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Leptospirosis outbreak in Sri Lanka in 2008: Lessons for assessing the global burden of disease

  • Suneth B. Agampodi
  • , Sharon J. Peacock
  • , Vasanthi Thevanesam
  • , Danaseela B. Nugegoda
  • , Lee Smythe
  • , Janjira Thaipadungpanit
  • , Scott B. Craig
  • , Mary Ann Burns
  • , Michael Dohnt
  • , Siriphan Boonsilp
  • , Thamarasi Senaratne
  • , Athula Kumara
  • , Paba Palihawadana
  • , Sahan Perera
  • , Joseph M. Vinetz
  • University of Colombo
  • Department of Medicine
  • Mahidol-Oxford Tropical Medicine Research Unit
  • Faculty of Tropical Medicine, Mahidol University
  • Department of Medicine
  • Faculty of Medicine, University of Peradeniya
  • World Organisation for Animal Health (WOAH)
  • University of the Sunshine Coast
  • Ministry of Health Colombo

Research output: Contribution to journalArticlepeer-review

77 Scopus citations

Abstract

Global leptospirosis disease burden estimates are hampered by the lack of scientifically sound data from countries with probable high endemicity and limited diagnostic capacities. We describe the seroepidemiologic and clinical characteristics of the leptospirosis outbreak in 2008 in Sri Lanka. Definitive/presumptive case definitions proposed by the World Health Organization Leptospirosis Epidemiology Reference Group were used for case confirmation. Of the 404 possible cases, 155 were confirmed to have leptospirosis. Highest titers of patient seum samples reacted with serovars Pyrogenes (28.7%), Hardjo (18.8%), Javanica (11.5%), and Hebdomadis (11.5%). Sequencing of the 16S ribosomal DNA gene identified six infections: five with Leptospira interrogans and one with L. weilli. In this patient population, acute renal failure was the main complication (14.8%), followed by myocarditis (7.1%) and heart failure (3.9%). The case-fatality rate was 1.3%. This report strengthens the urgent need for increasing laboratory diagnostic capabilities to determine the causes of epidemic and endemic infectious diseases in Sri Lanka, a finding relevant to other tropical regions.

Original languageEnglish
Pages (from-to)471-478
Number of pages8
JournalAmerican Journal of Tropical Medicine and Hygiene
Volume85
Issue number3
DOIs
StatePublished - Sep 2011
Externally publishedYes

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