Leptospirosis in the Asia Pacific region.
BACKGROUND
Leptospirosis is a worldwide zoonotic infection that has been recognized for decades, but the problem of the disease has not been fully addressed, particularly in resource-poor, developing countries, where the major burden of the disease occurs. This paper presents an overview of the current situation of leptospirosis in the region. It describes the current trends in the epidemiology of leptospirosis, the existing surveillance systems, and presents the existing prevention and control programs in the Asia Pacific region.


METHODS
Data on leptospirosis in each member country were sought from official national organizations, international public health organizations, online articles and the scientific literature. Papers were reviewed and relevant data were extracted.


RESULTS
Leptospirosis is highly prevalent in the Asia Pacific region. Infections in developed countries arise mainly from occupational exposure, travel to endemic areas, recreational activities, or importation of domestic and wild animals, whereas outbreaks in developing countries are most frequently related to normal daily activities, over-crowding, poor sanitation and climatic conditions.


CONCLUSIONS
In the Asia Pacific region, predominantly in developing countries, leptospirosis is largely a water-borne disease. Unless interventions to minimize exposure are aggressively implemented, the current global climate change will further aggravate the extent of the disease problem. Although trends indicate successful control of leptospirosis in some areas, there is no clear evidence that the disease has decreased in the last decade. The efficiency of surveillance systems and data collection varies significantly among the countries and areas within the region, leading to incomplete information in some instances. Thus, an accurate reflection of the true burden of the disease remains unknown.
Victoriano
Ann Florence B
AF
Department of Medical Microbiology, University of the Philippines, College of Public Health, Manila, Philippines. entyv@yahoo.com
Smythe
Lee D
LD
Gloriani-Barzaga
Nina
N
Cavinta
Lolita L
LL
Kasai
Takeshi
T
Limpakarnjanarat
Khanchit
K
Ong
Bee Lee
BL
Gongal
Gyanendra
G
Hall
Julie
J
Coulombe
Caroline Anne
CA
Yanagihara
Yasutake
Y
Yoshida
Shin-Ichi
S
Adler
Ben
B
D000818:Animals; D001208:Asia / Q000453:epidemiology; D003906:Developing Countries; D006801:Humans; D015994:Incidence; D007922:Leptospirosis / Q000453:epidemiology* / Q000517:prevention & control; D010139:Pacific Islands / Q000453:epidemiology; D011159:Population Surveillance; D015995:Prevalence; D015047:Zoonoses / Q000453:epidemiology*