title: The importance of leptospirosis in Southeast Asia.
abstract: 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.
authors.affiliation: U.S. Naval Medical Research Unit No. 2, Jakarta, Indonesia.
authors.forename: Kanti
authors.initials: K
authors.lastname: Laras
authors.forename: Bao Van
authors.initials: BV
authors.lastname: Cao
authors.forename: Khanthong
authors.initials: K
authors.lastname: Bounlu
authors.forename: Thi Kim Tien
authors.initials: TK
authors.lastname: Nguyen
authors.forename: James G
authors.initials: JG
authors.lastname: Olson
authors.forename: Sisouk
authors.initials: S
authors.lastname: Thongchanh
authors.forename: Nguyen Van Anh
authors.initials: NV
authors.lastname: Tran
authors.forename: Kim Loan
authors.initials: KL
authors.lastname: Hoang
authors.forename: Narain
authors.initials: N
authors.lastname: Punjabi
authors.forename: Ba Khiem
authors.initials: BK
authors.lastname: Ha
authors.forename: Sam An
authors.initials: SA
authors.lastname: Ung
authors.forename: Sithat
authors.initials: S
authors.lastname: Insisiengmay
authors.forename: Douglas M
authors.initials: DM
authors.lastname: Watts
authors.forename: H James
authors.initials: HJ
authors.lastname: Beecham
authors.forename: Andrew L
authors.initials: AL
authors.lastname: Corwin
mesh_terms: 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
chemical_list: D017931:DNA Primers