WHO/FAO/OIE COLLABORATING CENTRE FOR
REFERENCE & RESEARCH ON LEPTOSPIROSIS
NATIONAL LEPTOSPIROSIS SURVEILLANCE
REPORT
NUMBER 14
JANUARY – DECEMBER 2005
Report compiled by
Meegan Symonds
Senior Technician
Staff of the Leptospirosis Reference Laboratory
Supervising Scientist
Scientist
Senior Technical Officers
Administration Officer
Lee Smythe
Andrew Slack
Meegan Symonds
Michael Dohnt
Ruth Kropp
Website: http://www.health.qld.gov.au/qhpss/leptospirosis.asp
Surveillance Report Website:
http://www.health.qld.gov.au/qhpss/lepto_reports.asp
Queensland Health Scientific Services
39 Kessels Road Coopers Plains Queensland 4108
P.O. Box 594 Archerfield Qld 4108
Telephone 07 - 3274 9064 or 07 - 3274 9061
Facsimile 07 - 3274 9175
Email : [email protected]
Leptospirosis Surveillance Report 14
January – December 2005
The following issues are covered in this surveillance report:
Notifications __________________________________________________________________ 2
Notification Rates ______________________________________________________________ 3
Notifications by Queensland Health Service Districts _________________________________ 4
Age and Gender _______________________________________________________________ 5
Serovars______________________________________________________________________ 6
Most Common Serovars _________________________________________________________ 8
Occupations___________________________________________________________________ 9
Hospitalisation _______________________________________________________________ 10
Isolations ____________________________________________________________________ 10
This report summarises leptospirosis surveillance data for 2005. This information has been collated from
questionnaire data with the valued and appreciated assistance of public health staff, doctors and scientific
staff throughout Australia.
This report and previous reports are available at : http://www.health.qld.gov.au/qhpss/leptospirosis.asp
Leptospira under Dark Field Microscope
The reference laboratory staff would like to acknowledge all contributors for their time and
assistance in sending out questionnaires and in the collection of data.
Leptospirosis Surveillance Report 14
January – December 2005
Notifications
In 2005, Queensland accounted for 55% of leptospirosis notifications in Australia. Both the Australian and
Queensland notification rates have decreased from 2004.
Table 1.
Leptospirosis Notifications for Queensland & Australia 2003, 2004 and 2005
Year
Australia**
Queensland (laboratory data)
2003
2004
2005
129
177
123
71 (55.0%)
124 (70.1%)
65 (52.8%)
**Australian figures for Table 1 and 2 and Figure 1 consist of Reference Laboratory data for Queensland and
Communicable Diseases Network - Australia New Zealand - National Notifiable Diseases Surveillance System data for the
remaining states. Communicable Diseases Network figures are higher than those collected by this laboratory and it is likely
that some positive leptospirosis cases have not submitted a Leptospirosis Surveillance Questionnaire to the Reference
Laboratory and are therefore not included in our data. All further graphs and tables in this report are based on the
Reference Laboratory figures. There were 94 notifications for Australia in 2005 according to laboratory figures.
Figure 1.
Notifications of Leptospirosis for Australia in 2005 by State and Territory
(Communicable Diseases Network Data)
70
65
Notifications
60
50
36
40
30
20
10
5
10
4
3
SA
NT
0
Qld
NSW
Vic
WA
State
Page 2
Leptospirosis Surveillance Report 14
January – December 2005
Queensland notifications were below average for much of 2005and the traditional increase in cases during
the first half of the year was not as evident as in previous years.
Figure 2.
Leptospirosis Notifications for Queensland – Average, 2004, 2005
30
25
20
15
10
10
5
7
6
9
3
7
7
7
4
Jan
3
2
0
Feb
Mar
Apr
May
Jun
Average
Jul
Aug
Sep
2004
Oct
0
Nov
Dec
2005
Notification Rates
Table 2 shows the notification rates per 100 000 population for all States and Territories of Australia – 2003
to 2005.
Table 2.
