Leptospirosis-associated Severe Pulmonary Hemorrhagic Syndrome, Salvador, Brazil
2008

Leptospirosis and Severe Pulmonary Hemorrhagic Syndrome in Brazil

Sample size: 474 publication 10 minutes Evidence: high

Author Information

Author(s): Gouveia Edilane L., Metcalfe John, de Carvalho Ana Luiza F., Aires Talita S.F., Villasboas-Bisneto José Caetano, Queirroz Adriano, Santos Andréia C., Salgado Kátia, Reis Mitermayer G., Ko Albert I.

Primary Institution: Fundação Oswaldo Cruz, Ministério da Saúde, Salvador, Bahia, Brazil

Hypothesis

What factors are responsible for the emergence of leptospirosis-associated severe pulmonary hemorrhagic syndrome (SPHS) in Salvador, Brazil?

Conclusion

The study found that SPHS emerged in Salvador, Brazil, with a high case-fatality rate of 74% among identified cases.

Supporting Evidence

  • 47 cases of SPHS were identified from 2003 through 2005.
  • The case-fatality rate for SPHS was 74%.
  • By 2005, SPHS caused 55% of the deaths due to leptospirosis.
  • 79% of SPHS cases had a confirmed diagnosis of leptospirosis.
  • SPHS was associated with a significantly higher fatality rate compared to non-SPHS leptospirosis.

Takeaway

Leptospirosis can cause a serious lung problem called SPHS, which is very dangerous and can lead to death, especially in slum areas during heavy rain.

Methodology

The study involved active surveillance for leptospirosis cases, clinical evaluations, and laboratory testing for diagnosis.

Potential Biases

Potential bias in case identification due to heightened awareness of SPHS in other regions.

Limitations

The study did not identify significant environmental risk exposures for acquiring SPHS.

Participant Demographics

Most SPHS case-patients were adults (mean age 37.6 years) and predominantly male (70%).

Statistical Information

P-Value

0.001

Confidence Interval

1.36–5.98

Statistical Significance

p<0.05

Digital Object Identifier (DOI)

10.3201/eid1403.071064

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