Skip directly to site content Skip directly to page options Skip directly to A-Z link Skip directly to A-Z link Skip directly to A-Z link
Volume 20, Number 8—August 2014
CME ACTIVITY - Synopsis

Leptospirosis-Associated Hospitalizations, United States, 1998–2009

Rita M. Traxler1Comments to Author , Laura S. Callinan1, Robert C. Holman, Claudia Steiner, and Marta A. Guerra
Author affiliations: Centers for Disease Control and Prevention, Atlanta, Georgia, USA (R.M. Traxler, L.S. Callinan, R.C. Holman, M.A. Guerra); Agency for Healthcare Research and Quality, Rockville, Maryland, USA (C. Steiner)

Main Article

Table 3

Selected diagnoses listed on leptospirosis-associated hospitalization discharge records, United States, 1998–2009*

Diagnosis† ICD-9-CM code No. (SE) discharge records % (SE) discharge records
Volume depletion 276.5 475 (53) 23.8 (2.1)
Thrombocytopenia, unspecified 287.5 373 (50) 18.7 (2.0)
Acute kidney failure, unspecified‡ 584.9 365 (48) 18.3 (2.0)
Fever and other physiologic disturbances of temperature regulation 780.6 261 (36) 13.1 (1.7)
Hyposmolality and/or hyponatremia 276.1 249 (37) 12.5 (1.6)
Hypopotassemia 276.8 203 (34) 10.2 (1.5)
Acute and subacute necrosis of liver‡ 570 148 (28) 7.4 (1.4)
Jaundice, unspecified, not of newborn‡ 782.4 124 (25) 6.2 (1.2)
Atrial fibrillation† 427.31 99 (24) 5.0 (1.1)
Acute respiratory failure‡ 518.81 93 (21) 4.7 (1.1)

* ICD-9-CM, International Classification of Diseases, 9th revision, Clinical Modification (17).
†Discharge records may contain >1 listed diagnosis.
‡Diagnoses commonly associated with leptospirosis.

