Posts filed under ‘Zoonosis’

LEPTOSPIROSIS – GUIA para el Equipo de Salud. Ministerio de Salud de la Nación Argentina – ABRIL 2014


Pág 3. Información para el equipo de salud:

  1. Introducción
  2. Manifestaciones clínicas
  3. ¿Cuándo sospechar leptospirosis?
  4. ¿Cómo confirmar leptospirosis?
  5. ¿Cómo notificar el caso de leptospirosis?
  6. ¿Cómo se trata el paciente con leptospirosis?
  7. Flujograma de manejo de casos sospechosos de leptospirosis
  8. Diagnóstico diferencial
  9. ¿Qué hacer si se confirma?
  10. ¿Cómo se tratan los casos caninos de leptospirosis?
  11. Prevención de la leptospirosis en la familia y la comunidad

Pág 25. Recomendaciones para la organización de las actividades en el Equipo de Salud

  1. ¿Qué pueden Ud y su equipo de salud hacer para contribuir al control de la leptospirosis en su área?

Pág 29. Información para la población

  1. ¿Qué es la leptospirosis?
  2. ¿Cómo se transmite la leptospirosis?
  3. ¿Cómo ingresa la bacteria?
  4. ¿Cuáles son los síntomas de la leptospirosis?
  5. ¿Qué hacer en caso de padecer de algunos de los síntomas mencionados antes?
  6. ¿Cuál es el tratamiento?

7 ¿Cómo afecta la enfermedad a los animales domésticos?

  1. ¿Qué podemos hacer para prevenir la leptospirosis?

Pág 35. Anexos

  1. Muestras clínicas para examen
  2. Notificación a través del Módulo SIVILA del SNVS
  3. Bioseguridad
  4. Laboratorios de la Red de leptospirosis
  5. Algoritmo de diagnóstico y notificación por laboratorio
  6. Ficha de notificación de casos de síndrome febril
  7. Ficha de notificación de caso leptospirosis canina


July 17, 2017 at 8:32 am

Leptospirosis. Puesta al día

Rev. Chil. infectol. Junio 2007 V.24 N.3 P.220-226

Enna Zunino M. y Rolando Pizarro P.

Hospital Dr. Lucio Córdova Santiago, Chile


Se revisan los aspectos clínicos, diagnóstico de laboratorio y alternativas terapéuticas para la leptospirosis.

Destaca en la epidemiología el riesgo ocupacional y laboral y la falta de datos, por no haber constituido en Chile tema de vigilancia epidemiológica hasta el año 2000.

Los datos clínicos evidencian una notable heterogeneidad de manifestaciones, muchas veces inespecíficas. La complejidad del diagnóstico diferencial que plantea hace necesario incluirlo en el análisis causal de múltiples situaciones clínicas.

El diagnóstico de laboratorio es aún complejo y poco accesible. Aunque es todavía controvertido, el análisis de la literatura apoya el beneficio del tratamiento antimicrobiano con varias alternativas de elección.


July 17, 2017 at 8:30 am

Practices of Lyme disease diagnosis and treatment by general practitioners in Quebec, 2008-2015.

BMC Fam Pract. 2017 May 22;18(1):65.

Gasmi S1,2, Ogden NH3,4, Leighton PA5, Adam-Poupart A6, Milord F6, Lindsay LR7, Barkati S8, Thivierge K9.

Author information

1 Laboratoire de santé publique du Québec, Institut national de santé publique du Québec, 20045, chemin Sainte-Marie, Sainte-Anne-de-Bellevue, H9X 3R5, Canada.

2 Policy Integration and Zoonoses Division, Centre for Food-borne, Environmental & Zoonotic Infectious Diseases, Public Health Agency of Canada, 3200 Sicotte, Saint-Hyacinthe, J2S 7C6, Canada.

3 Public Health Risk Sciences Division, National Microbiology Laboratory, Public Health Agency of Canada, 3200 Sicotte, Saint-Hyacinthe, J2S 7C6, Canada.

4 Groupe de Recherche en Épidémiologie des Zoonoses et Santé Publique (GREZOSP), 3200 Sicotte, Saint-Hyacinthe, J2S 7C6, Canada.

5 Faculty of Veterinary Medicine, University of Montreal, 3200 Sicotte, Saint-Hyacinthe, J2S 7C6, Canada.

6 Direction des risques biologiques et de la santé au travail, Institut national de santé publique du Québec, 190, boulevard Crémazie Est, Montréal, H2P 1E2, Canada.

