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First Reported Human Cases of Leptospirosis in the United States Virgin Islands in the Aftermath of Hurricanes Irma and Maria, September–November 2017
OBJECTIVE: Following Hurricanes Irma and Maria, the first case of human leptospirosis ever identified in the US Virgin Islands (USVI) was reported to the Virgin Islands Department of Health. Leptospirosis is a potentially fatal bacterial disease caused by Leptospira species found in animal urine and...
Autores principales: | , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Oxford University Press
2019
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6602892/ https://www.ncbi.nlm.nih.gov/pubmed/31289729 http://dx.doi.org/10.1093/ofid/ofz261 |
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author | Marinova-Petkova, Atanaska Guendel, Irene Strysko, Jonathan P Ekpo, Lisa LaPlace Galloway, Renee Yoder, Jonathan Kahler, Amy Artus, Aileen Hoffmaster, Alex R Bower, William A Walke, Henry Ellis, Brett R Hunte-Ceasar, Tai Ellis, Esther M Schafer, Ilana J |
author_facet | Marinova-Petkova, Atanaska Guendel, Irene Strysko, Jonathan P Ekpo, Lisa LaPlace Galloway, Renee Yoder, Jonathan Kahler, Amy Artus, Aileen Hoffmaster, Alex R Bower, William A Walke, Henry Ellis, Brett R Hunte-Ceasar, Tai Ellis, Esther M Schafer, Ilana J |
author_sort | Marinova-Petkova, Atanaska |
collection | PubMed |
description | OBJECTIVE: Following Hurricanes Irma and Maria, the first case of human leptospirosis ever identified in the US Virgin Islands (USVI) was reported to the Virgin Islands Department of Health. Leptospirosis is a potentially fatal bacterial disease caused by Leptospira species found in animal urine and urine-contaminated water and soil. Outbreaks can occur following extreme weather events. METHOD: Additional cases of leptospirosis were identified in the 2.5 months post-hurricanes by reviewing emergency department (ED) records from territorial hospitals for patients demonstrating leptospirosis-consistent symptoms, testing symptomatic patients previously enrolled in the USVI arbovirus surveillance system (VIASS), and adding leptospirosis testing prospectively to VIASS. Available patient sera underwent local rapid diagnostic testing for anti-Leptospira IgM followed by confirmatory microscopic agglutination testing at the US Centers for Disease Control and Prevention. Water was collected from cisterns with epidemiologic links to confirmed cases and tested by real-time PCR (qPCR) for pathogenic Leptospira spp. RESULTS: Sixteen retrospectively identified symptomatic patients were enrolled in VIASS; 15 with available samples tested negative. Based on review of 5226 ED charts, 6 patients were further investigated; of these, 5 were tested of which 1 was positive. Prospective leptospirosis surveillance tested 57 additional patients; of these, 1 was positive. Water from 1 of 5 tested cisterns was found positive by qPCR. CONCLUSIONS: This investigation documents the first 3 cases of leptospirosis reported in the USVI and demonstrates how VIASS successfully was adapted to establish leptospirosis surveillance. Contaminated cistern water was identified as a potential source for Leptospira spp. transmission, highlighting the need for additional post-hurricane remediation and disinfection guidance. |
format | Online Article Text |
id | pubmed-6602892 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | Oxford University Press |
record_format | MEDLINE/PubMed |
