菲奥娜 "飓风过后爆发钩端螺旋体病--波多黎各,2022 年。

IF 25.4 1区 医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH
Forrest K Jones, Abigail G Medina, Kyle R Ryff, Jessica Irizarry-Ramos, Joshua M Wong, Eduardo O'Neill, Ismael A Rodríguez, Iris Cardona, Lorena Hernández, Alfonso C Hernandez-Romieu, Maile T Phillips, Michael A Johansson, Tesfaye Bayleyegn, Christine Atherstone, Katherine Roguski DeBord, María E Negrón, Renee Galloway, Laura E Adams, Melissa Marzán-Rodríguez
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引用次数: 0

摘要

钩端螺旋体病是一种急性细菌性人畜共患病,在波多黎各呈地方性流行。大约 10%-15%的临床患者感染后会发展成严重的、可能致命的疾病。发病率的增加与世界各地流行地区的洪水有关。2022 年,1 级飓风 "菲奥娜 "登陆波多黎各,暴雨成灾,洪水泛滥,增加了钩端螺旋体病爆发的风险。为此,波多黎各卫生部(PRDH)修改了指导方针,规定钩端螺旋体病病例应在 24 小时内报告,集中管理病例调查管理系统,并向医疗保健提供者提供培训和信息。为了评估飓风菲奥娜过后与飓风之前钩端螺旋体病风险的变化,我们对病例的增加进行了量化,并对患者特征和地理分布进行了比较。在飓风菲奥娜过后的 15 周内,有 156 名患者出现了钩端螺旋体病的症状和体征,并向珠江三角洲卫生局报告了化验结果呈阳性的标本。在此期间,平均每周病例数为 10.4 例,比之前 37 周的每周病例数(2.9 例)高出 3.6 例。菲奥娜飓风过后,表明接触过可能受污染的水的病例比例从 11% 上升到 35%,接受检测的人数也有所增加;这些因素很可能导致报告病例的整体激增。洪水过后,强有力的监测与对医疗服务提供者的宣传相结合,可以提高钩端螺旋体病病例的识别率,为考虑早期开始治疗的临床医生提供信息,并引导公众避免涉水、游泳或接触可能受污染的洪水。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Leptospirosis Outbreak in Aftermath of Hurricane Fiona - Puerto Rico, 2022.

Leptospirosis, an acute bacterial zoonotic disease, is endemic in Puerto Rico. Infection in approximately 10%-15% of patients with clinical disease progresses to severe, potentially fatal illness. Increased incidence has been associated with flooding in endemic areas around the world. In 2022, Hurricane Fiona, a Category 1 hurricane, made landfall and inundated Puerto Rico with heavy rainfall and severe flooding, increasing the risk for a leptospirosis outbreak. In response, the Puerto Rico Department of Health (PRDH) changed guidelines to make leptospirosis cases reportable within 24 hours, centralized the case investigation management system, and provided training and messaging to health care providers. To evaluate changes in risk for leptospirosis after Hurricane Fiona to that before the storm, the increase in cases was quantified, and patient characteristics and geographic distribution were compared. During the 15 weeks after Hurricane Fiona, 156 patients experienced signs and symptoms of leptospirosis and had a specimen with a positive laboratory result reported to PRDH. The mean weekly number of cases during this period was 10.4, which is 3.6 as high as the weekly number of cases during the previous 37 weeks (2.9). After Hurricane Fiona, the proportion of cases indicating exposure to potentially contaminated water increased from 11% to 35%, and the number of persons receiving testing increased; these factors likely led to the resulting overall surge in reported cases. Robust surveillance combined with outreach to health care providers after flooding events can improve leptospirosis case identification, inform clinicians considering early initiation of treatment, and guide public messaging to avoid wading, swimming, or any contact with potentially contaminated floodwaters.

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来源期刊
MMWR. Morbidity and mortality weekly report
MMWR. Morbidity and mortality weekly report PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH -
CiteScore
65.40
自引率
0.90%
发文量
309
期刊介绍: The Morbidity and Mortality Weekly Report (MMWR ) series is prepared by the Centers for Disease Control and Prevention (CDC). Often called “the voice of CDC,” the MMWR series is the agency’s primary vehicle for scientific publication of timely, reliable, authoritative, accurate, objective, and useful public health information and recommendations. MMWR readership predominantly consists of physicians, nurses, public health practitioners, epidemiologists and other scientists, researchers, educators, and laboratorians.
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