{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,25]],"date-time":"2026-10-25T02:52:39Z","timestamp":1792896759025,"version":"4.5.0"},"reference-count":43,"publisher":"Pan American Health Organization","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2020,7,15]]},"abstract":"<p><bold>Objective.<\/bold> This review describes the geographic and temporal distribution of, detection methods for, and other epidemiological features of published leptospirosis outbreaks, with the aim of informing efforts to standardize outbreak-reporting practices.<\/p>\n<p><bold>Methods.<\/bold> We conducted a systematic review of leptospirosis outbreaks reported in the scientific literature and ProMED during 1970\u20132012. Predefined criteria were used to identify and classify outbreaks and a standard form was used to extract information.<\/p>\n<p><bold>Results.<\/bold> During 1970\u20132012, we identified 318 outbreaks (average: 7 outbreaks\/year; range: 1\u201319). Most outbreaks were reported in the Latin America and the Caribbean region (36%), followed by Southern Asia (13%), and North America (11%). Most outbreaks were located in tropical and subtropical ecoregions (55%). Quality classification showed that there was clear description of laboratory-confirmed cases in 40% of outbreaks. Among those, the average outbreak size was 82 cases overall (range: 2\u20132 259) but reached 253 cases in tropical\/subtropical ecoregions. Common risk factors included outdoor work activities (25%), exposure to floodwaters (23%), and recreational exposure to water (22%). Epidemiologic investigation was conducted in 80% of outbreaks, mainly as case interviews. Case fatality was 5% overall (range: 0%\u201360%).<\/p>\n<p><bold>Conclusions.<\/bold> Outbreak reporting increased over the study period with outbreaks covering tropical and non-tropical regions. Outbreaks varied by size, setting, and risk factors; however, data reviewed often had limited information regarding diagnosis and epidemiology. Guidelines are recommended to develop standardized procedures for diagnostic and epidemiological investigations during an outbreak and for reporting.<\/p>","DOI":"10.26633\/rpsp.2020.78","type":"journal-article","created":{"date-parts":[[2020,7,15]],"date-time":"2020-07-15T18:19:50Z","timestamp":1594837190000},"page":"1","source":"Crossref","is-referenced-by-count":100,"title":["A systematic literature review of leptospirosis outbreaks worldwide, 1970\u20132012"],"prefix":"10.26633","volume":"44","author":[{"given":"Claudia","family":"Munoz-Zanzi","sequence":"first","affiliation":[{"name":"University of Minnesota, Minneapolis MN, United States of America"},{"name":"munozzan@umn.edu"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emily","family":"Groene","sequence":"additional","affiliation":[{"name":"University of Minnesota, Minneapolis MN, United States of America"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bozena M","family":"Morawski","sequence":"additional","affiliation":[{"name":"University of Minnesota, Minneapolis MN, United States of America"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kimberly","family":"Bonner","sequence":"additional","affiliation":[{"name":"University of Minnesota, Minneapolis MN, United States of America"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Federico","family":"Costa","sequence":"additional","affiliation":[{"name":"Universidade Federal da Bahia, Salvador BA, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eric","family":"Bertherat","sequence":"additional","affiliation":[{"name":"World Health Organization, Geneva, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria Cristina","family":"Schneider","sequence":"additional","affiliation":[{"name":"Pan American Health Organization, Washington DC, United States of America"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"11167","reference":[{"key":"ref1","doi-asserted-by":"crossref","unstructured":"Costa F, Hagan JE, Calcagno J, Kane M, Torgerson P, Martinez-Silveira MS, et al. 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