title: High Prevalence of Intermediate Leptospira spp. DNA in Febrile Humans from Urban and Rural Ecuador.
abstract: Leptospira spp., which comprise 3 clusters (pathogenic, saprophytic, and intermediate) that vary in pathogenicity, infect >1 million persons worldwide each year. The disease burden of the intermediate leptospires is unclear. To increase knowledge of this cluster, we used new molecular approaches to characterize Leptospira spp. in 464 samples from febrile patients in rural, semiurban, and urban communities in Ecuador; in 20 samples from nonfebrile persons in the rural community; and in 206 samples from animals in the semiurban community. We observed a higher percentage of leptospiral DNA-positive samples from febrile persons in rural (64%) versus urban (21%) and semiurban (25%) communities; no leptospires were detected in nonfebrile persons. The percentage of intermediate cluster strains in humans (96%) was higher than that of pathogenic cluster strains (4%); strains in animal samples belonged to intermediate (49%) and pathogenic (51%) clusters. Intermediate cluster strains may be causing a substantial amount of fever in coastal Ecuador.
authors.forename: Jorge
authors.initials: J
authors.lastname: Chiriboga
authors.forename: Verónica
authors.initials: V
authors.lastname: Barragan
authors.forename: Gabriela
authors.initials: G
authors.lastname: Arroyo
authors.forename: Andrea
authors.initials: A
authors.lastname: Sosa
authors.forename: Dawn N
authors.initials: DN
authors.lastname: Birdsell
authors.forename: Karool
authors.initials: K
authors.lastname: España
authors.forename: Ana
authors.initials: A
authors.lastname: Mora
authors.forename: Emilia
authors.initials: E
authors.lastname: Espín
authors.forename: María Eugenia
authors.initials: ME
authors.lastname: Mejía
authors.forename: Melba
authors.initials: M
authors.lastname: Morales
authors.forename: Carmina
authors.initials: C
authors.lastname: Pinargote
authors.forename: Manuel
authors.initials: M
authors.lastname: Gonzalez
authors.forename: Rudy
authors.initials: R
authors.lastname: Hartskeerl
authors.forename: Paul
authors.initials: P
authors.lastname: Keim
authors.forename: Gustavo
authors.initials: G
authors.lastname: Bretas
authors.forename: Joseph N S
authors.initials: JN
authors.lastname: Eisenberg
authors.forename: Gabriel
authors.initials: G
authors.lastname: Trueba
mesh_terms: D000818:Animals; D004196:Disease Outbreaks; D004484:Ecuador / Q000453:epidemiology; D005335:Fever of Unknown Origin / Q000175:diagnosis* / Q000453:epidemiology / Q000821:virology; D006801:Humans; D007919:Leptospira / Q000235:genetics / Q000472:pathogenicity* / Q000821:virology; D007922:Leptospirosis / Q000175:diagnosis* / Q000453:epidemiology; D015995:Prevalence; D012424:Rural Population; D017422:Sequence Analysis, DNA / Q000379:methods; D014505:Urban Population
keywords: Ecuador; Leptospira spp.; bacteria; carrier animals; febrile; fever; humans; intermediate cluster; intermediate species; prevalence; rrs gene; rural areas; semiurban areas; urban areas; zoonoses