Leptospirosis Notification Rates per 100 000 for 2003, 2004 and 2005 by State and Territory
State
2003
Rate / 100 000
2004
Rate / 100 000
New South Wales
Victoria
Queensland
South Australia
Western Australia
Tasmania
Northern Territory
ACT
0.55
0.14
1.89
0.13
0.31
0
2.02
0
0.55
0.16
3.23
0.20
0.20
0
0.50
0
2005
Rate / 100 000
0.53
0.20
1.64
0.26
0.25
0
1.48
0
Australia
0.61
0.87
0.61
Page 3
Leptospirosis Surveillance Report 14
January – December 2005
Notifications by Queensland Health Service Districts
Table 3 provides notification numbers, percentages and rates per 100 000 population for districts in
Queensland for 2003 - 2005. The Innisfail region again demonstrated the highest rate.
Table 3.
Leptospirosis Notifications by Queensland Health Service Districts
2003
Southern Zone
Central Zone
Northern Zone
Health Service District
2004
2005
2005
Notifications /
100 000
Cases
%
Cases
%
Cases
%
Innisfail
28
39.4
53
43.4
32
49.3
Cape York
1
1.4
0
0
1
1.5
12.1
Tablelands
5
7.0
15
12.3
3
4.6
7.9
Cairns
13
18.3
13
10.7
7
10.8
4.9
Townsville
1
1.4
2
1.6
3
4.6
1.8
Mackay
2
2.8
2
1.6
2
3.1
1.8
Torres Strait
0
0
0
0
0
0
0
Moranbah
0
0
0
0
0
0
0
Mt Isa
0
0
0
0
0
0
0
Bowen
0
0
0
0
0
0
0
Charters Towers
0
0
0
0
0
0
0
93.9
TOTAL
50
70.4
85
69.7
48
73.9
7.8
Gympie
South Burnett
1
0
1.4
0
7
0
5.8
0
3
1
4.6
1.5
8.4
3.0
Sunshine Coast
4
5.6
4
3.3
5
7.7
1.8
Fraser Coast
0
0
0
0
0
0
0
Gladstone
0
0
0
0
0
0
0
Central West
0
0
0
0
0
0
0
Central Highlands
0
0
0
0
0
0
0
Banana
0
0
0
0
0
0
0
North Burnett
0
0
0
0
0
0
0
Bundaberg
0
0
0
0
0
0
0
Rockhampton
0
0
0
0
0
0
0
Redcliffe-Caboolture
1
1.4
1
0.8
0
0
0
Brisbane North
1
1.4
0
0
0
0
0
TOTAL
7
9.9
12
9.8
9
13.8
0.6
Northern Downs
Southern Downs
3
2
4.2
2.8
2
6
1.6
5.0
2
2
3.1
3.1
6.5
3.4
Toowoomba
5
7.0
6
5.0
1
1.5
0.7
Logan-Beaudesert
0
0
0
0
2
3.1
0.7
West Moreton
3
4.2
4
3.3
1
1.5
0.6
Roma
0
0
2
1.6
0
0
0
Brisbane South
0
0
2
1.6
0
0
0
Bayside
0
0
1
0.8
0
0
0
Charleville
0
0
0
0
0
0
0
Gold Coast
1
1.4
2
1.6
0
0
0
TOTAL
14
19.7
25
20.5
8
12.3
0.4
TOTAL ALL ZONES
71
122
Page 4
1.6
Leptospirosis Surveillance Report 14
January – December 2005
Age and Gender
Table 4 and Figure 3 show gender and age data reported for Australia in 2005. The male to female ratio
for 2005 was 10.8 : 1.
Table 4.
Age
Average Female Age (n=8)
34.9 years
Average Male Age (n=86)
38.7 years
Average Age (n=94)
38.4 years
Oldest
76 years
Youngest
11 years
Figure 3.
Gender
100
91.5
90
80
70
60
Male
Percent of
50
Notifications
Female
40
30
20
8.5
10
0
Sex
Page 5
Leptospirosis Surveillance Report 14
January – December 2005
Serovars
Serovars Zanoni, Arborea, Hardjo and Australis (Table 5 and Figure 4) were responsible for most
notifications in Australia for 2005. Serovar Arborea has the highest percentage of notifications for Australia
with 23.4%, slightly higher than 2004. Zanoni is still the most notified serovar in Queensland, accounting for
26.3% of notifications. The serovar trends for Queensland are shown in Table 6 and Figure 5.
