title: Leptospirosis in Hawaii, USA, 1999-2008.
abstract: Although infrequently diagnosed in the United States, leptospirosis is a notable reemerging infectious disease throughout developing countries. Until 1995, when the disease was eliminated from the US list of nationally notifiable diseases, Hawaii led the nation in reported annual incidence rates. Leptospirosis remains a notifiable disease in Hawaii. To ascertain the status of leptospirosis in Hawaii since the most recent US report in 2002, we reviewed 1999-2008 data obtained from case investigation reports by the Hawaii State Department of Health. Of the 345 case reports related to in-state exposures, 198 (57%) were laboratory confirmed. Our findings indicate a change in seasonal disease occurrence from summer to winter and in the infective serogroup from Icterohemorrhagiae to Australis. Also, during the past 20 years, recreational exposures have plateaued, while occupational exposures have increased. Ongoing surveillance is needed to clarify and track the dynamic epidemiology of this widespread zoonosis.
authors.affiliation: Department of Public Health Sciences, John A. Burns School of Medicine, University of Hawaii, Biomedical Sciences Building, Rm D104M, 1960 East-West Rd, Honolulu, HI 96822, USA. katz@hawaii.edu
authors.forename: Alan R
authors.initials: AR
authors.lastname: Katz
authors.forename: Arlene E
authors.initials: AE
authors.lastname: Buchholz
authors.forename: Kialani
authors.initials: K
authors.lastname: Hinson
authors.forename: Sarah Y
authors.initials: SY
authors.lastname: Park
authors.forename: Paul V
authors.initials: PV
authors.lastname: Effler
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D002675:Child, Preschool; D004196:Disease Outbreaks; D005260:Female; D006254:Hawaii / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D007919:Leptospira / Q000145:classification / Q000302:isolation & purification*; D007922:Leptospirosis / Q000175:diagnosis / Q000453:epidemiology* / Q000382:microbiology / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D016273:Occupational Exposure; D011998:Recreation; D012621:Seasons; D055815:Young Adult