The importance of leptospirosis in Southeast Asia.
The importance of leptospirosis in Southeast Asia was assessed in conjunction with other studies supported by the U.S. Naval Medical Research Unit No. 2 (US NAMRU-2), Jakarta, Republic of Indonesia. These included studies of hospital-based, acute clinical jaundice in Indonesia, Lao PDR, and Socialist Republic of Vietnam; nonmalarial fever in Indonesia; and hemorrhagic fever in Cambodia. Background prevalence estimates of leptospiral infection were obtained by a cross-sectional, community-based study in Lao PDR. Laboratory testing methods involved serology, microscopic agglutination test, and reverse-transcriptase polymerase chain reaction. Suggestive evidence of recent leptospiral infections was detected in 17%, 13%, and 3% of patients selected on the basis of non-hepatitis A through E jaundice, nonmalarial fever, and hemorrhagic fever (in the absence of acute, dengue viral infections). Leptospiral IgG antibody, reflective of prior infections, was detected in 37% of human sera, collected in Lao PDR. The predominant leptospiral serogroups identified from cases with clinical jaundice were Hurstbridge, Bataviae, and Icterohaemorrhagiae tonkini LT 96 69. Among the nonmalarial febrile cases, Bataviae was the most frequently recognized serogroup. Pyrogenes and Hurstbridge were the principal serogroups among the hemorrhagic fever case subjects. These findings further attest to the relative importance of clinical leptospirosis in Southeast Asia. The wide spectrum of clinical signs and symptoms associated with probable, acute, leptospiral infections contributes to the potential of significant underreporting.
Laras
Kanti
K
U.S. Naval Medical Research Unit No. 2, Jakarta, Indonesia.
Cao
Bao Van
BV
Bounlu
Khanthong
K
Nguyen
Thi Kim Tien
TK
Olson
James G
JG
Thongchanh
Sisouk
S
Tran
Nguyen Van Anh
NV
Hoang
Kim Loan
KL
Punjabi
Narain
N
Ha
Ba Khiem
BK
Ung
Sam An
SA
Insisiengmay
Sithat
S
Watts
Douglas M
DM
Beecham
H James
HJ
Corwin
Andrew L
AL
D000293:Adolescent; D000328:Adult; D001210:Asia, Southeastern / Q000453:epidemiology; D001483:Base Sequence; D003430:Cross-Sectional Studies; D017931:DNA Primers; D003710:Demography; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D006801:Humans; D007919:Leptospira / Q000235:genetics / Q000276:immunology; D007922:Leptospirosis / Q000453:epidemiology*; D008297:Male; D008875:Middle Aged; D017720:Molecular Epidemiology; D016133:Polymerase Chain Reaction
D017931:DNA Primers