Laboratory diagnostic, epidemiological, and clinical characteristics of human leptospirosis in Okinawa Prefecture, Japan, 2003-2020
Leptospirosis is considered an endemic disease among agricultural workers in Okinawa Prefecture, which is the southernmost part of Japan and has a subtropical climate, but data on the current status and trend of this disease are scarce. We conducted a retrospective study of clinically suspected lept...
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| Veröffentlicht in: | PLoS neglected tropical diseases 2021-12, Vol.15 (12), p.e0009993-e0009993 |
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| creator | Kakita, Tetsuya Okano, Sho Kyan, Hisako Miyahira, Masato Taira, Katsuya Kitashoji, Emi Koizumi, Nobuo |
| description | Leptospirosis is considered an endemic disease among agricultural workers in Okinawa Prefecture, which is the southernmost part of Japan and has a subtropical climate, but data on the current status and trend of this disease are scarce.
We conducted a retrospective study of clinically suspected leptospirosis patients whose sample and information were sent to the Okinawa Prefectural Institute of Health and Environment from November 2003 to December 2020. Laboratory diagnosis was established using culture, nested polymerase chain reaction (PCR), and/or microscopic agglutination test (MAT) with blood, cerebrospinal fluid, and/or urine samples. Statistical analyses were performed to compare the epidemiological information, clinical features, and sensitivities of diagnostic methods among laboratory-confirmed cases. Serogroups and the species of Leptospira isolates were determined by MAT using 13 antisera and flaB sequencing. A total of 531 clinically suspected patients were recruited, among whom 246 (46.3%) were laboratory confirmed to have leptospirosis. Among the confirmed cases, patients aged 20-29 years (22.4%) and male patients (85.7%) were the most common. The most common estimated sources of infection were recreation (44.5%) and labor (27.8%) in rivers. Approximately half of the isolates were of the L. interrogans serogroup Hebdomadis. The main clinical symptoms were fever (97.1%), myalgia (56.3%), and conjunctival hyperemia (52.2%). Headache occurred significantly more often in patients with Hebdomadis serogroup infections than those with other serogroup infections. The sensitivities of culture and PCR exceeded 65% during the first 6 days, while the sensitivity of MAT surpassed that of culture and PCR in the second week after onset. PCR using blood samples was a preferable method for the early diagnosis of leptospirosis.
The results of this study will support clinicians in the diagnosis and treatment of undifferentiated febrile patients in Okinawa Prefecture as well as patients returning from Okinawa Prefecture. |
| doi_str_mv | 10.1371/journal.pntd.0009993 |
| format | Article |
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We conducted a retrospective study of clinically suspected leptospirosis patients whose sample and information were sent to the Okinawa Prefectural Institute of Health and Environment from November 2003 to December 2020. Laboratory diagnosis was established using culture, nested polymerase chain reaction (PCR), and/or microscopic agglutination test (MAT) with blood, cerebrospinal fluid, and/or urine samples. Statistical analyses were performed to compare the epidemiological information, clinical features, and sensitivities of diagnostic methods among laboratory-confirmed cases. Serogroups and the species of Leptospira isolates were determined by MAT using 13 antisera and flaB sequencing. A total of 531 clinically suspected patients were recruited, among whom 246 (46.3%) were laboratory confirmed to have leptospirosis. Among the confirmed cases, patients aged 20-29 years (22.4%) and male patients (85.7%) were the most common. The most common estimated sources of infection were recreation (44.5%) and labor (27.8%) in rivers. Approximately half of the isolates were of the L. interrogans serogroup Hebdomadis. The main clinical symptoms were fever (97.1%), myalgia (56.3%), and conjunctival hyperemia (52.2%). Headache occurred significantly more often in patients with Hebdomadis serogroup infections than those with other serogroup infections. The sensitivities of culture and PCR exceeded 65% during the first 6 days, while the sensitivity of MAT surpassed that of culture and PCR in the second week after onset. PCR using blood samples was a preferable method for the early diagnosis of leptospirosis.
