weil/epidemiologia
Adulto
Brasil/epidemiologia
Dengue/diagnóstico
Diagnóstico Diferencial
Feminino
Humanos
Leptospira interrogans/isolamento & purificação
Masculino
Vigilância da População
Doença de Weil/diagnóstico
description Fundação Oswaldo Cruz. Centro de Pesquisa Gonçalo Moniz. Salvador, BA, Brasil / Division of International Medicine and Infectious Disease. Cornell University Medical College. New York, USA
publishDate 1999
dc.date.issued.fl_str_mv 1999
dc.date.accessioned.fl_str_mv 2014-05-05T12:29:57Z
dc.date.available.fl_str_mv 2014-05-05T12:29:57Z
dc.type.status.fl_str_mv info:eu-repo/semantics/publishedVersion
dc.type.driver.fl_str_mv info:eu-repo/semantics/article
format article
status_str publishedVersion
dc.identifier.citation.fl_str_mv KO, A. I. et al. Urban epidemic of severe leptospirosis in Brazil. Lancet, v. 354, n. 9181, p. 820-825, 1999.
dc.identifier.uri.fl_str_mv https://www.arca.fiocruz.br/handle/icict/7574
dc.identifier.issn.none.fl_str_mv 0140-6736
identifier_str_mv KO, A. I. et al. Urban epidemic of severe leptospirosis in Brazil. Lancet, v. 354, n. 9181, p. 820-825, 1999.
0140-6736
url https://www.arca.fiocruz.br/handle/icict/7574
dc.language.iso.fl_str_mv eng
language eng
dc.rights.driver.fl_str_mv info:eu-repo/semantics/openAccess
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dc.publisher.none.fl_str_mv Lancet
publisher.none.fl_str_mv Lancet
dc.source.none.fl_str_mv reponame:Repositório Institucional da FIOCRUZ (ARCA)
instname:Fundação Oswaldo Cruz (FIOCRUZ)
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instname_str Fundação Oswaldo Cruz (FIOCRUZ)
instacron_str FIOCRUZ
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reponame_str Repositório Institucional da FIOCRUZ (ARCA)
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