Leptospirosis outbreak following severe flooding: a rapid assessment and mass prophylaxis campaign; Guyana, January-February 2005.
BACKGROUND
Leptospirosis is a zoonosis usually transmitted through contact with water or soil contaminated with urine from infected animals. Severe flooding can put individuals at greater risk for contracting leptospirosis in endemic areas. Rapid testing for the disease and large-scale interventions are necessary to identify and control infection. We describe a leptospirosis outbreak following severe flooding and a mass chemoprophylaxis campaign in Guyana.


RESULTS
From January-March 2005, we collected data on suspected leptospirosis hospitalizations and deaths. Laboratory testing included anti-leptospiral dot enzyme immunoassay (DST), immunohistochemistry (IHC) staining, and microscopic agglutination testing (MAT). DST testing was conducted for 105 (44%) of 236 patients; 52 (50%) tested positive. Four (57%) paired serum samples tested by MAT were confirmed leptospirosis. Of 34 total deaths attributed to leptospirosis, postmortem samples from 10 (83%) of 12 patients were positive by IHC. Of 201 patients interviewed, 89% reported direct contact with flood waters. A 3-week doxycycline chemoprophylaxis campaign reached over 280,000 people.


CONCLUSIONS
A confirmed leptospirosis outbreak in Guyana occurred after severe flooding, resulting in a massive chemoprophylaxis campaign to try to limit morbidity and mortality.
Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America. adechet@gmail.com
Amy M
AM
Dechet
Michele
M
Parsons
Madan
M
Rambaran
Pheona
P
Mohamed-Rambaran
Anita
A
Florendo-Cumbermack
Shamdeo
S
Persaud
Shirematee
S
Baboolal
Mary D
MD
Ari
Sean V
SV
Shadomy
Sherif R
SR
Zaki
Christopher D
CD
Paddock
Thomas A
TA
Clark
Lazenia
L
Harris
Douglas
D
Lyon
Eric D
ED
Mintz
D000328:Adult; D000372:Agglutination Tests; D000818:Animals; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D004196:Disease Outbreaks; D004318:Doxycycline / Q000627:therapeutic use*; D005260:Female; D055868:Floods; D006172:Guyana / Q000453:epidemiology; D006801:Humans; D007118:Immunoassay; D007150:Immunohistochemistry; D007919:Leptospira / Q000472:pathogenicity* / Q000502:physiology; D007922:Leptospirosis / Q000453:epidemiology* / Q000382:microbiology / Q000401:mortality / Q000517:prevention & control*; D008297:Male; D015996:Survival Rate
D000900:Anti-Bacterial Agents; D004318:Doxycycline