Table 5.
Leptospirosis Notifications, Australia 2003 - 2005 by Serovar
Serovar
Zanoni
2003
No.
14
%
14.6
Arborea
7
7.3
32
22.1
22
23.4
Hardjo
26
27.1
19
13.1
15
16.0
Australis
18
18.8
18
12.4
13
13.7
Kremastos
6
6.3
8
5.5
6
6.3
Robinsoni
6
6.3
7
4.8
5
5.3
Tarassovi
3
3.1
5
3.4
1
1.1
Szwajizak
3
3.1
5
3.4
2
2.1
Canicola
1
1.0
4
2.8
0
0
Topaz
0
0
4
2.8
4
4.3
Pomona
6
6.3
2
1.4
3
3.2
Copenhageni
3
3.1
2
1.4
2
2.1
Celledoni
0
0
1
0.7
0
0
Grippotyphosa
0
0
1
0.7
0
0
Medanensis
0
0
0
0
1
1.1
Pyrogenes
0
0
0
0
1
1.1
Bulgarica
0
0
1
0.7
1
1.1
Mankarso
1
1.0
0
0
0
0
Cynopteri
1
1.0
0
0
0
0
Unresolved
1
1.0
1
0.7
1
1.1
96
Total
2004
No.
35
2005
No.
17
%
24.1
145
%
18.1
94
Figure 4.
Leptospirosis Notifications of Selected Serovars, Australia 2003- 2005
40
35
Notifications
30
25
2003
20
2004
2005
15
10
5
0
Zanoni
Arborea
Hardjo
Australis
Page 6
Kremastos
Robinsoni
Tarassovi
Pomona
Leptospirosis Surveillance Report 14
January – December 2005
Table 6.
Leptospirosis Notifications, Queensland 2003 - 2005 by Serovar
2003
2004
2005
Serovar
Zanoni
No.
13
%
18.3
No.
35
%
28.8
No.
17
%
26.3
Arborea
6
8.5
27
22.1
14
21.5
Australis
15
21.2
17
13.9
7
10.8
5
7.0
8
6.6
6
9.2
15
21.2
8
6.6
4
6.2
Robinsoni
5
7.0
6
4.9
5
7.7
Szwajizak
3
4.2
5
4.1
2
3.1
Tarassovi
1
1.4
4
3.3
0
0
Topaz
0
0
3
2.5
3
4.6
Pomona
4
5.6
2
1.6
3
4.6
Canicola
1
1.4
2
1.6
0
0
Bulgarica
0
0
1
0.8
0
0
Grippotyphosa
0
0
1
0.8
0
0
Copenhageni
0
0
1
0.8
1
1.5
Celledoni
0
0
1
0.8
0
0
Cynopteri
1
1.4
0
0
0
0
Pyrogenes
0
0
0
0
1
1.5
Medanensis
0
0
0
0
1
1.5
Mankarso
1
1.4
0
0
0
0
Unresolved
1
1.4
1
0.8
1
1.5
Kremastos
Hardjo
71
Total
122
65
Figure 5.
Leptospirosis Notifications, Queensland 2003 - 2005 by Serovar
40
35
Notifications
30
25
2003
20
2004
2005
15
10
5
0
Zanoni
Arborea
Australis
Kremastos
Hardjo
Page 7
Robinsoni
Szwajizak
Tarassovi
Pomona
Leptospirosis Surveillance Report 14
January – December 2005
Most Common Serovars
Serovars Zanoni, Arborea and Hardjo accounted for 57.5% of all Australian notifications of leptospirosis in
2005.
Serovar Zanoni
This organism was one of the serovars associated with "Cane-cutter's Disease". It is found mainly from
Mackay to Cape York in coastal and tableland areas. The main carriers are rats and small marsupials
(mainly bandicoots). In recent years it has been demonstrated in dairy cattle on the Atherton Tablelands
(North Queensland) and many dairy workers have been infected. Probable sources of infection include
contact with soil, water or other materials contaminated with the urine of one of these animals. Zanoni is a
very common serovar in North Queensland with 13 cases reported for 2003.
