Network for Prevention and Control of Leptospirosis in Asia

Transcription

1 Network for Prevention and Control of Leptospirosis in Asia JUN FUJII, SHIN-ICHI YOSHIDA Kyushu University, Japan XIAO-KUI GUO Shanghai Jiao Tong University, China SUBHASH C SEHGAL WHO Collaborating Centre for Diagnosis, Reference, Research and Training in Leptospirosis, India ALICE A. C. BUNGAY University of the Philippines, Philippines What is leptospirosis? Leptospirosis is a bacterial disease that affects humans and animals. It is caused by bacteria of the genus Leptospira. If not treated, the patient could develop kidney damage, meningitis, liver failure, and respiratory distress or death. Symptoms: -high fever -severe headache -muscle aches -vomiting -jaundice (yellow skin and eyes) -red eyes

2 1915:discovery of leptospires Dr. Inada and colleagues of Kyushu University reported Leptospira as the causative agent of leptospirosis. Dr. Inada How do people get leptospirosis? Outbreaks of leptospirosis are usually caused by exposure to water contaminated with the urine of infected animals. Humans become infected through contact with water, food, or soil containing urine from infected animals. Flood in Philippines 2

3 Wild Rodents Domestic animals Where is leptospirosis found? Leptospirosis occurs worldwide but is most common in temperate or tropical climates. It is an occupational hazard for many people who work outdoors or with animals, for example, farmers, sewer workers, veterinarians, fishermen, dairy farmers, or military personnel. It is a recreational hazard for campers or those who participate in outdoor sports in contaminated areas and has been associated with swimming, wading, and whitewater rafting in contaminated lakes and rivers.

4 Can leptospirosis be prevented? The risk of acquiring leptospirosis can be greatly reduced by not swimming or wading in water that might be contaminated with animal urine. Protective clothing or footwear should be worn by those exposed to contaminated water or soil because of their job or recreational activities. Prevalence of Leptospirosis

5 Statement of the problem of Leptospirosis Estimated number of annual cases: 350,000 to 500,000 (1999 WHO & ILS survey) 5,779 deaths in 10 years Found to occur more among males (62%) than females (38%) Common in tropical or sub-tropical countries with humid climate, urban and rural environments of developed and developing countries Occurs in both humans and animals Overlooked and under-reported a) non-specific signs and symptoms b) laboratory tests are not always available Our Network of Surveillance for Leptospira infection Shanghai Jiao Tong University Andaman and Nicobar Island WHO collaborating centre for Leptospirosis Kyushu University University of the Philippines Thai NIAH

6 Five points of our project against leptospirosis 1. Network building for leptospirosis 2. Surveillance of infected humans and animals in Philippines 3. Information dissemination about preventive and control measure against leptospirosis to Filipinos 4. Establishment of rapid test for diagnosis 5. Vaccine development Kyushu University -Microarray and proteomics analysis -Vaccine development -Development of diagnostic tool Shanghai Jiao Tong University -Whole genome sequence of Leptospira determined University of the Philippines -Surveillance of leptospirosis Andaman and Nicobar Island -Vaccine trial area

7 1998.6~ Philippines data from Dept. of Health: 187 cases of leptospirosis (154 males vs. 33 females) : rate of infection = 0.2 per 100,000 population : 1 death - underestimation of cases due to: a) diagnosis based on only clinical signs and symptoms b) lack of resources to buy diagnostic kits Surveillance studies are fundamental for disease prevention and control. Using a new diagnostic kit that we will develop, we can estimate the true burden of Leptospirosis in the study area. 7

8 Our Leptospira network should be the model case as follows 1. Review risks associated with new technologies, and vaccine, and monitor the risk of acquiring an infection from new device and products, before their approval for use. 2. Review and provide input into investigation of outbreaks of emerging infectious diseases. 3. Communicate and cooperate with other health-care facilities with common interest, such as pharmacy and therapeutics, antimicrobial use, biosafety, health and safety, waste management, and blood transfusion committees/centers. How do we use Asia-Pacific Advanced Network? Real-time conference of leptospirosis among collaborating institutes Exchange of Information on laboratory high technologies such as microarray, proteomics and vaccine development Medical education including diagnosis and therapeutic method of leptospirosis Possibility of network building for other emerging infectious diseases including avian influenza and SARS

9 Emerging Infectious Diseases Avian influenza SARS Creutzfeldt-Jakob disease West Nile viral encephalitis Ebola fever Hantavirus pulmonary syndrome HIV Hepatitis C Lyme disease E. coli O157 Legionella pneumophila Areas reporting confirmed occurrence of H5N1 avian influenza in poultry and wild birds

10 Recommended approaches to emerging infectious diseases through Asia-Pacific Advanced Network 1. Surveillance 2. Epidemiology for early diagnosis 3. Early response to outbreaks and changing pattern 4. Laboratory support for rapid and accurate diagnosis 5. Rapid communication links to private providers and hospitals 6. Information dissemination to public 7. Education about prevention and/or early and rapid detection