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
{"title":"菲奥娜 \"飓风过后爆发钩端螺旋体病--波多黎各,2022 年。","authors":"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","doi":"10.15585/mmwr.mm7335a2","DOIUrl":null,"url":null,"abstract":"<p><p>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.</p>","PeriodicalId":18637,"journal":{"name":"MMWR. Morbidity and mortality weekly report","volume":null,"pages":null},"PeriodicalIF":25.4000,"publicationDate":"2024-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11376507/pdf/","citationCount":"0","resultStr":"{\"title\":\"Leptospirosis Outbreak in Aftermath of Hurricane Fiona - Puerto Rico, 2022.\",\"authors\":\"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\",\"doi\":\"10.15585/mmwr.mm7335a2\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><p>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.</p>\",\"PeriodicalId\":18637,\"journal\":{\"name\":\"MMWR. 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Morbidity and mortality weekly report","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.15585/mmwr.mm7335a2","RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH","Score":null,"Total":0}
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.
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.