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 18, Number 1—January 2012

Outbreak of Leptospirosis after Flood, the Philippines, 2009

Al-shere T. Amilasan1, Mugen Ujiie1, Motoi SuzukiComments to Author , Eumelia Salva, Maria Cecilia P. Belo, Nobuo Koizumi, Kumiko Yoshimatsu, Wolf-Peter Schmidt, Shane Marte, Efren M. Dimaano, Jose Benito Villarama, and Koya Ariyoshi
Author affiliations: San Lazaro Hospital, Manila, Republic of the Philippines (A.T. Amilasan, E. Salva, M.C.P. Belo, S. Marte, E.M. Dimaano, J.B. Villarama); National Center for Global Health and Medicine, Tokyo, Japan (M. Ujiie); Nagasaki University, Nagasaki, Japan (M. Ujiie, M. Suzuki, W.-P. Schmidt, K. Ariyoshi); National Institute of Infectious Diseases, Tokyo (N. Koizumi); Hokkaido University, Sapporo, Japan (K. Yoshimatsu)

Main Article


Figure. Phylogenetic tree based on the Leptospira flaB gene sequence. The sequences obtained in this study are indicated in boldface and have been deposited in DDBJ/GenBank/EMBL (accession numbers indicated). The sequences of rat isolates are derived from a previous study (9). Sequence alignments were conducted by using MEGA4 software and ClustalW (, and phylogenetic distances were calculated by using MEGA4 software and the neighbor-joining method. All 4 PCR products belong to L. interrogans; 2 are closely related to serovar Losbanos, 1 to serovar Manilae, and 1 is not associated with strains or serovars included in our analysis. Microscopic agglutination test results indicate infecting serogroups. L. borgpetersenii serovar Tarassovi had the highest titer in patients 307 and 486, but this finding can be explained by a cross-reaction. Scale bar indicates nucleotide substitutions per site.

Main Article

  1. Victoriano AF, Smythe LD, Gloriani-Barzaga N, Cavinta LL, Kasai T, Limpakarnjanarat K, Leptospirosis in the Asia Pacific region.BMC Infect Dis. 2009;9:147. DOIPubMedGoogle Scholar
  2. Yanagihara Y, Villanueva SY, Yoshida S, Okamoto Y, Masuzawa T. Current status of leptospirosis in Japan and Philippines.Comp Immunol Microbiol Infect Dis. 2007;30:399413. DOIPubMedGoogle Scholar
  3. Pappas G, Papadimitriou P, Siozopoulou V, Christou L, Akritidis N. The globalization of leptospirosis: worldwide incidence trends.Int J Infect Dis. 2008;12:3517. DOIPubMedGoogle Scholar
  4. Republic of the Philippines, National Disaster Coordinating Council. Situation report No. 52 on Tropical “Ondoy” (Ketsana) glide no. TC-2009–000205-PHL and Typhoon “Pepeng” (Parma) glide no. TC-2009–000214-PHL [cited 2011 Nov 4].
  5. Asian Disaster Reduction Center. Philippines’ country profile 2009 [cited 2011 Nov 4].
  6. World Health Organization, International Leptospirosis Society. Human leptospirosis: guidance for diagnosis, surveillance and control. Geneva: The Organization; 2003.
  7. Barros AJ, Hirakata VN. Alternatives for logistic regression in cross-sectional studies: an empirical comparison of models that directly estimate the prevalence ratio.BMC Med Res Methodol. 2003;3:21. DOIPubMedGoogle Scholar
  8. Villanueva SY, Ezoe H, Baterna RA, Yanagihara Y, Muto M, Koizumi N, Serologic and molecular studies of Leptospira and leptospirosis among rats in the Philippines.Am J Trop Med Hyg. 2010;82:88998. DOIPubMedGoogle Scholar
  9. Koizumi N, Muto M, Yamamoto S, Baba Y, Kudo M, Tamae Y, Investigation of reservoir animals of Leptospira in the northern part of Miyazaki Prefecture.Jpn J Infect Dis. 2008;61:4658.PubMedGoogle Scholar
  10. Truong TT, Yoshimatsu K, Araki K, Lee BH, Nakamura I, Endo R, Molecular epidemiological and serological studies of hantavirus infection in northern Vietnam.J Vet Med Sci. 2009;71:135763. DOIPubMedGoogle Scholar
  11. Bharti AR, Nally JE, Ricaldi JN, Matthias MA, Diaz MM, Lovett MA, Leptospirosis: a zoonotic disease of global importance.Lancet Infect Dis. 2003;3:75771. DOIPubMedGoogle Scholar
  12. Dupont H, Dupont-Perdrizet D, Perie JL, Zehner-Hansen S, Jarrige B, Daijardin JB. Leptospirosis: prognostic factors associated with mortality.Clin Infect Dis. 1997;25:7204. DOIPubMedGoogle Scholar
  13. Panaphut T, Domrongkitchaiporn S, Thinkamrop B. Prognostic factors of death in leptospirosis: a prospective cohort study in Khon Kaen, Thailand.Int J Infect Dis. 2002;6:529. DOIPubMedGoogle Scholar
  14. Gouveia EL, Metcalfe J, de Carvalho AL, Aires TS, Villasboas-Bisneto JC, Queirroz A, Leptospirosis-associated severe pulmonary hemorrhagic syndrome, Salvador, Brazil.Emerg Infect Dis. 2008;14:5058. DOIPubMedGoogle Scholar

Main Article

1These authors contributed equally to this article.

Page created: December 16, 2011
Page updated: December 16, 2011
Page reviewed: December 16, 2011
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.