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Regional differences of leptospirosis in Sri Lanka: observations from a flood-associated outbreak in 2011

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dc.contributor.author Agampodi, Suneth B.
dc.contributor.author Dahanayaka, Niroshan J.
dc.contributor.author Bandaranayaka, Anoma K.
dc.contributor.author Perera, Manoj
dc.contributor.author Priyankara, Sumudu
dc.contributor.author Weerawansa, Prasanna
dc.contributor.author Matthias, Michael A.
dc.contributor.author Vinetz, Joseph Michael
dc.date.accessioned 2020-06-10T18:12:16Z
dc.date.available 2020-06-10T18:12:16Z
dc.date.issued 2014
dc.identifier.uri https://hdl.handle.net/20.500.12866/8086
dc.description.abstract Leptospirosis is known to be an important cause of weather disaster-related infectious disease epidemics. In 2011, an outbreak of leptospirosis occurred in the relatively dry district of Anuradhapura, Sri Lanka where diagnosis was resisted by local practitioners because leptospirosis was not known in the area and the clinical presentation was considered atypical. To identify the causative Leptospira associated with this outbreak, we carried out a cross-sectional study. Consecutive clinically suspected cases in this district were studied during a two-and-a-half-month period. Of 96 clinically suspected cases, 32 (33.3%) were confirmed by qPCR, of which the etiological cause in 26 cases was identified using 16S rDNA sequencing to the species level. Median bacterial load was 4.1 x 10(2)/mL (inter-quartile range 3.1-6.1 x 10(2)/mL). In contrast to a 2008 Sri Lankan leptospirosis outbreak in the districts of Kegalle, Kandy, and Matale, in which a predominance of Leptospira interrogans serovars Lai and Geyaweera was found, most cases in the 2011 outbreak were caused by Leptospira kirschneri. Seven (21.9%) confirmed cases had acute renal failure; five (15.6%) had myocarditis; severe thrombocytopenia (<20,000/uL) was seen in five (15.6%) cases. This outbreak of leptospirosis in the relatively dry zone of Sri Lanka due primarily to L. kirschneri was characterized by markedly different clinical presentations and low leptospiremia. These observations and data demonstrate the public health relevance of molecular diagnostics in such settings, possibly related to the microgeographic variations of different Leptospira species, but of particular value to public health intervention in what appears to have been a regionally neglected tropical disease. en_US
dc.language.iso eng
dc.publisher Public Library of Science
dc.relation.ispartofseries PLoS Neglected Tropical Diseases
dc.rights info:eu-repo/semantics/restrictedAccess
dc.rights.uri https://creativecommons.org/licenses/by-nc-nd/4.0/deed.es
dc.subject Disease Outbreaks en_US
dc.subject Floods en_US
dc.subject Adult en_US
dc.subject Cross-Sectional Studies en_US
dc.subject DNA, Bacterial/chemistry/genetics en_US
dc.subject DNA, Ribosomal/chemistry/genetics en_US
dc.subject Female en_US
dc.subject Humans en_US
dc.subject Leptospira/classification/genetics/isolation & purification en_US
dc.subject Leptospirosis/epidemiology/microbiology/pathology en_US
dc.subject Male en_US
dc.subject Middle Aged en_US
dc.subject Real-Time Polymerase Chain Reaction en_US
dc.subject RNA, Ribosomal, 16S/genetics en_US
dc.subject Sequence Analysis, DNA en_US
dc.subject Sri Lanka/epidemiology en_US
dc.title Regional differences of leptospirosis in Sri Lanka: observations from a flood-associated outbreak in 2011 en_US
dc.type info:eu-repo/semantics/article
dc.identifier.doi https://doi.org/10.1371/journal.pntd.0002626
dc.subject.ocde https://purl.org/pe-repo/ocde/ford#3.03.06
dc.relation.issn 1935-2735


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