A ten-year follow-up of human leptospirosis in Uruguay: an unresolved health problem

Abstract

<jats:p>Leptospira spp. are delicate bacteria that cannot be studied by usual microbiological methods. They cause leptospirosis, a zoonotic disease transmitted to humans through infected urine of wild or domestic animals. We studied the incidence of this disease in the Uruguayan population, its epidemiologic and clinical features, and compared diagnostic techniques. After examining 6,778 suspect cases, we estimated that about 15 infections/100,000 inhabitants occurred yearly, affecting mainly young male rural workers. Awareness about leptospirosis has grown among health professionals, and its lethality has consequently decreased. Bovine infections were probably the principal source of human disease. Rainfall volumes and floods were major factors of varying incidence. Most patients had fever, asthenia, myalgias or cephalalgia, with at least one additional abnormal clinical feature. 30-40% of confirmed cases presented abdominal signs and symptoms, conjunctival suffusion and altered renal or urinary function. Jaundice was more frequent in patients aged &gt; 40 years. Clinical infections followed an acute pattern and their usual outcome was complete recovery. Laboratory diagnosis was based on indirect micro-agglutination standard technique (MAT). Second serum samples were difficult to obtain, often impairing completion of diagnosis. Immunofluorescence was useful as a screening test and for early detection of probable infections.</jats:p>

Usefulness of real-time PCR assay targeting lipL32 gene for diagnosis of human leptospirosis in Uruguay

“…Also, in many patients a convalescent-phase serum sample is not collected and the diagnosis is uncertain. In our study, for example, we had a second serum sample from only 183 of the 235 patients, complicating laboratory confirmation of infections [22]. This In our hands, the qPCR assay showed high sensitivity, detecting 10 2 bacteria per mL in DNA extracted from spiked serum, plasma or whole blood samples.…”

“…We estimate that at least 500 new cases occur per year, with an approximate incidence of 15 cases per 100,000 inhabitants [22]. Since 2000, MAT has been routinely used in our laboratory for the diagnosis of leptospirosis.…”

Situación epidemiológica de la leptospirosis humana en Centroamérica, Suramérica y el Caribe

“…En segundo lugar está la transmisión recreacional, que se da en personas que tienen contacto con aguas contaminadas como nadadores o conductores de botes rápidos, entre otros (Velasco et al 2009, Navarrete et al 2011) y en tercer lugar está la transmisión domiciliaria, que se da en personas que presentan convivencia con roedores o animales domésticos infectados (Schelotto et al 2012). …”

“…Otros posibles factores de riesgo que pueden ser considerados como terciarios o de poco reporte son: presencia de época de lluvias, actividades de natación (incluso en agua tratada), trabajadores en el área de alcantarillado, estudiantes y trabajadores de piscicultura (Schelotto et al 2012). Lo anterior posiblemente se debe a las condiciones más favorables para que la bacteria pueda sobrevivir fuera de un reservorio, como son las aguas con pH neutro o ligeramente alcalinas, temperatura de 22 a 30 °C, suelos húmedos y ausencia de exposición a la luz directa del sol (Osés et al 2010).…”

Blood clotting response test for detecting resistance to second generation anticoagulant bromadiolone in house rat (Rattus rattus)

“…The house rat, Rattus rattus Linnaeus (Rodentia: Muridae), is one of the most commonly encountered and economically important commensal rodents. It not only inflicts heavy damage to stored food but also have nuisance value being a disease carrier or vector (Schelotto et al, 2012;Singla et al, 2013;Garedaghi and Khaki, 2014).…”