The results of this study will support clinicians in the diagnosis and treatment of undifferentiated febrile patients in Okinawa Prefecture as well as patients returning from Okinawa Prefecture.</description><identifier>ISSN: 1935-2735</identifier><identifier>ISSN: 1935-2727</identifier><identifier>EISSN: 1935-2735</identifier><identifier>DOI: 10.1371/journal.pntd.0009993</identifier><identifier>PMID: 34905535</identifier><language>eng</language><publisher>United States: Public Library of Science</publisher><subject>Academies and Institutes ; Adult ; Agglutination ; Agglutination tests ; Agriculture ; Antibodies ; Antisera ; Biology and Life Sciences ; Blood ; Cerebrospinal fluid ; Conjunctivitis - epidemiology ; Conjunctivitis - microbiology ; Culture ; Demographic aspects ; Dengue fever ; Diagnosis ; Diagnostic systems ; Earth Sciences ; Ecology and Environmental Sciences ; Endemic Diseases ; Epidemiology ; Farmworkers ; Female ; Fever ; Fever - epidemiology ; Fever - microbiology ; Headache - epidemiology ; Headache - microbiology ; Health surveillance ; Hemorrhage ; Humans ; Hyperemia ; Infections ; Infectious diseases ; Japan - epidemiology ; Laboratories ; Labour ; Leptospira - classification ; Leptospira - genetics ; Leptospira - immunology ; Leptospira - pathogenicity ; Leptospirosis ; Leptospirosis - diagnosis ; Leptospirosis - epidemiology ; Leptospirosis - physiopathology ; Male ; Medicine and Health Sciences ; Mortality ; Myalgia ; Myalgia - epidemiology ; Myalgia - microbiology ; Nucleotide sequence ; Patients ; PCR ; Polymerase chain reaction ; Research and Analysis Methods ; Retrospective Studies ; Rivers ; Samples ; Sensitivity ; Serogroup ; Signs and symptoms ; Statistical analysis ; Statistical methods ; Statistics ; Symptoms ; Tropical diseases ; Urine ; Young Adult</subject><ispartof>PLoS neglected tropical diseases, 2021-12, Vol.15 (12), p.e0009993-e0009993</ispartof><rights>COPYRIGHT 2021 Public Library of Science</rights><rights>2021 Kakita et al. This is an open access article distributed under the terms of the Creative Commons Attribution License: http://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>2021 Kakita et al 2021 Kakita et al</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c690t-47ffc87a69167febfb17f9f3548086df5ee17a1ce8c9c438e1fcef7edc5942d53</citedby><cites>FETCH-LOGICAL-c690t-47ffc87a69167febfb17f9f3548086df5ee17a1ce8c9c438e1fcef7edc5942d53</cites><orcidid>0000-0002-5733-535X ; 0000-0002-8991-7397</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC8670671/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC8670671/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,724,777,781,861,882,2096,2915,23847,27905,27906,53772,53774,79349,79350</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/34905535$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><contributor>Neela, Vasantha kumari</contributor><creatorcontrib>Kakita, Tetsuya</creatorcontrib><creatorcontrib>Okano, Sho</creatorcontrib><creatorcontrib>Kyan, Hisako</creatorcontrib><creatorcontrib>Miyahira, Masato</creatorcontrib><creatorcontrib>Taira, Katsuya</creatorcontrib><creatorcontrib>Kitashoji, Emi</creatorcontrib><creatorcontrib>Koizumi, Nobuo</creatorcontrib><title>Laboratory diagnostic, epidemiological, and clinical characteristics of human leptospirosis in Okinawa Prefecture, Japan, 2003-2020</title><title>PLoS neglected tropical diseases</title><addtitle>PLoS Negl Trop Dis</addtitle><description>Leptospirosis is considered an endemic disease among agricultural workers in Okinawa Prefecture, which is the southernmost part of Japan and has a subtropical climate, but data on the current status and trend of this disease are scarce.
