Open AccessLeptospirosis Outbreak following Severe Flooding: A Rapid Assessment and Mass Prophylaxis Campaign; Guyana, January–February 2005
Author(s) -
Amy Dechet,
Michele B. Parsons,
Madan Rambaran,
Pheona Mohamed-Rambaran,
Anita Florendo-Cumbermack,
S. Persaud,
Shirematee Baboolal,
Mary D. Ari,
Sean V. Shadomy,
Sherif R. Zaki,
Christopher D. Paddock,
Thomas A. Clark,
Lazenia Harris,
Douglas Lyon,
Eric D. Mintz
Publication year - 2012
Publication title -
plos one
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.99
H-Index - 332
ISSN - 1932-6203
DOI - 10.1371/journal.pone.0039672
Subject(s) - leptospirosis , outbreak , medicine , chemoprophylaxis , direct agglutination test , zoonosis , environmental health , veterinary medicine , serology , virology , immunology , antibody
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. Methodology/Principal Findings 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.