| Amilasan et al.47
|
The Philippines, 2009 |
Hospital-based investigation- investigating risk factors for leptospirosis mortality following flooding. Prospective surveillance and retrospective data collection. |
Outbreak of 471 leptospirosis cases, 51 cases died. Patients predominately young and male. Delayed initiation of treatment, older age, jaundice, anuria, hemoptysis increased risk for death. |
| Bhardwaj et al.33
|
India, 2006 |
Case-control study- identifying risk factors for leptospirosis during flooding. 62 confirmed cases and 253 age and sex matched fever and healthy controls given a questionnaire. |
4 factors identified by multivariate analysis: contact of injured part with floodwater (OR 6.69; 95% CI 3.05–14.64), walking barefoot (OR 4.95; 95% CI 2.22–11.06), constant presence of rats (OR 4.95; 95% CI 1.53–16.05), spending > 4 d cleaning (OR 2.64; 85% CI 1.18–5.89). |
| Chiu et al.48
|
Taiwan, 2004–2008 |
Routine data- analyze characteristics of patients with laboratory-diagnosed leptospirosis and correlate onset of symptoms with exposure to floodwater. |
6 patients identified with history of contact with contaminated soil/water. 5/6 patients (83%) suffered from leptospirosis after typhoon. |
| Dechet et al.44
|
Guyana, 2005 |
Routine data- laboratory testing on suspected leptospirosis hospitalizations and deaths. Confirmed outbreak of leptospirosis after severe flooding. |
Of 236 suspected cases admitted, 105 (44%) tested with Dip-S-Tick IgM ELISA; 52 (50%) positive, 41 (39%) negative, and 12 (11%) indeterminate. 34 deaths attributed (11 confirmed, 10 probable, 13 suspected) to leptospirosis. Of 201 patients interviewed, 89% reported floodwater contact. |
| Desai et al.34
|
Germany, 2007 |
Retrospective cohort study- leptospirosis in strawberry harvesters. Local rodents examined for leptospirosis. |
13 confirmed patients. Risk of disease increased with each day an individual worked in the rain with hand wounds (OR = 1.1; 95% CI, 1.04–1.14) and accidental rodent contact (OR = 4.8; 95% CI 1.5–15.9). |
| Gaynor et al.35
|
United States, 2004 |
Outbreak investigation- leptospirosis. |
271 persons responded to Internet survey, 90 (33%) reported febrile illness within 30 d of floodwater contact. One additional acute leptospirosis case identified. Patient 2 epidemiologically linked to Patient 1. |
| Maskey et al.45
|
India, 2001–2005 |
Longitudinal study- prevalence of leptospirosis. |
8 fold rise in leptospirosis in 2005 observed after heavy rainfall and water logging. 432 laboratory confirmed cases. |
| Pellizzer et al.36
|
Italy, 2002 |
Sero-epidemiogical study- evaluated leptospirosis risk in flood-exposed population. |
7/44 patients exposed to floodwaters exhibited anti-Leptospira specific IgM antibodies and 5 confirmed positive. Re-testing months later found significant antibody titers > 100 against serovar Copenhangeni in 3 cases (6.8% seroconversion rate). Flooding appeared to be sole risk factor, verification not possible due to lack of control group. |
| Radl et al.43
|
Austria, 2010 |
Outbreak investigation- leptospirosis. |
1st documented outbreak of leptospirosis in Austria. Four serologically confirmed cases, all triathlon athletes. Triathlon preceded by heavy rainfall (22mm). Cases contracted leptospirosis while swimming in recreational body of water. |
| Renato et al.37
|
Mexico, 2007 |
Outbreak investigation- leptospirosis. |
165 hospital cases showed febrile illness: 30 (18.2%) leptospirosis. 12/30 cases of leptospirosis confirmed serologically, all with moderate to severe floodwater contact. 4/12 positive cases died. |
| Smith et al.46
|
Australia, 2011 |
Routine data- leptospirosis surveillance. |
9 cases confirmed, all with floodwater exposure. 1st reported outbreak in central Queensland. |
| Socolovschi et al.38
|
France, 2009 |
Longitudinal-study- leptospirosis cases compared with weather conditions and garbage management strikes. |
3 autochthonous cases identified in Marseilles (October 2009) preceded by heavy rainfall. 1st autochthonous case identified after period of flooding preceded by heavy rainfall over several days (34.6 mm/day; 79.2 mm/day; 137 mm/day with an episode of 63 mm/3hr). Two autochthonous cases occurred during period of high rainfall (13.6–23.8 mm). |
| Zitek and Benes41
|
Czech Republic, 1997,2002 |
Routine data- leptospirosis surveillance. |
Rates of reported and serologically confirmed cases of leptospirosis 3 times higher with specific morbidity (0.9 cases/100,000 inhabitants). 94 confirmed cases in 1997 and 92 confirmed cases in 2002. Two-thirds from inundation areas, half directly associated with floodwater. |
