Unsuspected leptospirosis is a cause of acute febrile illness in Nicaragua.
Epidemic severe leptospirosis was recognized in Nicaragua in 1995, but unrecognized epidemic and endemic disease remains unstudied.To determine the burden of and risk factors associated with symptomatic leptospirosis in Nicaragua, we prospectively studied patients presenting with fever at a large te...
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doaj-df9782ff7dcb46c480d8ea013a48c5b42020-11-25T02:32:28ZengPublic Library of Science (PLoS)PLoS Neglected Tropical Diseases1935-27271935-27352014-07-0187e294110.1371/journal.pntd.0002941Unsuspected leptospirosis is a cause of acute febrile illness in Nicaragua.Megan E RellerElsio A WunderJeremy J MilesJudith E FlomOrlando MayorgaChristopher W WoodsAlbert I KoJ Stephen DumlerArmando J MatuteEpidemic severe leptospirosis was recognized in Nicaragua in 1995, but unrecognized epidemic and endemic disease remains unstudied.To determine the burden of and risk factors associated with symptomatic leptospirosis in Nicaragua, we prospectively studied patients presenting with fever at a large teaching hospital. Epidemiologic and clinical features were systematically recorded, and paired sera tested by IgM-ELISA to identify patients with probable and possible acute leptospirosis. Microscopic Agglutination Test and PCR were used to confirm acute leptospirosis. Among 704 patients with paired sera tested by MAT, 44 had acute leptospirosis. Patients with acute leptospirosis were more likely to present during rainy months and to report rural residence and fresh water exposure. The sensitivity of clinical impression and acute-phase IgM detected by ELISA were poor.Leptospirosis is a common (6.3%) but unrecognized cause of acute febrile illness in Nicaragua. Rapid point-of-care tests to support early diagnosis and treatment as well as tests to support population-based studies to delineate the epidemiology, incidence, and clinical spectrum of leptospirosis, both ideally pathogen-based, are needed.http://europepmc.org/articles/PMC4109853?pdf=render |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Megan E Reller Elsio A Wunder Jeremy J Miles Judith E Flom Orlando Mayorga Christopher W Woods Albert I Ko J Stephen Dumler Armando J Matute |
spellingShingle |
Megan E Reller Elsio A Wunder Jeremy J Miles Judith E Flom Orlando Mayorga Christopher W Woods Albert I Ko J Stephen Dumler Armando J Matute Unsuspected leptospirosis is a cause of acute febrile illness in Nicaragua. PLoS Neglected Tropical Diseases |
author_facet |
Megan E Reller Elsio A Wunder Jeremy J Miles Judith E Flom Orlando Mayorga Christopher W Woods Albert I Ko J Stephen Dumler Armando J Matute |
author_sort |
Megan E Reller |
title |
Unsuspected leptospirosis is a cause of acute febrile illness in Nicaragua. |
title_short |
Unsuspected leptospirosis is a cause of acute febrile illness in Nicaragua. |
title_full |
Unsuspected leptospirosis is a cause of acute febrile illness in Nicaragua. |
title_fullStr |
Unsuspected leptospirosis is a cause of acute febrile illness in Nicaragua. |
title_full_unstemmed |
Unsuspected leptospirosis is a cause of acute febrile illness in Nicaragua. |
title_sort |
unsuspected leptospirosis is a cause of acute febrile illness in nicaragua. |
publisher |
Public Library of Science (PLoS) |
series |
PLoS Neglected Tropical Diseases |
issn |
1935-2727 1935-2735 |
publishDate |
2014-07-01 |
description |
Epidemic severe leptospirosis was recognized in Nicaragua in 1995, but unrecognized epidemic and endemic disease remains unstudied.To determine the burden of and risk factors associated with symptomatic leptospirosis in Nicaragua, we prospectively studied patients presenting with fever at a large teaching hospital. Epidemiologic and clinical features were systematically recorded, and paired sera tested by IgM-ELISA to identify patients with probable and possible acute leptospirosis. Microscopic Agglutination Test and PCR were used to confirm acute leptospirosis. Among 704 patients with paired sera tested by MAT, 44 had acute leptospirosis. Patients with acute leptospirosis were more likely to present during rainy months and to report rural residence and fresh water exposure. The sensitivity of clinical impression and acute-phase IgM detected by ELISA were poor.Leptospirosis is a common (6.3%) but unrecognized cause of acute febrile illness in Nicaragua. Rapid point-of-care tests to support early diagnosis and treatment as well as tests to support population-based studies to delineate the epidemiology, incidence, and clinical spectrum of leptospirosis, both ideally pathogen-based, are needed. |
url |
http://europepmc.org/articles/PMC4109853?pdf=render |
work_keys_str_mv |
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