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Int. J. Environ. Res. Public Health 2014, 11(1), 968-982; doi:10.3390/ijerph110100968

Human Leptospirosis on Reunion Island: Past and Current Burden

1,* , 2
1 Regional Office (Cire) of the French Institute for Public Health Surveillance (Institut de veille sanitaire), Réunion 97400, France 2 Public Health Authority (Agence de santé Océan Indien ARS OI), Réunion 97400, France 3 National Reference Centre for Leptospirosis (NRC), Institut Pasteur, Paris 75015, France 4 Biology/Microbiology/Virology/Biochemistry Units, Centre Hospitalier Universitaire (CHU North Felix-Guyon), Saint-Denis 97405, France 5 Laboratoire de Bactériologie-Parasitologie-Virologie-Hygiène, Centre Hospitalier Universitaire (CHU Sud), St. Pierre Reunion Island 97448, France
* Author to whom correspondence should be addressed.
Received: 26 November 2013 / Revised: 30 December 2013 / Accepted: 7 January 2014 / Published: 10 January 2014
(This article belongs to the Special Issue Leptospirosis in the Animal—Human-Ecosystem Interface)
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Since 1953, leptospirosis has been recognized as a public health problem on Reunion Island. In 2004, was implemented a specific surveillance system that included systematic reporting and the realization of environmental investigations around hospitalized cases. Here, we present the synthesis of historical data and the assessment of 9 years of leptospirosis surveillance. From 2004 to 2012, 414 hospitalized cases were reported. Cases of leptospirosis occurred mostly during the rainy season from December to May. Approximately 41% of infections occurred at home, 12% of infections occurred during aquatic leisure and 5% of cases were linked to professional activities. Furthermore, for 41% of cases, the place of infection could not be determined due to the accumulation of residential and non-residential exposure. Most of the cases of leptospirosis were linked to rural areas or traditional, rural occupations. We did not observe a shift to recreational leptospirosis as described in some developed countries. According to the new surveillance system, the number of reported cases has regularly increased since 2004. This situation is in part due to the improvement of the system in the first years but also to a real increase in the number of detected cases due to the introduction of molecular methods and to increased biological investigation into the Dengue-like syndrome by medical practitioners on the island since the Chikungunya crisis in 2006. This increase is probably due to surveillance and diagnosis biases but need to be carefully monitored. Nevertheless, the possibility of an outbreak is always present due to climatic events, such as after the “hyacinth” hurricane in 1980.
Keywords: leptospirosis; epidemiology; surveillance; human; Reunion Island; Indian Ocean leptospirosis; epidemiology; surveillance; human; Reunion Island; Indian Ocean
This is an open access article distributed under the Creative Commons Attribution License (CC BY) which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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Pagès, F.; Polycarpe, D.; Dehecq, J.-S.; Picardeau, M.; Caillère, N.; Jaffar-Bandjee, M.-C.; Michault, A.; Filleul, L. Human Leptospirosis on Reunion Island: Past and Current Burden. Int. J. Environ. Res. Public Health 2014, 11, 968-982.

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