|Zaki, S - CDC, ATLANTA, GA|
|Shieh, W - CDC, ATLANTA, GA|
|Working Group, Epidemic - MINISTRY OF HEALTH, NIC|
|Working Group, Epidemic - PAN AMER HEALTH ORG|
|Working Group, Epidemic - CDC, ATLANTA, GA|
Submitted to: Lancet
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: February 24, 1996
Publication Date: N/A
Interpretive Summary: Leptospirosis is a worldwide zoonotic disease that causes abortions in domestic animals and mild to severe febrile illness in humans. Recently, an epidemic of severe febrile illness associated with bleeding in the lungs occurred in thousands of people in Nicaragua. The diagnosis of leptospirosis was made, the causative bacteria was isolated, and the epidemic was controlled. Studies are underway to determine the animal reservoir of the infection. Identification of the animal reservoir is important for the design of rational control programs for this disease.
Technical Abstract: Leptospirosis is a worldwide zoonotic disease that results from infection by one of the many serovars of Leptospira. The clinical features are extremely variable, and patients may present with a mild to severe febrile illness. Deaths are usually associated with severe jaundice and oliguric renal failure. Pulmonary manifestations in leptospirosis usually are mild and of little clinical significance, and pulmonary hemorrhage as an early, dominant, and life-threatening complication of leptospirosis is thought to be relatively uncommon. Recently, an epidemic of febrile illness associated with pulmonary hemorrhage occurred in Nicaragua during a time of unusually heavy rains, a climatic condition often associated with epidemics of mosquito- and rodent-borne diseases, including leptospirosis. We report here the initial laboratory investigation that led to the identification of leptospirosis as the cause of death in at least seven of eight patients in whom hemorrhagic pneumonitis was an early and striking manifestation of th disease.