Epidemic leptospirosis associated with pulmonary hemorrhage -: Nicaragua, 1995

被引:275
作者
Trevejo, RT
Rigau-Pérez, JG
Ashford, DA
McClure, EM
Jarquín-González, C
Amador, JJ
de los Reyes, JO
Gonzalez, A
Zaki, SR
Shieh, WJ
McLean, RG
Nasci, RS
Weyant, RS
Bolin, CA
Bragg, SL
Perkins, BA
Spiegel, RA
机构
[1] Ctr Dis Control & Prevent, Epidemiol Program Off, Epidem Intelligence Serv, Atlanta, GA USA
[2] Ctr Dis Control & Prevent, Natl Ctr Infect Dis, Div Bacterial & Mycot Dis, Childhood & Resp Dis Branch, Atlanta, GA USA
[3] Ctr Dis Control & Prevent, Emerging Bacterial & Mycot Dis Branch, Atlanta, GA USA
[4] Ctr Dis Control & Prevent, Div Viral & Rickettsial Dis, Mol Pathol & Ultrastruct Act, Atlanta, GA USA
[5] Ctr Dis Control & Prevent, Natl Ctr Infect Dis, Div Vector Borne Infect Dis, Bacterial Zoonoses Branch, Ft Collins, CO USA
[6] Ctr Dis Control & Prevent, Natl Ctr Infect Dis, Div Vector Borne Infect Dis, Arbovirus Dis Branch, Ft Collins, CO USA
[7] USDA, Natl Wildlife Res Ctr, Ft Collins, CO USA
[8] ARS, USDA, Natl Anim Dis Ctr, Ames, IA USA
[9] Ctr Dis Control & Prevent, Natl Ctr Infect Dis, Div Vector Borne Infect Dis, Dengue Branch, San Juan, PR USA
[10] Asociac Probienestar Familia Nicaraguense, Managua, Nicaragua
[11] Minist Salud, Complejo Nacl Salud, Managua, Nicaragua
关键词
D O I
10.1086/314424
中图分类号
R392 [医学免疫学]; Q939.91 [免疫学];
学科分类号
100102 ;
摘要
In October 1995, epidemic "hemorrhagic fever," without jaundice or renal manifestations, was reported in rural Nicaragua following heavy flooding; 2259 residents were evaluated for nonmalarial febrile illnesses (cumulative incidence, 6.1%) and 15 (0.7%) died with pulmonary hemorrhage, A case-control study found that case-patients were more likely than controls to have ever walked in creeks (matched odds ratio [MOR], 15.0; 95% confidence interval [CI], 1.7-132.3), have household rodents (MOR, 10.4; 95% CI, 1.1-97.1), or own dogs with titers greater than or equal to 400 to Leptospira species (MOR, 23.4; 95% CI, 3.6-proportional to), Twenty-six of 51 case-patients had serologic or postmortem evidence of acute leptospirosis. Leptospira species were isolated from case-patients and potential animal reservoirs. This leptospirosis epidemic likely resulted from exposure to flood waters contaminated by urine from infected animals, particularly dogs. Leptospirosis should be included in the differential diagnosis for nonmalarial febrile illness, particularly during periods of flooding or when pulmonary hemorrhage occurs.
引用
收藏
页码:1457 / 1463
页数:7
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