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. 2014 Jan 10;11(1):968-82.
doi: 10.3390/ijerph110100968.

Human leptospirosis on Reunion Island: past and current burden

Frédéric Pagès  1 , Dominique Polycarpe  2 , Jean-Sébastien Dehecq  3 , Mathieu Picardeau  4 , Nadège Caillère  5 , Marie-Christine Jaffar-Bandjee  6 , Alain Michault  7 , Laurent Filleul  8
Affiliations

Human leptospirosis on Reunion Island: past and current burden

Frédéric Pagès et al. Int J Environ Res Public Health. .

Abstract

Since 1953, leptospirosis has been recognized as a public health problem on Reunion Island. In 2004, was implemented a specific surveillance system that included systematic reporting and the realization of environmental investigations around hospitalized cases. Here, we present the synthesis of historical data and the assessment of 9 years of leptospirosis surveillance. From 2004 to 2012, 414 hospitalized cases were reported. Cases of leptospirosis occurred mostly during the rainy season from December to May. Approximately 41% of infections occurred at home, 12% of infections occurred during aquatic leisure and 5% of cases were linked to professional activities. Furthermore, for 41% of cases, the place of infection could not be determined due to the accumulation of residential and non-residential exposure. Most of the cases of leptospirosis were linked to rural areas or traditional, rural occupations. We did not observe a shift to recreational leptospirosis as described in some developed countries. According to the new surveillance system, the number of reported cases has regularly increased since 2004. This situation is in part due to the improvement of the system in the first years but also to a real increase in the number of detected cases due to the introduction of molecular methods and to increased biological investigation into the Dengue-like syndrome by medical practitioners on the island since the Chikungunya crisis in 2006. This increase is probably due to surveillance and diagnosis biases but need to be carefully monitored. Nevertheless, the possibility of an outbreak is always present due to climatic events, such as after the "hyacinth" hurricane in 1980.

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Figures

Figure 1
Figure 1
(a) Monthly repartition of the 414 cases of leptospirosis reported on Reunion Island from 2004 to 2012. (b) Evolution of the incidence and the incidence rate of Leptospirosis on Reunion Island from 2004 to 2012.
Figure 2
Figure 2
The change in the average incidence of leptospirosis on Reunion Island by commune between 2008 and 2012 is shown.
Figure 3
Figure 3
The distribution of the first symptoms described by leptospirosis cases, and the distribution of clinical manifestations of leptospirosis reported by medical practitioners from 2004 to 2012 on Reunion Island.
Figure 4
Figure 4
The distribution of cases by age and sex (women are shown in black columns and the men are shown in white columns) for the 405 hospitalized (a) and 32 non-hospitalized (b) cases reported from 2004 to 2012 on Reunion Island.
See this image and copyright information in PMC

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