Distribution of human leptospirosis in guilan province, Northern Iran

Leptospirosis is the most widespread zoonosis in the world and is more prevalent in tropical and temperate regions. Guilan Province in north of Iran, is an endemic region of human leptospirosis. Since diagnosis of leptospirosis according to clinical symptoms is very difficult due to lack of characteristic pathogonomic sign[s], laboratory support is necessary. In 2003, we obtained blood samples from patients hospitalized in main general hospitals of Guilan Province and were suspected as having leptospirosis according to their clinical presentations. We examined 995 sera by a commercial IgM and IgG ELISA kit to find positive cases. 62.7% of positive cases were male and about 86% of them were farmer. High distribution rate of leptospirosis was seen in middle-aged people [65% in 20-50 years old]. It seems that leptospirosis has a high occurrence in major cities and is mostly distributed in warm months of the year. Demographic analysis of the results indicates that leptospirosis is typically a rural and an occupational disease in the area

[Identifying serogroup and servers of acute human leptospirosis in Gillan province by MAT method]

Introduction: Leptospirosis is a common Zoonosis, which is more prevalent in tropical and temperate regions. Rodents, wild and domestic animals are reservoir of Leptospirosis. Usually the infected animals are carriers for the rest of their lives and the bacteri is secreted from their urine. The secreted bacteria can enter a host [animal or human] and continue the circle of disease

Objective: Diagnosis of leptospirsis according to clinical symptoms is difficult due to lack of pathogenic sign[s] and the similarities of its clinical features to some common febrile diseases, so laboratory is important in diagnosis. Leptospira is fastidious and its isolation from other clinical specimens is difficult, time consuming and usually unsuccessful, so MAT is the gold standard for diagnosis and serotyping of leptospira and is usual in all reference laboratories

Materials and Methods: We performed this study in 1383 by taking blood sample from patients hospitalized in Emam Khomeini Hospital in Some- e-sara, Razi and 22 Aban Lahijan and had clinical symptoms and were suspected of leptospirosis. Sampling was done in spring and summer, which are prevalent seasons of leptospirosis in Gailan prorince. We stored all serums in- 200[degree]c until examination, and in summer of 1383 serum samples were screened by a Quantitative Elisa method to detect positive samples for doing MAT, and performed MAT to determine causative serogroups

Results: 282 serum sample were all tested by quantitative Elisa and 130 cases had IgM titer equal or greater than 1:60 which were considered for MAT test. Seventy serum samples had titer

Conclusion: Analyzing the results of MAT was hard and complex due to alternate reactions happening between different serogroups specially in clinical samples related to acute disease. According to CDC, a serum titer of >/= 200 and if it correlates with clinical symptoms can present probable diagnosis. In this study, considering the samples were only taken from patients with clinical symptoms and suspected of leptospirosis and then after screening by Elisa, only positive samples with IgM titer equal or greater than 1:16 were assessed by MAT keeping in mind three criteria [Correlating clinical symptoms Elisa and MAT results] there is a high efficacy of diagnosis and determines servoirs and serogroups are prevalent in this area

[Evaluation of two commercial qualitative and semi quantitative ELISA methods for diagnosis of acute human leptospirosis]

Introduction: Leptospirosis is most widespread Zoonosis in the world, especially in Tropical and temperate regions with moist climate. Diagnosis of Leptospirosis according to clinical symptoms is difficult and uncertain due to lack of specific sign [s]. Leptospira is a fastidious bacterium. Isolation of these bacteria by culture is difficult, time consuming and hence doses not contribute to an early diagnosis. Specific antibodies against Leptospira appear from 6th day of disease onset. The Microscopic Agglutination Test [MAT] is most reliable assay but generally requires paired sera for detection of seroconversion and is considered too complex for routine use

Objective: We performed this study to final a simple and reliable method for diagnosis of acute human leptospirosis. ELISA is another common method for diagnosis of Leptospirosis

Materials and Methods: In summer of 2004, we examined 282 single sera of patients who were suspected of Leptospirosis by a commercial none quantities and an in-house semi quantative ELISA assays and compared their results with MAT

Results: Mean time of first taking blood samples were 6:36 after onset of symptoms. All specimens with titers >/=640 against a pathogenic serovar in MAT were regarded as confirmed leptospirosis [104 from 282]. All specimens which were positive in any IgM-ELISA assays were compared with the results of MAT. In our study, sensitivity, specifity, positive and negative predictive values of in house ELISA were 89.4%, 87%, 80.2% and 93.4% consequently but were 87.5%, 41.5%, 44.6% and 85% for comerical IgM-ELISA assay consequently

Conclusion: The results of our study show that IgM- ELISA assay is a reliable and sensitive method for diagnosis of acute leptospirosis and also show that in house semi quantative IgM ELISA was more specific and commercial qualitative IgM- ELISA was more sensitive

[Survey spread of positive lepotospirosis by Elisa in Guilan province]

Introduction: Leptospirosis is most widespread zoonosis in the world and is prevalent in tropical and temperate regions. Diagnosis of leptospirosis by clinical symptoms is difficult due to lack of specified pathogenic signs and similarity of its clinical symptoms to some bacterial and viral febrile disease, so laboratory plays an important role and ELISA is a common serological method. Animal leptospirosis is common in regions of Iran where traditional and unmechanized husbandry are used. But human leptospirosis is only prevalent in Guilan and Mazandaran and is endemic in Guilan. Factors such as climate conditions, wild animals, rice plantations, environmental water and finally keeping pets by traditional ways all contribute to this disease in Guilan

Objective: This study was done to determine the epidemiological characteristics of leptospirosis in Guilan

Materials and Methods: The sample of this study consisted of all suspected persons who referred to general hospitals of Guilan province. Blood samples were taken from these patients. All blood samples were examined by a commercial ELISA kit to detect positive cases and determine epidemiological features of this disease in this province

Results: Findings show that most of positive cases belong to males [62.37%] than females [27.23%], and in farmers [86%] and in warm months [90% from first of Khordad to end of Sharivar], and its frequency in middle age [20 - 50 year olds] was almost 65%

Conclusion: The geographical spread of the disease was more in big cities of Guilan province where more villages had and were crowded as well. This study showed that most cases of disease was detected in people who are somehow involved in farming