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Epidemiological and clinical features of leptospirosis in a highly endemic area over three time periods
Author(s) -
MišićMajerus Ljiljana,
Habuš Josipa,
Štritof Zrinka,
Bujić Nevenka,
Mađarić Vesna,
KolaricSviben Gordana,
Vince Silvijo,
Peršić Zdenka,
Turk Nenad
Publication year - 2017
Publication title -
tropical medicine and international health
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.056
H-Index - 114
eISSN - 1365-3156
pISSN - 1360-2276
DOI - 10.1111/tmi.12967
Subject(s) - leptospirosis , epidemiology , incidence (geometry) , medicine , retrospective cohort study , pediatrics , demography , veterinary medicine , physics , sociology , optics
Objectives To present the features of human leptospirosis over three time periods (1970–1975; 2000–2005; 2010–2015), to compare the collected data and to determine whether the incidence, seasonal and spatial distribution, prevalence of presumptive infective serogroups and clinical features have changed over the last 50 years. Methods Epidemiological and clinical data obtained from patients hospitalised and treated in a well‐known endemic focus of leptospirosis, Koprivnica‐Križevci County in Croatia, were analysed. Results We observed a steady decline in the overall incidence of leptospirosis and a change in the patient age distribution, with the age ratio changing in favour of middle‐aged and older patients. Although leptospirosis was most frequently diagnosed in August in all time periods, the number of cases increased in autumn. The most prevalent serogroup during the first and the second time period was Icterohaemorrhagiae, while in the third time period, the serogroup Australis prevailed. We also noted an increase in the number of severe clinical manifestations. Conclusions This retrospective research demonstrates a continuous decline in the incidence of human leptospirosis in Croatia. The pattern of disease has changed from predominantly mild clinical forms observed in children to more severe clinical forms observed in middle‐aged to older patients, especially those working in agriculture. Additional epidemiological changes included an increase in the number of cases during the autumn months and changes in prevailing serogroups. Statistical analysis revealed a significant relationship between the severity of the clinical picture, patient age and presumed sources of infection.