A ProMED-mail post
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International Society for Infectious Diseases
Date: Sat 3 Apr 2010
Source: El Diario [in Spanish, trans. Mod.JG, edited]
Since last December [2009], a plan for surveillance of febrile illness
has been implemented in the Argentine province of Entre Rios. In
addition to leptospirosis, the plan also includes looking for cases of
dengue and hantavirus infections. A meeting was scheduled in Padre
Kolbe community [a neighborhood in Parana, the capital of the
Argentine province of Entre Rios], where its inhabitants are quite
concerned after learning of a fatal case that occurred one week ago.
The number of cases of leptospirosis reported in Entre Rios province
now has reached 48 persons, according to the official figures of the
Health Secretariat in the aforementioned province. However, this
number may represent only one quarter of the total number of suspected
cases recorded until now, which account for 200 persons, according to
Ms. Fabiana Leiva, Subsecretary for Health Prevention and Promotion
from the Health Secretariat. These case reports coincide with floods
that affect both (river) margins in Entre Rios province.
The 1st leptospirosis fatality is a young man who worked picking up
garbage and lived in a house located in Vicente Quesada street, in
Padre Kolbe community, in Parana [Parana is the capital city of the
province of Entre Rios, located on the eastern shore of the Parana
River, opposite the city of Santa Fe, capital of the neighboring Santa
Fe Province, where leptospirosis has previously been reported. See
below].
"We are quite concerned because last Tuesday [23 Mar 2010], a young
man died because of leptospirosis, and there are so many rats all over
the neighborhood", said Ms. Marisol Tabares, a person living in Padre
Kolbe community. "Officers from the Municipality placed poison in
holes in streets and parks, and they became quite surprised when they
found so many holes inhabited by rodents all over the place", she
pointed out.
The transmission for humans is by contact with the urine of infected
rodents, dogs, and pigs, [or by contact with contaminated water or
mud]. The potential for transmission becomes higher after floods,
where there is plenty of still water and mud. These features, together
with high temperatures, generate adequate conditions for acquiring the
infection. Bacteria enter the body through skin wounds, mucous
membranes, or even through intact skin in people walking or working
with no protection in flooded areas.
Because of the similarity of symptoms of leptospirosis and other
conditions, such as hantavirus infection and dengue fever, physicians
report every febrile illness case as suspected for the aforementioned
infections. For this reason, the Health Secretariat is currently using
a double test for confirming the diagnoses of these infectious
diseases, according to an official report. A 1st test is performed in
the Provincial Epidemiology Laboratory, which has high reliability,
and a 2nd test is performed in Emilio Coni Institute in Santa Fe.
Although according to the Subsecretary for Health Prevention and
Promotion from the Health Secretariat it was not possible to perform
any test on the deceased patient one week ago, considering the
symptoms he developed and the conditions he lived in, a diagnosis of
leptospirosis was given.
[Byline: Ricardo Leguizamon]
--
Communicated by:
ProMED-mail
[Leptospirosis is a spirochetal infection that is distributed widely
throughout the world in warm climates. It is caused by exposure to
_Leptospira_ bacteria, in fresh (not salty) water, wet soil, or
vegetation that has been contaminated by the urine of chronically
infected animals. Leptospirosis affects humans and a variety of
animals including dogs, cattle, pigs, and rodents. Outbreaks
frequently follow heavy rainfalls, flooding with fresh water and
rodent infestation.
Leptospirosis is an occupational hazard for people who work outdoors
or with animals, for example, workers in wet agricultural settings
(such as rice field workers), ranchers, slaughterhouse workers,
trappers, loggers, sewer workers, veterinarians, fishery workers,
dairy farmers, or military personnel. Also leptospirosis is a risk
during recreational activities, such as camping, fresh water swimming,
canoeing, kayaking, rafting, golfing, and trail biking, that involve
exposure to water in lakes, rivers, or ponds contaminated by urine
from leptospire-infected animals, as well as household exposure to
infected pet animals or rodents
and in rural and urban settings
Leptospirosis has been reported recently in the neighboring city of
Santa Fe, capital of the Argentine Santa Fe province, associated with
flooding after heavy rains (see ProMED-mail Leptospirosis, fatal -
Argentina: (SF) RFI 20100302.0683). Historically, intense rainfall and
the rise of the Parana River periodically produce severe flooding,
affecting the cities of Santa Fe and Parana
The HealthMap/ProMED-mail interactive map of Argentina can be found at
[This is not an outbreak (it's endemic). The same thing happened some
years ago in Peru with respect to Bartonellosis. It was not an
outbreak, there were less cases than the previous year. The point was
that since one person (connected with the media) died, then the whole
thing became a mess. - Mod. JG]
[see also:
Leptospirosis, fatal - Argentina: (SF) RFI 20100302.0683
Leptospirosis, farm workers, travelers - Australia (02): background
20100220.0581
Leptospirosis, farm workers, travelers - Australia: (QL) alert 20100219.0571
Leptospirosis, fatal - Ireland (02): background 20100106.0055
Leptospirosis, fatal - Ireland 20100105.0041
2009
----
Leptospirosis - Philippines (05) 20091026.3704
Leptospirosis - India (02) 20090404.1296
Leptospirosis - Fiji (03) 20090225.0772
2008
----
Leptospirosis, fatal - UK (02) 20081010.3210
2007
----
Leptospirosis - Jamaica (02) 20071018.3409
Leptospirosis - Ukraine (Lvov, Kiev, Kherson) 20071018.3401
Leptospirosis - Argentina (Santa Fe) 20070429.1395
2006
----
Leptospirosis, fishermen - UK ex France (Picardie) 20061029.3101
2005
----
Leptospirosis - Ukraine (Chernovtsy) 20051111.3294
Leptospirosis - Russia (Chechnya) 20050830.2562
Leptospirosis, military personnel - Australia (QLD): not 20050329.0910
2004
----
Leptospirosis, fatal - Argentina (Entre Rios) (03) 20040810.2204
Leptospirosis, fatal - Argentina (Entre Rios) (02) 20040807.2166
Leptospirosis, fatal - Argentina (Entre Rios) 20040805.2141]
......................................................ml/msp/jw
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