Environmental exposure and leptospirosis, Peru.
Human infection by leptospires has highly variable clinical manifestations, which range from subclinical infection to fulminant disease. We conducted a population-based, cross-sectional seroepidemiologic study in Peru to determine potential relationships of environmental context to human exposure to Leptospira and disease associated with seroconversion. Three areas were studied: a flooded, urban slum in the Peruvian Amazon city of Iquitos; rural, peri-Iquitos villages; and a desert shantytown near Lima. Seroprevalence in Belen was 28% (182/650); in rural areas, 17% (52/316); and in a desert shantytown, 0.7% (1/150). Leptospira-infected peridomestic rats were found in all locales. In Belen, 20 (12.4%) of 161 patients seroconverted between dry and wet seasons (an incidence rate of 288/1,000). Seroconversion was associated with history of febrile illness; severe leptospirosis was not seen. Human exposure to Leptospira in the Iquitos region is high, likely related both to the ubiquity of leptospires in the environment and human behavior conducive to transmission from infected zoonotic sources.
Johnson
Michael A S
MA
Asociación Benéfica Prisma, Lima, Peru.
Smith
Hannah
H
Joeph
Priya
P
Gilman
Robert H
RH
Bautista
Christian T
CT
Campos
Kalina J
KJ
Cespedes
Michelle
M
Klatsky
Peter
P
Vidal
Carlos
C
Terry
Hilja
H
Calderon
Martiza M
MM
Coral
Carlos
C
Cabrera
Lilia
L
Parmar
Paminder S
PS
Vinetz
Joseph M
JM
D000293:Adolescent; D000328:Adult; D000368:Aged; D000818:Animals; D000913:Antibodies, Protozoan / Q000097:blood; D002648:Child; D002675:Child, Preschool; D016054:DNA, Protozoan / Q000737:chemistry / Q000235:genetics; D004781:Environmental Exposure; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D006801:Humans; D007223:Infant; D007919:Leptospira / Q000235:genetics / Q000302:isolation & purification*; D007922:Leptospirosis / Q000453:epidemiology* / Q000469:parasitology / Q000635:transmission; D008297:Male; D008875:Middle Aged; D010568:Peru / Q000453:epidemiology; D016133:Polymerase Chain Reaction; D011203:Poverty; D051381:Rats / Q000469:parasitology*; D016036:Seroepidemiologic Studies; D014329:Tropical Climate
D000913:Antibodies, Protozoan; D016054:DNA, Protozoan