7 Zoonotic Diseases & Special Pathogens Division, National Microbiology Laboratory, Public Health Agency of Canada, 1015 Arlington Street, Winnipeg, R3E 3R2, Canada.

8 Department of Microbiology and Immunology, Faculty of Medicine, University of Montreal, 2900, boul. Édouard-Montpetit, Montréal, H3T 1J4, Canada.

9 Laboratoire de santé publique du Québec, Institut national de santé publique du Québec, 20045, chemin Sainte-Marie, Sainte-Anne-de-Bellevue, H9X 3R5, Canada.



Lyme disease (LD), a multisystem infection caused by the spirochete Borrelia burgdorferi sensu stricto (B. burgdorferi), is the most reported vector-borne disease in North America, and by 2020, 80% of the population in central and eastern Canada could live in LD risk areas. Among the key factors for minimising the impact of LD are the accurate diagnosis and appropriate management of patients bitten by ticks. In this study, the practices of Quebec general practitioners (GPs) on LD diagnosis and management of patients bitten by infected ticks are described.


Eight years (2008 to 2015) of retrospective demographic and clinical data on patients bitten by infected Ixodes scapularis (I. scapularis) ticks and on the management of suspected and confirmed LD cases by Quebec GPs were analysed.


Among 50 patients, all the antimicrobial treatments of LD clinical cases were appropriate according to current guidelines. However, more than half (62.8%) of erythema migrans (EM) were possibly misdiagnosed, 55.6%, (n = 27) of requested serologic tests were possibly unnecessary and the majority (96.5%, n = 57) of prophylactic antimicrobial treatments were not justified according to current guidelines.


These observations underline the importance for public health to enhance the knowledge of GPs where LD is emerging, to minimise the impact of the disease on patients and the financial burden on the health system


July 15, 2017 at 2:12 pm

Update of the Swiss guidelines on post-treatment Lyme disease syndrome.

Swiss Med Wkly. 2016 Dec 5;146:w14353.

Nemeth J1, Bernasconi E2, Heininger U3, Abbas M4, Nadal D5, Strahm C6, Erb S7, Zimmerli S8, Furrer H8, Delaloye J9, Kuntzer T10, Altpeter E11, Sturzenegger M12, Weber R1, For The Swiss Society For Infectious Diseases And The Swiss Society For Neurology.

Author information

1 Division of Infectious Diseases and Hospital Epidemiology, University Hospital Zurich, University of Zurich, Switzerland.

2 Division of Infectious Diseases, Regional Hospital Lugano, Switzerland.

3 Paediatric Infectious Diseases and Vaccinology, University of Basel Children’s Hospital, Basel, Switzerland.

4 Division of Infectious Diseases, Geneva University Hospital, Switzerland.

5 Division of Infectious Diseases and Hospital Epidemiology, University Children’s Hospital Zürich, Switzerland.

6 Division of Infectious Diseases, Cantonal Hospital St. Gallen, Switzerland.

7 Division of Infectious Diseases and Hospital Epidemiology, University Hospital Basel, Switzerland.

8 Division of Infectious Diseases, University Hospital Bern, Switzerland.

9 Division of Infectious Diseases, University Hospital Lausanne (CHUV), Switzerland.

10 Service of Neurology, University Hospital Lausanne (CHUV), Switzerland.

11 Swiss Federal Office of Public Health, Bern, Switzerland.

12 Department of Neurology, Inselspital, University Hospital of Bern, Switzerland.


Lyme borreliosis is caused by Borrelia burgdorferi sensu lato infection, which responds well to antibiotic therapy in the overwhelming majority of cases.

However, despite adequate antibiotic treatment some patients report persisting symptoms which are commonly summarised as post-treatment Lyme disease syndrome (PTLDS). In 2005, the Swiss Society of Infectious Diseases published a case definition for PTLDS.

We aimed to review the scientific literature with a special emphasis on the last 10 years, questioning whether the definitions from 2005 are still valid in the light of current knowledge.

Furthermore, we describe the clinical history of infection with Borrelia burgdorferi sensu lato, the estimated prevalence of PTLDS, the possible pathogenesis of PTLDS, and treatment options with an emphasis on clinical studies. In summary, we were unable to find a scientific reason for modification of the PTLDS definitions published in 2005.

