title: Evidence of rickettsial and leptospira infections in Andean northern Peru.
abstract: Between May and October 2002, a cluster of acute febrile illnesses occurred in the subtropical Andean foothills of Peru. Serologic evidence in villages where disease had been documented showed that the prevalence of IgM antibody to Leptospira ranged from 6% to 52%, that of IgM antibody to spotted fever group (SFG) rickettsia ranged from 10% to 19%, and that of IgM antibody to Coxiella burnetii from 1% to 15%. Measurement of IgG antibodies for SFG rickettsiae suggested that this disease was endemic. In contrast, IgG antibodies against C. burnetii were largely absent. In humans, microagglutination tests identified pathogenic variants of Leptospira. The presence of an SFG rickettsial infection was confirmed in four febrile patients following polymerase chain reaction and sequencing of the conserved 17-kD common antigen gene (htrA). Collectively, these analyses indicated that Rickettsia sp., C. burnetii, and Leptospira sp. were circulating in the region during the time of disease outbreak and implicate the involvement of an as yet undetermined SFG rickettsia in northwestern Peru.
authors.affiliation: US Naval Medical Research Center Detachment, Lima, Peru. blair@nmrcd.med.navy.mil
authors.forename: Patrick J
authors.initials: PJ
authors.lastname: Blair
authors.forename: George B
authors.initials: GB
authors.lastname: Schoeler
authors.forename: Cecilia
authors.initials: C
authors.lastname: Moron
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Anaya
authors.forename: Roxana
authors.initials: R
authors.lastname: Caceda
authors.forename: Manuel
authors.initials: M
authors.lastname: Cespedes
authors.forename: Christopher
authors.initials: C
authors.lastname: Cruz
authors.forename: Vidal
authors.initials: V
authors.lastname: Felices
authors.forename: Carolina
authors.initials: C
authors.lastname: Guevara
authors.forename: Alfredo
authors.initials: A
authors.lastname: Huaman
authors.forename: Ricky
authors.initials: R
authors.lastname: Luckett
authors.forename: Leonardo
authors.initials: L
authors.lastname: Mendoza
authors.forename: Allen L
authors.initials: AL
authors.lastname: Richards
authors.forename: Zonia
authors.initials: Z
authors.lastname: Rios
authors.forename: John W
authors.initials: JW
authors.lastname: Sumner
authors.forename: Pablo
authors.initials: P
authors.lastname: Villaseca
authors.forename: James G
authors.initials: JG
authors.lastname: Olson
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000372:Agglutination Tests; D000907:Antibodies, Bacterial / Q000097:blood; D002648:Child; D016997:Coxiella burnetii / Q000302:isolation & purification*; D004269:DNA, Bacterial / Q000737:chemistry / Q000235:genetics; D004196:Disease Outbreaks; D004797:Enzyme-Linked Immunosorbent Assay; D019084:Fluorescent Antibody Technique, Indirect; D016905:Gram-Negative Bacterial Infections / Q000453:epidemiology* / Q000276:immunology / Q000382:microbiology*; D006801:Humans; D007919:Leptospira / Q000302:isolation & purification*; D008875:Middle Aged; D010568:Peru / Q000453:epidemiology; D016133:Polymerase Chain Reaction; D012281:Rickettsia / Q000235:genetics / Q000302:isolation & purification*; D012424:Rural Population; D016036:Seroepidemiologic Studies
chemical_list: D000907:Antibodies, Bacterial; D004269:DNA, Bacterial