We conducted a retrospective study of clinically suspected leptospirosis patients whose sample and information were sent to the Okinawa Prefectural Institute of Health and Environment from November 2003 to December 2020. Laboratory diagnosis was established using culture, nested polymerase chain reaction (PCR), and/or microscopic agglutination test (MAT) with blood, cerebrospinal fluid, and/or urine samples. Statistical analyses were performed to compare the epidemiological information, clinical features, and sensitivities of diagnostic methods among laboratory-confirmed cases. Serogroups and the species of Leptospira isolates were determined by MAT using 13 antisera and flaB sequencing. A total of 531 clinically suspected patients were recruited, among whom 246 (46.3%) were laboratory confirmed to have leptospirosis. Among the confirmed cases, patients aged 20-29 years (22.4%) and male patients (85.7%) were the most common. The most common estimated sources of infection were recreation (44.5%) and labor (27.8%) in rivers. Approximately half of the isolates were of the L. interrogans serogroup Hebdomadis. The main clinical symptoms were fever (97.1%), myalgia (56.3%), and conjunctival hyperemia (52.2%). Headache occurred significantly more often in patients with Hebdomadis serogroup infections than those with other serogroup infections. The sensitivities of culture and PCR exceeded 65% during the first 6 days, while the sensitivity of MAT surpassed that of culture and PCR in the second week after onset. PCR using blood samples was a preferable method for the early diagnosis of leptospirosis.
The results of this study will support clinicians in the diagnosis and treatment of undifferentiated febrile patients in Okinawa Prefecture as well as patients returning from Okinawa Prefecture.</description><subject>Academies and Institutes</subject><subject>Adult</subject><subject>Agglutination</subject><subject>Agglutination tests</subject><subject>Agriculture</subject><subject>Antibodies</subject><subject>Antisera</subject><subject>Biology and Life Sciences</subject><subject>Blood</subject><subject>Cerebrospinal fluid</subject><subject>Conjunctivitis - epidemiology</subject><subject>Conjunctivitis - microbiology</subject><subject>Culture</subject><subject>Demographic aspects</subject><subject>Dengue fever</subject><subject>Diagnosis</subject><subject>Diagnostic systems</subject><subject>Earth Sciences</subject><subject>Ecology and Environmental Sciences</subject><subject>Endemic Diseases</subject><subject>Epidemiology</subject><subject>Farmworkers</subject><subject>Female</subject><subject>Fever</subject><subject>Fever - epidemiology</subject><subject>Fever - microbiology</subject><subject>Headache - epidemiology</subject><subject>Headache - microbiology</subject><subject>Health surveillance</subject><subject>Hemorrhage</subject><subject>Humans</subject><subject>Hyperemia</subject><subject>Infections</subject><subject>Infectious diseases</subject><subject>Japan - epidemiology</subject><subject>Laboratories</subject><subject>Labour</subject><subject>Leptospira - classification</subject><subject>Leptospira - genetics</subject><subject>Leptospira - immunology</subject><subject>Leptospira - pathogenicity</subject><subject>Leptospirosis</subject><subject>Leptospirosis - diagnosis</subject><subject>Leptospirosis - epidemiology</subject><subject>Leptospirosis - physiopathology</subject><subject>Male</subject><subject>Medicine and Health Sciences</subject><subject>Mortality</subject><subject>Myalgia</subject><subject>Myalgia - epidemiology</subject><subject>Myalgia - microbiology</subject><subject>Nucleotide sequence</subject><subject>Patients</subject><subject>PCR</subject><subject>Polymerase chain reaction</subject><subject>Research and Analysis Methods</subject><subject>Retrospective Studies</subject><subject>Rivers</subject><subject>Samples</subject><subject>Sensitivity</subject><subject>Serogroup</subject><subject>Signs and symptoms</subject><subject>Statistical analysis</subject><subject>Statistical methods</subject><subject>Statistics</subject><subject>Symptoms</subject><subject>Tropical diseases</subject><subject>Urine</subject><subject>Young