1887

8 : Epidemic Leptospirosis Associated with Pulmonary Hemorrhage in Nicaragua, Other Recent Outbreaks, and Diagnostic Testing: Issues and Opportunities

MyBook is a cheap paperback edition of the original book and will be sold at uniform, low price.

Ebook: Choose a downloadable PDF or ePub file. Chapter is a downloadable PDF file. File must be downloaded within 48 hours of purchase

Buy this Chapter
Digital (?) $15.00

Preview this chapter:
Zoom in
Zoomout

Epidemic Leptospirosis Associated with Pulmonary Hemorrhage in Nicaragua, Other Recent Outbreaks, and Diagnostic Testing: Issues and Opportunities, Page 1 of 2

| /docserver/preview/fulltext/10.1128/9781555816957/9781555811419_Chap08-1.gif /docserver/preview/fulltext/10.1128/9781555816957/9781555811419_Chap08-2.gif

Abstract:

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.

Citation: Perkins B. 1998. Epidemic Leptospirosis Associated with Pulmonary Hemorrhage in Nicaragua, Other Recent Outbreaks, and Diagnostic Testing: Issues and Opportunities, p 159-168. In Scheld W, Craig W, Hughes J (ed), Emerging Infections 2. ASM Press, Washington, DC. doi: 10.1128/9781555816957.ch8

Key Concept Ranking

Enzyme-Linked Immunosorbent Assay
0.45879766
0.45879766
Highlighted Text: Show | Hide
Loading full text...

Full text loading...

Figures

Image of Figure 1
Figure 1

Leptospirosis associated with pulmonary hemorrhage. A single leptospire in alveolar space is seen by immunostaining in a lung sample from a patient who died of a pulmonary hemorrhage. Naphthol-fast red with hematoxylin counterstain was used. Original magnification, x250. (Courtesy of Sherif R. Zaki.)

Citation: Perkins B. 1998. Epidemic Leptospirosis Associated with Pulmonary Hemorrhage in Nicaragua, Other Recent Outbreaks, and Diagnostic Testing: Issues and Opportunities, p 159-168. In Scheld W, Craig W, Hughes J (ed), Emerging Infections 2. ASM Press, Washington, DC. doi: 10.1128/9781555816957.ch8
Permissions and Reprints Request Permissions
Download as Powerpoint
Image of Figure 2
Figure 2

Epidemic curve or suspected leptospirosis cases from Achuapa and El Sauce, Nicaragua. for October and November 1995.

Citation: Perkins B. 1998. Epidemic Leptospirosis Associated with Pulmonary Hemorrhage in Nicaragua, Other Recent Outbreaks, and Diagnostic Testing: Issues and Opportunities, p 159-168. In Scheld W, Craig W, Hughes J (ed), Emerging Infections 2. ASM Press, Washington, DC. doi: 10.1128/9781555816957.ch8
Permissions and Reprints Request Permissions
Download as Powerpoint