spelling | pubmed-66028922019-07-09 First Reported Human Cases of Leptospirosis in the United States Virgin Islands in the Aftermath of Hurricanes Irma and Maria, September–November 2017 Marinova-Petkova, Atanaska Guendel, Irene Strysko, Jonathan P Ekpo, Lisa LaPlace Galloway, Renee Yoder, Jonathan Kahler, Amy Artus, Aileen Hoffmaster, Alex R Bower, William A Walke, Henry Ellis, Brett R Hunte-Ceasar, Tai Ellis, Esther M Schafer, Ilana J Open Forum Infect Dis Major Article OBJECTIVE: Following Hurricanes Irma and Maria, the first case of human leptospirosis ever identified in the US Virgin Islands (USVI) was reported to the Virgin Islands Department of Health. Leptospirosis is a potentially fatal bacterial disease caused by Leptospira species found in animal urine and urine-contaminated water and soil. Outbreaks can occur following extreme weather events. METHOD: Additional cases of leptospirosis were identified in the 2.5 months post-hurricanes by reviewing emergency department (ED) records from territorial hospitals for patients demonstrating leptospirosis-consistent symptoms, testing symptomatic patients previously enrolled in the USVI arbovirus surveillance system (VIASS), and adding leptospirosis testing prospectively to VIASS. Available patient sera underwent local rapid diagnostic testing for anti-Leptospira IgM followed by confirmatory microscopic agglutination testing at the US Centers for Disease Control and Prevention. Water was collected from cisterns with epidemiologic links to confirmed cases and tested by real-time PCR (qPCR) for pathogenic Leptospira spp. RESULTS: Sixteen retrospectively identified symptomatic patients were enrolled in VIASS; 15 with available samples tested negative. Based on review of 5226 ED charts, 6 patients were further investigated; of these, 5 were tested of which 1 was positive. Prospective leptospirosis surveillance tested 57 additional patients; of these, 1 was positive. Water from 1 of 5 tested cisterns was found positive by qPCR. CONCLUSIONS: This investigation documents the first 3 cases of leptospirosis reported in the USVI and demonstrates how VIASS successfully was adapted to establish leptospirosis surveillance. Contaminated cistern water was identified as a potential source for Leptospira spp. transmission, highlighting the need for additional post-hurricane remediation and disinfection guidance. Oxford University Press 2019-06-05 /pmc/articles/PMC6602892/ /pubmed/31289729 http://dx.doi.org/10.1093/ofid/ofz261 Text en © The Author(s) 2019. Published by Oxford University Press on behalf of Infectious Diseases Society of America. http://creativecommons.org/licenses/by-nc-nd/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs licence (http://creativecommons.org/licenses/by-nc-nd/4.0/), which permits non-commercial reproduction and distribution of the work, in any medium, provided the original work is not altered or transformed in any way, and that the work is properly cited. For commercial re-use, please contact journals.permissions@oup.com |
spellingShingle | Major Article Marinova-Petkova, Atanaska Guendel, Irene Strysko, Jonathan P Ekpo, Lisa LaPlace Galloway, Renee Yoder, Jonathan Kahler, Amy Artus, Aileen Hoffmaster, Alex R Bower, William A Walke, Henry Ellis, Brett R Hunte-Ceasar, Tai Ellis, Esther M Schafer, Ilana J First Reported Human Cases of Leptospirosis in the United States Virgin Islands in the Aftermath of Hurricanes Irma and Maria, September–November 2017 |
title | First Reported Human Cases of Leptospirosis in the United States Virgin Islands in the Aftermath of Hurricanes Irma and Maria, September–November 2017 |
title_full | First Reported Human Cases of Leptospirosis in the United States Virgin Islands in the Aftermath of Hurricanes Irma and Maria, September–November 2017 |
title_fullStr | First Reported Human Cases of Leptospirosis in the United States Virgin Islands in the Aftermath of Hurricanes Irma and Maria, September–November 2017 |
title_full_unstemmed | First Reported Human Cases of Leptospirosis in the United States Virgin Islands in the Aftermath of Hurricanes Irma and Maria, September–November 2017 |
title_short | First Reported Human Cases of Leptospirosis in the United States Virgin Islands in the Aftermath of Hurricanes Irma and Maria, September–November 2017 |
title_sort | first reported human cases of leptospirosis in the united states virgin islands in the aftermath of hurricanes irma and maria, september–november 2017 |
topic | Major Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6602892/ https://www.ncbi.nlm.nih.gov/pubmed/31289729 http://dx.doi.org/10.1093/ofid/ofz261 |
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