Thus, the diagnostic criteria remain unchanged, namely documented clinical and laboratory evidence of previous infection with B. burgdorferi, a completed course of appropriate antibiotic therapy, symptoms including fatigue, arthralgia, myalgia, cognitive dysfunction or radicular pain persisting for >6 months, a plausible timely association between documented B. burgdorferi infection and onset of symptoms (i.e., persistent or recurrent symptoms that began within 6 months of completion of a recommended antibiotic therapy for early or late Lyme borreliosis), and exclusion of other somatic or psychiatric causes of symptoms.

The main therapeutic options remain cognitive behavioural therapy and low-impact aerobic exercise programmes. Growing and unequivocal evidence confirms that prolonged or repeated antibiotic therapy for PTLDS is not beneficial, but potentially harmful and therefore contraindicated.

The Guidelines of the Swiss Society of Infectious Diseases offer an evidence based, diagnostic and therapeutic framework for physicians caring for patients suffering from presumptive PTLDS in Switzerland.


July 15, 2017 at 2:11 pm

Epidemiology of human plague in the United States, 1900-2012.

Emerg Infect Dis. 2015 Jan;21(1):16-22.

Kugeler KJ, Staples JE, Hinckley AF, Gage KL, Mead PS.


We summarize the characteristics of 1,006 cases of human plague occurring in the United States over 113 years, beginning with the first documented case in 1900.

Three distinct eras can be identified on the basis of the frequency, nature, and geographic distribution of cases. During 1900-1925, outbreaks were common but were restricted to populous port cities.

During 1926-1964, the geographic range of disease expanded rapidly, while the total number of reported cases fell. During 1965-2012, sporadic cases occurred annually, primarily in the rural Southwest.

Clinical and demographic features of human illness have shifted over time as the disease has moved from crowded cities to the rural West.

These shifts reflect changes in the populations at risk, the advent of antibiotics, and improved detection of more clinically indistinct forms of infection.

Overall, the emergence of human plague in the United States parallels observed patterns of introduction of exotic plants and animals.


June 29, 2017 at 8:17 am

Gentamicin and tetracyclines for the treatment of human plague: review of 75 cases in new Mexico, 1985-1999.

Clin Infect Dis. MARCH 2004 Mar 1;38(5):663-9.

Boulanger LL1, Ettestad P, Fogarty JD, Dennis DT, Romig D, Mertz G.

Author information

1 Department of Internal Medicine, Division of Infectious Diseases, University of New Mexico, Albuquerque, NM, USA.


Streptomycin, an antimicrobial with limited availability, is the treatment of choice for plague, a fulminating and potentially epidemic disease that poses a bioterrorism concern. We evaluated the efficacy of gentamicin and tetracyclines for treating human plague. A medical record review was conducted on all 75 patients with plague who were reported in New Mexico during 1985-1999. Fifty patients were included in an analysis that compared streptomycin-treated patients (n=14) with those treated with gentamicin and/or a tetracycline (n=36). The mean numbers of fever days, hospital days, and complications and the number of deaths did not differ between patients treated with streptomycin and those treated with gentamicin. One patient who received tetracycline alone experienced a serious complication. Gentamicin alone or in combination with a tetracycline was as efficacious as streptomycin for treating human plague. The efficacy of a tetracycline alone could not be determined from the study.


June 29, 2017 at 8:15 am

Brucella melitensis prosthetic joint infection.

J Bone Jt Infect. 2017 Apr 5;2(3):136-142.         doi: 10.7150/jbji.18408. eCollection 2017.

Flury D1, Behrend H2, Sendi P3, von Kietzell M1, Strahm C1.

Author information

1 Department of Infectious Diseases, Cantonal Hospital of St. Gallen, St. Gallen.

2 Department of Orthopaedics and Traumatology, Cantonal Hospital of St. Gallen, St. Gallen.

3 Department of Infectious Diseases, Bern University Hospital, University of Bern, Bern, Switzerland.


Periprosthetic joint infection (PJI) due to Brucella spp. is rare.

We report a case in a 75-year-old man and review 29 additional cases identified in a literature search. The diagnosis of Brucella PJI is challenging, in particular in non-endemic countries.

Serological tests prior to joint aspiration or surgical intervention are reasonable. Involvement of infection control and timely information to laboratory personnel is mandatory upon diagnosis.

There is no uniform treatment concept, neither with respect to surgical intervention nor for the duration of antimicrobials.

Most cases have a successful outcome, irrespective of surgical modality, and with an antimicrobial combination regimen for 12 or more weeks.


June 21, 2017 at 7:59 am

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