Chiriboga J, Barragan V, Arroyo G, Sosa A, Birdsell DN, España K, Mora A, Espín E, Mejía ME, Morales M, Pinargote C, Gonzalez M, Hartskeerl R, Keim P, Bretas G, Eisenberg JNS, Trueba G. High Prevalence of Intermediate Leptospira spp. DNA in Febrile Humans from Urban and Rural Ecuador.
Emerg Infect Dis 2016;
21:2141-7. [PMID:
26583534 PMCID:
PMC4672404 DOI:
10.3201/eid2112.140659]
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Abstract
Intermediate clusters may cause disease in areas where dengue and malaria are present, so differential diagnosis is necessary.
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.
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