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8 : Epidemic Leptospirosis Associated with Pulmonary Hemorrhage in Nicaragua, Other Recent Outbreaks, and Diagnostic Testing: Issues and Opportunities
Epidemic Leptospirosis Associated with Pulmonary Hemorrhage in Nicaragua, Other Recent Outbreaks, and Diagnostic Testing: Issues and Opportunities, Page 1 of 2< Previous page Next page > /docserver/preview/fulltext/10.1128/9781555816957/9781555811419_Chap08-1.gif /docserver/preview/fulltext/10.1128/9781555816957/9781555811419_Chap08-2.gif
This chapter reviews the investigation of a large epidemic of leptospirosis in Nicaragua, two other recent smaller outbreaks, and the current status of diagnostic testing. It may be tempting to speculate that cases of pulmonary hemorrhage resulted from particular virulence factors associated with an as-yet-unidentified new leptospiral serovar. The human serology and culture results suggest that there were multiple serovars involved. This is consistent with the importance of flooding in causing this epidemic as well as identifying walking through creeks as an independent risk factor. The epidemic in Nicaragua and the smaller outbreaks in Puerto Rico and Costa Rica demonstrate the difficulties associated with recognition of leptospirosis, both because of its similarity to other febrile diseases and the lack of simple, widely applicable diagnostic tests. Development of new diagnostic tests including enzyme-linked immunosorbent assay (ELISA) and dipstick format tests to detect IgM antibodies on acute serum specimens, immunohistochemistry, and polymerase chain reaction (PCR)-based detection of leptospiral DNA, provide opportunities for developed and developing countries to improve or implement diagnostic testing for leptospirosis.
Key Concept Ranking
- Enzyme-Linked Immunosorbent Assay