Adult</subject><issn>1935-2735</issn><issn>1935-2727</issn><issn>1935-2735</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>DOA</sourceid><recordid>eNptkstu1DAUhiMEoqXwBggsISEWM4Mdx3G8QaoqLkWVygLW1oljz3jw2MFOQF3z4jidtJpBlRe-fec_F_1F8ZLgFaGcvN-GMXpwq94P3QpjLISgj4pTIihblpyyxwfnk-JZSluMmWANeVqc0Epgxig7Lf5eQRsiDCHeoM7C2oc0WLVAured3tngwtoqcAsEvkPKWT_dkNpABDXoaCc6oWDQZtyBR073Q0i9jSHZhKxH1z-thz-AvkVttBrGqBfoK_TgF6jEmC5LXOLnxRMDLukX835W_Pj08fvFl-XV9efLi_OrpaoFHpYVN0Y1HGpBam50a1rCjTCUVQ1u6s4wrQkHonSjhKpoo4lR2nDdKSaqsmP0rHi91-1dSHKeX5JlXWJCKME8E5d7oguwlX20O4g3MoCVtw8hriXE3LHTMielvG5UVUJZYcZbDDl5WXe4bKHSOmt9mLON7S4Xof0QwR2JHv94u5Hr8Fs2Ncc1J1ng3SwQw69Rp0HubFLaOfA6jFPdBFeEilv0zX_ow93N1BpyA9abkPOqSVSe100jqGCEZmr1AJXX5AcVvDY2vx8FvD0I2GhwwyYFNw42-HQMVntQZXukbIj7YRAsJ0_fVS0nT8vZ0zns1eEg74PuTEz_AbGw88g</recordid><startdate>20211201</startdate><enddate>20211201</enddate><creator>Kakita, Tetsuya</creator><creator>Okano, Sho</creator><creator>Kyan, Hisako</creator><creator>Miyahira, Masato</creator><creator>Taira, Katsuya</creator><creator>Kitashoji, Emi</creator><creator>Koizumi, Nobuo</creator><general>Public Library of Science</general><general>Public Library of Science (PLoS)</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7QL</scope><scope>7SS</scope><scope>7T2</scope><scope>7T7</scope><scope>7U9</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8C1</scope><scope>8FD</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AEUYN</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>C1K</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>F1W</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>H94</scope><scope>H95</scope><scope>H97</scope><scope>K9.</scope><scope>L.G</scope><scope>M0S</scope><scope>M1P</scope><scope>M7N</scope><scope>P64</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><scope>5PM</scope><scope>DOA</scope><orcidid>https://orcid.org/0000-0002-5733-535X</orcidid><orcidid>https://orcid.org/0000-0002-8991-7397</orcidid></search><sort><creationdate>20211201</creationdate><title>Laboratory diagnostic, epidemiological, and clinical characteristics of human leptospirosis in Okinawa Prefecture, Japan, 2003-2020</title><author>Kakita, Tetsuya ; Okano, Sho ; Kyan, Hisako ; Miyahira, Masato ; Taira, Katsuya ; Kitashoji, Emi ; Koizumi, Nobuo</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c690t-47ffc87a69167febfb17f9f3548086df5ee17a1ce8c9c438e1fcef7edc5942d53</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Academies and Institutes</topic><topic>Adult</topic><topic>Agglutination</topic><topic>Agglutination tests</topic><topic>Agriculture</topic><topic>Antibodies</topic><topic>Antisera</topic><topic>Biology and Life Sciences</topic><topic>Blood</topic><topic>Cerebrospinal fluid</topic><topic>Conjunctivitis - 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We conducted a retrospective study of clinically suspected leptospirosis patients whose sample and information were sent to the Okinawa Prefectural Institute of Health and Environment from November 2003 to December 2020. Laboratory diagnosis was established using culture, nested polymerase chain reaction (PCR), and/or microscopic agglutination test (MAT) with blood, cerebrospinal fluid, and/or urine samples. Statistical analyses were performed to compare the epidemiological information, clinical features, and sensitivities of diagnostic methods among laboratory-confirmed cases. Serogroups and the species of Leptospira isolates were determined by MAT using 13 antisera and flaB sequencing. A total of 531 clinically suspected patients were recruited, among whom 246 (46.3%) were laboratory confirmed to have leptospirosis. Among the confirmed cases, patients aged 20-29 years (22.4%) and male patients (85.7%) were the most common. The most common estimated sources of infection were recreation (44.5%) and labor (27.8%) in rivers. Approximately half of the isolates were of the L. interrogans serogroup Hebdomadis. The main clinical symptoms were fever (97.1%), myalgia (56.3%), and conjunctival hyperemia (52.2%). Headache occurred significantly more often in patients with Hebdomadis serogroup infections than those with other serogroup infections. The sensitivities of culture and PCR exceeded 65% during the first 6 days, while the sensitivity of MAT surpassed that of culture and PCR in the second week after onset. PCR using blood samples was a preferable method for the early diagnosis of leptospirosis.