References

/content/book/10.1128/9781555816957.chap8
1. Adler, B.,, A. M. Murphy,, S. A. Locarnini,, and S. Faine. 1980. Detection of specific anti-leptospiral immunoglobulins M and G in human serum by solid-phase enzyme-linked immunosorbent assay. J. Clin. Microbial. 11:452457.
2. Bal, A. E.,, C. Gravekamp,, R. A. Harlskeerl,, J. Dc Meza-Brewstcr,, H. Korver,, and W. J. Terpstra. 1994. Detection of leptospires in urine by peR for early diagnosis of leptospirosis. J. Clin. Microbial. 32:18941898.
3. Brown, P. D.,, C. Gravekamp,, D. G. Carrington, et al. 1995. Evaluation of the polymerase chain reaction for early diagnosis of leptospirosis. J. Med. Microbial. 43:110114.
4.Centers for Disease Control and Prevention. 1995. Outbreak of acute febrile illness and pulmonary hemorrhage-Nicaragua, 1995. Morbid. Mortal. Weekly Rep. 44:841843.
5.Centers for Disease Control and Prevention. 1997. Outbreak of leptospirosis among white-water rafters-Costa Rica, 1996. Morbid. Mortal. Weekly Rep. 46:577579. Sa. Centers for Disease Control and Prevention. Unpublished data.
6.Faine S. 1982. Guidelines for the Control of Leptospirosis. World Health Organization, Geneva, Switzerland.
7. Farr, R. W.. Leptospirosis1995. cID 21:18.
8.Feigin, R D., and D. C. Anderson. 1975. Human leptospirosis. Crit. Rev. C1in. Lab. Sci. 5:413167.
9. Gussenhoven, G. C, M. A. W. G. van der Hoon, M. G. A. Goris, et al. 1997. LEPTO dipstick: a dipstick assay for the detection of Leptospira-specific immunoglobulin M antibodies in human sera. J. C1in. Microbial. 35:9297.
10.Inada, R, Y. Ido, R. Hoki, R. Kaneko, and H. Ito. 1916. The etiology, mode of infection and specific therapy of Weil’s disease (spirochaetosis icterohaemorrhagica). J. Exp. Med. 23:377402.
11. Merien, F.,, G. Baranlon,, and P. Perolat. 1995. Comparison of polymerase chain reaction with microagglutination test and culture for diagnosis of leptospirosis. J. Infect. Dis. 172:281285.
12. O'Neil, K. M.,, L. S. Rickman,, and A. A. Lazarus. 1991. Pulmonary manifestations of leptospirosi s. J. Infect. Dis. 13:705709.
13. Pappas, M. G.,, W. R. Ballou,, M. R. Gray,, E. T. Takafujl,, R. N. Miller,, and W. T. Hockmeyer. 1985. Rapid serodiagnosis of leptospirosis using the IgM-specific dot-ELISA: comparison with microscopic agglutination test. Am. J. Trop. Med. Hyg. 34:346354.
14. Park, S.-K.,, S.-H. Lee,, and Y.-K. Rhee, et al. 1989. Leptospirosis in Chonbuk province of Korea in 1987: a study of 93 patients. Am. J. Trop. Med. Hyg. 41:345351.
15. Ribeiro, M. A.,, C. C. Souza,, and S. H. Almeida. 1995. Dot-ELISA for human leptospirosis employing immunodominant antigen. J. Trop. Med. Hyg. 98:452456.
16. Rio Goncalves, A. J.,, J. E. Manhaes de Carvalho,, J. B. Guedes de Silva,, R. Rozenbaum,, and A. R. Machado Vierna. 1992. Hemoptise/ s e sindrome de angustia respiratoria do adulto como causas de morte na leptospirose. Mudancas de padroes cHoicos e anatomopatologicos. Rev. Soc. Brasil. Med. Trop. 25:261270.
17. Sanders, E. J.,, H. J. Rigau-Perez,, H. Smits, et al. 1997. Abstract 70. In Program and Abstracts of the 46th Annual Meeting of the American Society of Tropical Medicine and Hygiene.
18. Sanford, J. P. 1984. Leptospirosis-time for a booster. N. Engl. J. Med. 310:524525.
19. Sulzer, C. R.,, J. W. Glosser,, F. Rogers,, W. L. Jones,, and M. Frix. 1975. Evaluation of an indirect hemagglutination test for the diagnosis of human leptospirosis. J. Clin. Microbiol. 2:218221.
20. Sun-Ho, K.,, K. Ik-Sang,, C. Myung-Slk,, and W.-H. Chang. 1994. Detection of leptospiral DNA by PCR. J. Clin. Microbial. 32:10351039.
21. Takafuji, E. T.,, J. W. Kirkpatrick,, and R. N. Miller. 1984. An efficacy trial of doxycycline chemoprophylaxis against leptospirosis. N. Engl. J.. Med. 310:497.
22. Trevejo, R. T.,, J. G. Rigau-Perez,, D. A. Ashford, et al. Epidemic leptospirosis associated with pulmonary hemorrhage-Nicaragua. 1995.J., Infect. Dis., in press.
23. Wang, C. N.,, J. Liu,, T. F. Chang,, W. J. Cheng,, M. Y. Luo,, and A. T. Hung. 1965. Studies on anicteric leptospirosis: L Clinical manifestations and antibiotic therapy. Chin. Med. J. 84:283291.
24. Watt, G.,, M. L. Tuazon,, and E. Santiago. 1988. Placebo-controlled trial of intravenous penicillin for severe and late leptospirosis. Lancet 1:433435.
25. Yasuda, P. H.,, A. G. Steigerwalt,, K. R. Sulzer,, A. F. Kaufmann,, F. Rogers,, and D. J. Brenner. 1987. Deoxyribonucleic acid relatedness between serogroups and serovars in the family Leptospiraceae with proposals for seven new Leptospira species. Int. J., Syst. Bacterial. 37:407415.
26. Zaki, S. R.,, and W. J. Shieh. 1996. Epidemic Working Group. Leptospirosis associated with outbreak of acute febrile illness and pulmonary haemorrhage, Nicaragua, 1995. Lancet 347:535536.
27. Zuerner, R. L.,, D. Alt,, and C. A. Bolin. 1995. ISl533-based PCR assay for identification of Leptospira interrogans sensu lato serovars. J. Clin. Microbiol. 33:32843289.

Tables

Generic image for table
Table 1

Selected risk factors evaluated in the case-control study

Citation: Perkins B. 1998. Epidemic Leptospirosis Associated with Pulmonary Hemorrhage in Nicaragua, Other Recent Outbreaks, and Diagnostic Testing: Issues and Opportunities, p 159-168. In Scheld W, Craig W, Hughes J (ed), Emerging Infections 2. ASM Press, Washington, DC. doi: 10.1128/9781555816957.ch8
Generic image for table
Table 2

MAT seropositivity by serovar among persons enrolled in the case-control study

Citation: Perkins B. 1998. Epidemic Leptospirosis Associated with Pulmonary Hemorrhage in Nicaragua, Other Recent Outbreaks, and Diagnostic Testing: Issues and Opportunities, p 159-168. In Scheld W, Craig W, Hughes J (ed), Emerging Infections 2. ASM Press, Washington, DC. doi: 10.1128/9781555816957.ch8
Generic image for table
Table 3

MAT seropositivity by animal type at case and control households where at least one of the animal type was present and tested at matched case and control household sets

Citation: Perkins B. 1998. Epidemic Leptospirosis Associated with Pulmonary Hemorrhage in Nicaragua, Other Recent Outbreaks, and Diagnostic Testing: Issues and Opportunities, p 159-168. In Scheld W, Craig W, Hughes J (ed), Emerging Infections 2. ASM Press, Washington, DC. doi: 10.1128/9781555816957.ch8

This is a required field
Please enter a valid email address
Please check the format of the address you have entered.
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error