Leptospirosis Enhanced Surveillance System in Santa Fe and Entre Ríos (2012-2013)

Abstract

INTRODUCTION: Leptospirosis is the most prevalent zoonosis worldwide. In Argentina, Santa Fe and Entre Ríos are the provinces where most cases occur. OBJECTIVE: To implement and describe a system of enhanced surveillance of leptospirosis in Santa Fe and Entre Ríos. METHODS: The enhanced surveillance was carried out from January 2012 to March 2013. The study involved the intervention in health services and systems as well as the laboratory network strengthening for specific diagnosis and leptospira isolation. The information collected from clinicalepidemiological records of confirmed cases was analyzed and presented through summary measures. The surveillance was implemented in seven strategic hospitals. RESULTS: A total of 183 patients were enrolled, and 24 cases (13%) were confirmed: 10 through MAT, 9 through real time PCR and 5 through both methods. It was possible to obtain 3 isolates (Canicola serogroup). 4 patients died with pulmonary hemorrhage coupled with renal impairment, hepatic and/ or thrombocytopenia. CONCLUSIONS: The enhanced surveillance allowed to obtain human isolates, confirmed the diagnostic value of MAT, showed the utility of real time PCR for early diagnosis and the difficulties to obtain second samples. The clinical presentation revealed a high global mortality and a high frequency of respiratory involvement related to multiple organ dysfunctions from early stages.