Main Article

References
  1. World Health Organization. Leptospirosis: an emerging public health problem. Wkly Epidemiol Rec. 2011;86:4550 .PubMedGoogle Scholar
  2. Guerra  MA. Leptospirosis. J Am Vet Med Assoc. 2009;234:472–8, 430.
  3. Levett  PN. Leptospirosis. Clin Microbiol Rev. 2001;14:296326. DOIPubMedGoogle Scholar
  4. Katz  AR, Ansdell  VE, Effler  PV, Middleton  CR, Sasaki  DM. Leptospirosis in Hawaii, 1974–1998: epidemiologic analysis of 353 laboratory-confirmed cases. Am J Trop Med Hyg. 2002;66:6170 .PubMedGoogle Scholar
  5. Hartskeerl  RA, Collares-Pereira  M, Ellis  WA. Emergence, control and re-emerging leptospirosis: dynamics of infection in the changing world. Clin Microbiol Infect. 2011;17:494501. DOIPubMedGoogle Scholar
  6. Bruce  MG, Sanders  EJ, Leake  JA, Zaidel  O, Bragg  SL, Aye  T, Leptospirosis among patients presenting with dengue-like illness in Puerto Rico. Acta Trop. 2005;96:3646. DOIPubMedGoogle Scholar
  7. Vinetz  JM, Glass  GE, Flexner  CE, Mueller  P, Kaslow  DC. Sporadic urban leptospirosis. Ann Intern Med. 1996;125:7948. DOIPubMedGoogle Scholar
  8. Centers for Disease Control and Prevention. Update: leptospirosis and unexplained acute febrile illness among athletes participating in triathlons—Illinois and Wisconsin, 1998. MMWR Morb Mortal Wkly Rep. 1998;47:6736 .PubMedGoogle Scholar
  9. Stern  EJ, Galloway  R, Shadomy  SV, Wannemuehler  K, Atrubin  D, Blackmore  C, Outbreak of leptospirosis among Adventure Race participants in Florida, 2005. Clin Infect Dis. 2010;50:8439. DOIPubMedGoogle Scholar
  10. Council of State and Territorial Epidemiologists. Public health reporting and national notification for leptospirosis. 2012 [cited 2012 Dec 12]. http://c.ymcdn.com/sites/www.cste.org/resource/resmgr/PS/12-ID-02FINAL.pdf
  11. Meites  E, Jay  MT, Deresinski  S, Shieh  WJ, Zaki  SR, Tompkins  L, Reemerging leptospirosis, California. Emerg Infect Dis. 2004;10:40612. DOIPubMedGoogle Scholar
  12. Katz  AR, Buchholz  AE, Hinson  K, Park  SY, Effler  PV. Leptospirosis in Hawaii, USA, 1999–2008. Emerg Infect Dis. 2011;17:2216. DOIPubMedGoogle Scholar
  13. Centers for Disease Control and Prevention. Notes from the field: investigation of leptospirosis underreporting—Puerto Rico, 2010. MMWR Morb Mortal Wkly Rep. 2012;61:421 .PubMedGoogle Scholar
  14. Agency for Healthcare Research and Quality. Healthcare Cost and Utilization Project (HCUP). Databases; last modified February 2013 [cited 2013 Mar 2]. www.hcup-us.ahrq.gov/databases.jsp
  15. Agency for Healthcare Research and Quality. Healthcare Cost and Utilization Project (HCUP). NIS database documentation; last modified February 2013 [cited 2013 Mar 2]. www.hcup-us.ahrq.gov/db/nation/nis/nisdbdocumentation.jsp
  16. Houchens  R, Elixhauser  A. US Agency for Healthcare Research and Quality. Final report on calculating nationwide inpatient sample (NIS) variances, 2001. HCUP methods series report #2003–2. June 2005 (revised 2005 June 6) [cited 2011 Dec 13]. http://www.hcup-us.ahrq.gov/reports/methods/CalculatingNISVariances200106092005.pdf
  17. Public Health Service and Health Care Financing Administration. International classification of diseases, 9th revision, clinical modification, 6th ed. (CD-ROM). Washington (DC): US Department of Health and Human Services; 2005.
  18. National Center for Health Statistics. Bridged-race intercensal estimates of the July 1, 1990–July 1, 1999, United States resident population by county, single-year of age, sex, race, and Hispanic origin. July 26, 2004 [cited 2011 Dec 13]. http://www.cdc.gov/nchs/nvss/bridged_race/data_documentation.htm#july1999
  19. National Center for Health Statistics. Vintage 2009 bridged postcensal estimates of the resident population of the United States for July 1, 2000–July 1, 2009, by year, county, single-year of age (0 to 85+ years), bridged race, Hispanic origin, and sex. July 23, 2010 [cited 2011 Dec 13]. http://www.cdc.gov/nchs/nvss/bridged_race/data_documentation.htm#vintage2009
  20. US Census Bureau. Census regions and divisions of the United States [cited 2012 Nov 20]. https://www.census.gov/geo/maps-data/maps/pdfs/reference/us_regdiv.pdf