The results of this study will support clinicians in the diagnosis and treatment of undifferentiated febrile patients in Okinawa Prefecture as well as patients returning from Okinawa Prefecture.</abstract><cop>United States</cop><pub>Public Library of Science</pub><pmid>34905535</pmid><doi>10.1371/journal.pntd.0009993</doi><orcidid>https://orcid.org/0000-0002-5733-535X</orcidid><orcidid>https://orcid.org/0000-0002-8991-7397</orcidid><oa>free_for_read</oa></addata></record> |
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| issn | 1935-2735 1935-2727 1935-2735 |
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| recordid | cdi_plos_journals_2620113107 |
| source | MEDLINE; Public Library of Science; PubMed Central; Directory of Open Access Journals; EZB Electronic Journals Library; PubMed Central Open Access |
| subjects | Academies and Institutes Adult Agglutination Agglutination tests Agriculture Antibodies Antisera Biology and Life Sciences Blood Cerebrospinal fluid Conjunctivitis - epidemiology Conjunctivitis - microbiology Culture Demographic aspects Dengue fever Diagnosis Diagnostic systems Earth Sciences Ecology and Environmental Sciences Endemic Diseases Epidemiology Farmworkers Female Fever Fever - epidemiology Fever - microbiology Headache - epidemiology Headache - microbiology Health surveillance Hemorrhage Humans Hyperemia Infections Infectious diseases Japan - epidemiology Laboratories Labour Leptospira - classification Leptospira - genetics Leptospira - immunology Leptospira - pathogenicity Leptospirosis Leptospirosis - diagnosis Leptospirosis - epidemiology Leptospirosis - physiopathology Male Medicine and Health Sciences Mortality Myalgia Myalgia - epidemiology Myalgia - microbiology Nucleotide sequence Patients PCR Polymerase chain reaction Research and Analysis Methods Retrospective Studies Rivers Samples Sensitivity Serogroup Signs and symptoms Statistical analysis Statistical methods Statistics Symptoms Tropical diseases Urine Young Adult |
| title | Laboratory diagnostic, epidemiological, and clinical characteristics of human leptospirosis in Okinawa Prefecture, Japan, 2003-2020 |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-17T17%3A59%3A55IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-gale_plos_&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Laboratory%20diagnostic,%20epidemiological,%20and%20clinical%20characteristics%20of%20human%20leptospirosis%20in%20Okinawa%20Prefecture,%20Japan,%202003-2020&rft.jtitle=PLoS%20neglected%20tropical%20diseases&rft.au=Kakita,%20Tetsuya&rft.date=2021-12-01&rft.volume=15&rft.issue=12&rft.spage=e0009993&rft.epage=e0009993&rft.pages=e0009993-e0009993&rft.issn=1935-2735&rft.eissn=1935-2735&rft_id=info:doi/10.1371/journal.pntd.0009993&rft_dat=%3Cgale_plos_%3EA688939513%3C/gale_plos_%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=2620113107&rft_id=info:pmid/34905535&rft_galeid=A688939513&rft_doaj_id=oai_doaj_org_article_4803768c42a24057b0a7a126d02ba4ee&rfr_iscdi=true |