We describe a series of 144 cases of leptospirosis diagnosed in 1989 in New Caledonia.
The incidence rate was 90 per 100,000 person-years, with a specific mortality rate of 4% patients.
Those affected (100 males, 44 females) were mainly aged 20 to 40 years.
Incidence in rural areas (112 per 100,000 person-years) was seven times higher than in urban settlements.
Two periods with higher incidence were noticed corresponding to highest rainfall.
Twenty-nine of the cases occurred in individuals with professions commonly associated with leptospirosis.
Contacts with rats, dogs and ditch or river water were the most frequently mentioned.
The clinical expression of the disease was polymorphic : 60% of the patients had mild symptoms, 40% were acute forms including Weil's disease.
Of 57 hospitalized, 23% were admitted with an initial diagnosis of dengue, and 37% with leptospirosis.
Main clinical syndromes were :
Icterus and/or renal syndrome in 50% of patients, cardiac syndrome in 65%, acute myalgies in 58% and pulmonary syndrome in 50%. Although hemorrhages were uncommon (17%), 40% of the cases demonstrated thrombocytopenia (<50,000/m3).
Pancreatic involvement with hyperamylasemia was evidenced in 50% of cases.
Twelve serogroups of Leptospira were implicated, Icterohaemorragiae predominated (41%), but was not associated with severe forms. (...)
Mots-clés Pascal : Leptospirose, Spirochétose, Bactériose, Infection, Epidémiologie, Homme, Nouvelle Calédonie, Mélanésie, Océanie, Incidence, Symptomatologie
Mots-clés Pascal anglais : Leptospirosis, Spirachaetosis, Bacteriosis, Infection, Epidemiology, Human, New Caledonia, Melanesia, Oceania, Incidence, Symptomatology
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 97-0241949
Code Inist : 002B05B02L9. Création : 11/06/1997.