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Leptospirosis on Kauai: investigation of a common source waterborne outbreak
A R Katz1, S J Manea, D M Sasaki
1University of Hawaii, School of Public Health, Honolulu 96822.
Abstract:
During the summer of 1987, a common source waterborne outbreak of leptospirosis occurred on the island of Kauai in the state of Hawaii. Eight leptospirosis cases were identified using the microscopic agglutination test. Methodologic weaknesses in this technique were responsible for the initial missed diagnosis on six of the eight cases. All cases had repeated exposure to the Waimea River. A wide array of animal reservoirs and optimal water conditions may have been factors in this outbreak.
Insights
A 1987 waterborne outbreak of leptospirosis in Kauai, Hawaii, affected eight individuals. Diagnostic method limitations delayed diagnosis in most cases, highlighting the need for improved testing for this bacterial disease.
Area of Science:
- Epidemiology
- Infectious Diseases
- Public Health
Background:
- Leptospirosis is a zoonotic bacterial disease with significant public health implications.
- Waterborne outbreaks pose a risk in areas with specific environmental conditions.
Purpose of the Study:
- To investigate a common source waterborne outbreak of leptospirosis on Kauai, Hawaii.
- To identify the cause and contributing factors of the outbreak.
Main Methods:
- Case identification using the microscopic agglutination test.
- Epidemiological investigation of patient exposures.
Main Results:
- Eight cases of leptospirosis were confirmed.
- Six cases experienced initial misdiagnosis due to methodologic weaknesses in the microscopic agglutination test.
- All affected individuals had repeated exposure to the Waimea River.
Conclusions:
- The Waimea River was identified as the likely source of the outbreak.
- Potential contributing factors include a wide array of animal reservoirs and favorable water conditions.
- Methodologic limitations of diagnostic tests can impede timely identification of leptospirosis cases.