title: Leptospirosis outbreak in Sri Lanka in 2008: lessons for assessing the global burden of disease.
abstract: Global leptospirosis disease burden estimates are hampered by the lack of scientifically sound data from countries with probable high endemicity and limited diagnostic capacities. We describe the seroepidemiologic and clinical characteristics of the leptospirosis outbreak in 2008 in Sri Lanka. Definitive/presumptive case definitions proposed by the World Health Organization Leptospirosis Epidemiology Reference Group were used for case confirmation. Of the 404 possible cases, 155 were confirmed to have leptospirosis. Highest titers of patient seum samples reacted with serovars Pyrogenes (28.7%), Hardjo (18.8%), Javanica (11.5%), and Hebdomadis (11.5%). Sequencing of the 16S ribosomal DNA gene identified six infections: five with Leptospira interrogans and one with L. weilli. In this patient population, acute renal failure was the main complication (14.8%), followed by myocarditis (7.1%) and heart failure (3.9%). The case-fatality rate was 1.3%. This report strengthens the urgent need for increasing laboratory diagnostic capabilities to determine the causes of epidemic and endemic infectious diseases in Sri Lanka, a finding relevant to other tropical regions.
authors: Department of Community Medicine, Faculty of Medicine and Allied Sciences, Rajarata University of Sri Lanka Saliyapura, Sri Lanka. sunethagampodi@yahoo.com
authors: Suneth B
authors: SB
authors: Agampodi
authors: Sharon J
authors: SJ
authors: Peacock
authors: Vasanthi
authors: V
authors: Thevanesam
authors: Danaseela B
authors: DB
authors: Nugegoda
authors: Lee
authors: L
authors: Smythe
authors: Janjira
authors: J
authors: Thaipadungpanit
authors: Scott B
authors: SB
authors: Craig
authors: Mary Ann
authors: MA
authors: Burns
authors: Michael
authors: M
authors: Dohnt
authors: Siriphan
authors: S
authors: Boonsilp
authors: Thamarasi
authors: T
authors: Senaratne
authors: Athula
authors: A
authors: Kumara
authors: Paba
authors: P
authors: Palihawadana
authors: Sahan
authors: S
authors: Perera
authors: Joseph M
authors: JM
authors: Vinetz
mesh_terms: D004196:Disease Outbreaks / Q000706:statistics & numerical data*; D014943:Global Health; D006801:Humans; D007922:Leptospirosis / Q000453:epidemiology*; D009822:Oils, Volatile / Q000145:classification; D010696:Phloroglucinol / Q000031:analogs & derivatives; D010802:Phylogeny; D012336:RNA, Ribosomal, 16S / Q000235:genetics; D013188:Sri Lanka / Q000453:epidemiology
chemical_list: D009822:Oils, Volatile; D012336:RNA, Ribosomal, 16S; C508521:leptospermone; D010696:Phloroglucinol