title: An Unprecedented High Incidence of Leptospirosis in Futuna, South Pacific, 2004 - 2014, Evidenced by Retrospective Analysis of Surveillance Data.
abstract: Futuna is a small Polynesian island in the South Pacific with a population of 3,612 in 2013. The first human leptospirosis case was confirmed in 1997. Active surveillance started in 2004. Cases were confirmed by PCR or real time PCR, or by serology using MAT or a combination of IgM-ELISA and MAT. A retrospective analysis of surveillance data shows that the disease was endemic with a mean annual incidence of 844 cases per 100,000 over an 11-year period from 2004 to 2014. An epidemic peak as high as 1,945 cases per 100,000 occurred in 2008. Serogroup Australis was predominant until 2007, Icterohaemorrhagiae was dominant afterwards. Cluster analysis revealed different hot spots over time. Lifestyle habits, such as walking barefoot in irrigated taro fields or pig pens probably contributed to contamination from the swine and rodent reservoirs to humans. Severe forms were rare, and the case fatality rate was 0.5%. The medical community and general population were aware of leptospirosis and rapid treatment with amoxycillin was the main treatment, probably contributing to this low fatality rate.
authors.affiliation: Agence de Santé des îles Wallis & Futuna, Laboratoire de biologie médicale/hôpital de SIA, BP 4G, 98 600 Mata'Utu, Wallis & Futuna.
authors.forename: Denis
authors.initials: D
authors.lastname: Massenet
authors.affiliation: Agence de Santé des îles Wallis & Futuna, Laboratoire de biologie médicale/hôpital de SIA, BP 4G, 98 600 Mata'Utu, Wallis & Futuna; Laboratoire de Ducos, BP 3931, 98846 Nouméa, New Caledonia.
authors.forename: Jean-François
authors.initials: JF
authors.lastname: Yvon
authors.affiliation: Agence de Santé des îles Wallis & Futuna, Laboratoire de biologie médicale/hôpital de SIA, BP 4G, 98 600 Mata'Utu, Wallis & Futuna.
authors.forename: Clément
authors.initials: C
authors.lastname: Couteaux
authors.affiliation: Institut Pasteur in New Caledonia, Institut Pasteur International Network, Leptospirosis Research and Expertise Unit, 9-11 Avenue Paul Doumer, BP 61, 98 845 Noumea, New Caledonia.
authors.forename: Cyrille
authors.initials: C
authors.lastname: Goarant
mesh_terms: D000658:Amoxicillin / Q000008:administration & dosage; D000818:Animals; D062665:Epidemiological Monitoring; D005260:Female; D006801:Humans; D015994:Incidence; D007922:Leptospirosis / Q000188:drug therapy / Q000453:epidemiology*; D008019:Life Style; D008297:Male; D011114:Polynesia / Q000453:epidemiology; D012377:Rodentia; D013552:Swine
chemical_list: D000658:Amoxicillin