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An epidemiological study on subclinical Leptospiral infection among rural Koreans by Leptospira isolation in blood culture
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Joung Soon Kim, J.K Lee, H.W Chung, S.J Yang, H.S Lim, W.Y Lee
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Korean J Epidemiol. 1985;7(2):253-258.
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 Abstract
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Abstract
A clinical syndrome complex that had been known as epidemic pulmonary hemorrhagic fever in Korea since 1975 has been proved to be leptospiral infection by Kim et al. in 1984.
Even though hundreds of cases have been reported for the last 10 years, few information on the status of leptospiral infection among general population at risk is available.
This study was carried out in a small rural community with 189 population in 41 household to estimate subclinical leptospiral infection rate. The study consisted of interview, medical examination by doctors, and blood sampling. The first study in which only 50 inhabitants completed the study on November 3rd, and the second one for the drop-outs on December 17th, 1985.
The blood specimens were inoculated to a newly developed artificial media by Lee, YUMC-5050, which had been demonstrated to be quite sensitive, silver stained in two weeks of culture and examined under microscope for the characteristic leptospiral bacteria. Since leptospiral positives were found only among the first study group, probably due to the optimal timing for culture (November 3rd), but none of 40 specimens sampled in the second study was culture positive, the data analysis had to be depended upon the first study population. Among six positives re-cultured in the second study period, only one remained positive and five became negative within one and half month.
The summarized findings are as followings：
1) Leptospira culture positive rate was 16% average; 23% for males and 11% for females. The cases were net clustered to any particular age group but rather even for all active ages. Protective immunity for older ages was not evidenced.
2) Clinical symptoms and signs experienced by the study subjects during the last one month were not significantly different in kind and frequency between leptospira positives and negatives except one case each for hematuria and lymphadenpathy in positive group. Two out of eight positives had mild clinical manifestation competible to leptospiral infection but six of them were typical of subclinical infection.
3) Enviromental factors exposed also were not different between leptospira culture positives and negative, probably owing to the fact that these farmers were exposed to all environments in multiplicity making it difficult to find out the difference for any environmental particulars.
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