Serovar Arborea
This organism is representative of a small group of leptospira found world-wide in rats and mice. Until
recently it was thought that no member of the group was to be found in Australia. In 1997 some routine
cultures from the Brisbane area were positive for an organism from this group. At the same time
serologically positive human cases started to appear, first in northern New South Wales, then from Gatton
and the Darling Downs, Queensland and in 2000, from semi-rural areas of Brisbane and the hinterland of
the Sunshine Coast.
Further culture attempts from the home areas of some of the infected patients resulted in more isolations of
this organism. Patients infected with this serovar seem to demonstrate high fevers, anorexia, severe
lethargy and in some cases mental confusion.
Serovar Hardjo
This organism is found through-out Australia and most parts of the world. The main carriers are cattle, both
dairy and meat producing. Probable sources of infection include contact with soil, water or other materials
contaminated with urine from cattle. Serovar Hardjo is one of the most common leptospiral serovars with
26 cases reported in 2003.
Figure 6.
Occupation Type of Leptospirosis Notifications for Zanoni, Arborea and Hardjo cases in Australia, 2005
Percent of Notifications
100%
80%
60%
Other
Animal Based
Agricultural
40%
20%
0%
Zanoni
Arborea
Serovar
Page 8
Hardjo
Leptospirosis Surveillance Report 14
January – December 2005
Occupations
Table 7 and Figure 7 show the occupation of cases of leptospirosis in 2005.
demonstrated the highest rate of leptospirosis in Queensland at 28.8%.
The banana industry
Table 7.
Occupations – Australia, 2005
Occupation
Qld
NSW
Vic
WA
NT
Banana Worker
Meatworker/Inspector/
Butcher
Unknown/Not Stated
19
2
2
1
13
2
2
Dairy Farmer
3
2
Grain / Vegetable Farmer
6
1
Grazier
1
2
Tradesperson
1
Labourer
3
Other Agricultural Worker
2
Stationhand
1
Student
3
Professional
3
Tourist / Tourism Industry
1
Armed Forces
3
Unemployed
1
6
2
1
1
1
2
Other Animal Industry
2
Clerical/Admin
1
Landscape/Nursery Worker
2
Other
1
Figure 7.
Areas of occupation for Leptospirosis Notifications in 2005 for Queensland, New South Wales and Victoria
100%
Percent of Notifications
90%
80%
70%
60%
Other
50%
Animal Based
40%
Agricultural
30%
20%
10%
0%
Qld
NSW
State
Page 9
Victoria
Leptospirosis Surveillance Report 14
January – December 2005
Hospitalisation
Hospitalisation rates for leptospirosis in Queensland increased in 2005 from 66.7% (2004) to 68.0% and in
Australia from 65.5% (2004) to 67.1%.
Table 8.
Comparison of Hospitalisation Data – Australia and Queensland 2005
Australia
Queensland
Percentage Hospitalised
67.1%
68.0%
Average Hospitalisation
4.7 days
3.8 days
Longest Hospitalisation
34 days
17 days
Isolations
Table 9 demonstrates the data for isolation from blood cultures to 2005. All isolation attempts were from
Queensland specimens. Table 10 shows the percentage and number of isolations of leptospiral serovars
recovered.
Table 9.
Isolation Data for Blood Culture (Queensland)
2003
2004
2005
No. isolations
26
51
25
No. isolation attempts
353
391
369
% Successful attempts
7.4%
13.0%
6.8%
No. notifications
71
122
65
% of notifications that were isolations
36.6%
41.8%
38.5%
Table 10.
Percentage and Number of isolates recovered – Queensland 2005
Serovar
Number of
Isolations
Percentage of
Isolations
Zanoni
13
52%
Australis
4
16%
Kremastos
1
4%
Robinsoni
3
12%
Hardjo
1
4%
Arborea
2
8%
Unresolved
1
4%
Total
25
100%
Page 10