title: Travel-related leptospirosis in Israel: a nationwide study.
abstract: Leptospirosis is re-emerging in developed countries as a travel-related infection. In this nationwide study of travel-related leptospirosis in Israel, all cases diagnosed at the Central Reference Laboratory for Leptospirosis, during 2002-2008 were retrospectively reviewed and only travel-related cases were included. During the study years, 20 (42%) of 48 leptospirosis cases in Israel were travel-related. Exposure occurred in Southeast Asia in 15 (75%) of 20 cases. The estimated yearly incidence of travel-related leptospirosis was 1.78/100,000 travelers compared with an incidence of endemic cases of 0.06/100,000 inhabitants (risk ratio = 29.6, 95% confidence interval = 16.7-52.4). Most patients (89%) were infected during water-related activities. Severe disease was present in 10 (55%) of 18 patients; 7 of them were presumptively infected with the Icterohaemorrhagiae serogroup. Thus, travel-related leptospirosis is becoming increasingly important in the epidemiology of leptospirosis in Israel. Leptospirosis should be suspected in any traveler with undifferentiated febrile illness, especially when water exposure is reported.
authors.affiliation: The Center for Geographic Medicine, Chaim Sheba Medical Center, Tel Hashomer, Israel. leshem@gmail.com
authors.forename: Eyal
authors.initials: E
authors.lastname: Leshem
authors.forename: Gadi
authors.initials: G
authors.lastname: Segal
authors.forename: Ada
authors.initials: A
authors.lastname: Barnea
authors.forename: Shmuel
authors.initials: S
authors.lastname: Yitzhaki
authors.forename: Iris
authors.initials: I
authors.lastname: Ostfeld
authors.forename: Silvio
authors.initials: S
authors.lastname: Pitlik
authors.forename: Eli
authors.initials: E
authors.lastname: Schwartz
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D015994:Incidence; D007557:Israel / Q000453:epidemiology; D007922:Leptospirosis / Q000453:epidemiology*; D008297:Male; D008875:Middle Aged; D013997:Time Factors; D014195:Travel; D055815:Young Adult