  21. Christensen  KL, Holman  RC, Steiner  CA, Sejvar  JJ, Stoll  BJ, Schonberger  LB. Infectious disease hospitalizations in the United States. Clin Infect Dis. 2009;49:102535. DOIPubMedGoogle Scholar
  22. DeFrances  CJ, Cullen  KA, Kozak  LJ. National hospital discharge survey: 2005 annual summary with detailed diagnosis and procedure data. Vital Health Stat 13. 2007;165:1209 .PubMedGoogle Scholar
  23. Levy  PS, Lemeshow  S. Sampling of populations—methods and applications. New York: John Wiley & Sons, Inc.; 1991.
  24. Lehmann  E. Nonparametrics: statistical methods based on ranks. New York: Wiley; 1975.
  25. Jansen  A, Stark  K, Schneider  T, Schoneberg  I. Sex differences in clinical leptospirosis in Germany: 1997–2005. Clin Infect Dis. 2007;44:e6972. DOIPubMedGoogle Scholar
  26. Sasaki  DM, Pang  L, Minette  HP, Wakida  CK, Fujimoto  WJ, Manea  SJ, Active surveillance and risk factors for leptospirosis in Hawaii. Am J Trop Med Hyg. 1993;48:3543 .PubMedGoogle Scholar
  27. Centers for Disease Control and Prevention. Summary of notifiable diseases, United States, 1994. MMWR Morb Mortal Wkly Rep. 1994;43:180 .PubMedGoogle Scholar
  28. US Bureau of Labor Statistics. Household data annual averages 2010 April 1, 2011 [cited 2011 Aug 30]. Employed persons by detailed industry, sex, race, and Hispanic or Latino ethnicity. http://www.bls.gov/cps/cpsaat18.pdf
  29. Agampodi  SB, Matthias  MA, Moreno  AC, Vinetz  JM. Utility of quantitative polymerase chain reaction in leptospirosis diagnosis: association of level of leptospiremia and clinical manifestations in Sri Lanka. Clin Infect Dis. 2012;54:124955. DOIPubMedGoogle Scholar
  30. Herrmann-Storck  C, Saint-Louis  M, Foucand  T, Lamaury  I, Deloumeaux  J, Baranton  G, Severe leptospirosis in hospitalized patients, Guadeloupe. Emerg Infect Dis. 2010;16:3314. DOIPubMedGoogle Scholar
  31. Daher  EF, Lima  RS, Silva Junior  GB, Silva  EC, Karbage  NN, Kataoka  RS, Clinical presentation of leptospirosis: a retrospective study of 201 patients in a metropolitan city of Brazil. Braz J Infect Dis. 2010;14:310. DOIPubMedGoogle Scholar
  32. Spichler  A, Athanazio  D, Seguro  AC, Vinetz  JM. Outpatient follow-up of patients hospitalized for acute leptospirosis. Int J Infect Dis. 2011;15:e48690. DOIPubMedGoogle Scholar
  33. Katz  AR, Ansdell  VE, Effler  PV, Middleton  CR, Sasaki  DM. Assessment of the clinical presentation and treatment of 353 cases of laboratory-confirmed leptospirosis in Hawaii, 1974–1998. Clin Infect Dis. 2001;33:183441. DOIPubMedGoogle Scholar
  34. Vanasco  NB, Schmeling  MF, Lottersberger  J, Costa  F, Ko  AI, Tarabla  HD. Clinical characteristics and risk factors of human leptospirosis in Argentina (1999–2005). Acta Trop. 2008;107:2558. DOIPubMedGoogle Scholar
  35. Paganin  F, Bourdin  A, Dalban  C, Courtin  JP, Poubeau  P, Borgherini  G, Leptospirosis in Reunion Island (Indian Ocean): analysis of factors associated with severity in 147 confirmed cases. Intensive Care Med. 2007;33:195966. DOIPubMedGoogle Scholar
  36. Galloway  RL, Levett  PN, Tumeh  JW, Flowers  CR. Assessing cost effectiveness of empirical and prophylactic therapy for managing leptospirosis outbreaks. Epidemiol Infect. 2009;137:132332. DOIPubMedGoogle Scholar
  37. Lau  CL, Dobson  AJ, Smythe  LD, Fearnley  EJ, Skelly  C, Clements  AC, Leptospirosis in American Samoa 2010: epidemiology, environmental drivers, and the management of emergence. Am J Trop Med Hyg. 2012;86:30919. DOIPubMedGoogle Scholar

Main Article

1These authors contributed equally to this article.

Page created: July 17, 2014
Page updated: July 17, 2014
Page reviewed: July 17, 2014
The conclusions, findings, and opinions expressed by authors contributing to this journal do not necessarily reflect the official position of the U.S. Department of Health and Human Services, the Public Health Service, the Centers for Disease Control and Prevention, or the authors' affiliated institutions. Use of trade names is for identification only and does not imply endorsement by any of the groups named above.
file_external