title: A ten-year follow-up of human leptospirosis in Uruguay: an unresolved health problem.
abstract: 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 > 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.
authors.affiliation: Bacteriology and Virology Department, Institute of Hygiene, Universidad de la República, Montevideo, Uruguay. felipe@higiene.edu.uy
authors.forename: Felipe
authors.initials: F
authors.lastname: Schelotto
authors.forename: Elba
authors.initials: E
authors.lastname: Hernández
authors.forename: Sabina
authors.initials: S
authors.lastname: González
authors.forename: Alicia
authors.initials: A
authors.lastname: Del Monte
authors.forename: Silvana
authors.initials: S
authors.lastname: Ifran
authors.forename: Karina
authors.initials: K
authors.lastname: Flores
authors.forename: Lorena
authors.initials: L
authors.lastname: Pardo
authors.forename: Daniel
authors.initials: D
authors.lastname: Parada
authors.forename: Mercedes
authors.initials: M
authors.lastname: Filippini
authors.forename: Victoria
authors.initials: V
authors.lastname: Balseiro
authors.forename: Juan Pablo
authors.initials: JP
authors.lastname: Geymonat
authors.forename: Gustavo
authors.initials: G
authors.lastname: Varela
mesh_terms: D000293:Adolescent; D000328:Adult; D000818:Animals; D000907:Antibodies, Bacterial / Q000097:blood*; D002417:Cattle; D002648:Child; D002675:Child, Preschool; D005243:Feces / Q000382:microbiology; D019084:Fluorescent Antibody Technique, Indirect; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D007919:Leptospira / Q000276:immunology / Q000302:isolation & purification; D007922:Leptospirosis / Q000175:diagnosis / Q000453:epidemiology*; D008297:Male; D008875:Middle Aged; D012680:Sensitivity and Specificity; D014583:Uruguay / Q000453:epidemiology; D055815:Young Adult; D015047:Zoonoses / Q000453:epidemiology / Q000635:transmission
chemical_list: D000907:Antibodies, Bacterial