Leptospirosis as a Cause of Death in Kalasin Province, 2008

Abstract

Leptospirosis incidence has been high in Kalasin province since 1998. There were 381 cases reported with incidence rate of 38.68 per 100,000 population, the highest incidence in Thailand. In 2008, 15 cases died from leptospirosis, case fatality rate was 3.94 percent. For prevention of case morbidity and mortality, review of medical report including in depth interview of related medical doctors and their relatives of fatal cases in 2008 were undertaken in this study.

Of 15 dead cases, 5 were positive for rapid test leptospirosis IgM; 3 were positive for melioidosis titer and 1 was positive for both leptospirosis and melioidosis. The duration from the onsets of symptoms until treatment was 2 days. Community hospital was the first health service of treatment (66.67%). The duration from the onsets of symptoms until admission in the community hospitals was 4 days. The period of treatment in Kalasin province hospital since referring from community hospital until death was 1 day. The causes of death were septic shock (10 cases, 66.67%), Weil’s syndrome (9 cases, 60.00%), renal failure (9 cases, 60.00%) and pulmonary hemorrhage (5 cases, 33.33%).