TY - JOUR
T1 - Leptospirosis as frequent cause of acute febrile illness in southern Sri Lanka
AU - Reller, Megan E.
AU - Bodinayake, Champika
AU - Nagahawatte, Ajith
AU - Devasiri, Vasantha
AU - Kodikara-Arachichi, Wasantha
AU - Strouse, John J.
AU - Flom, Judith E.
AU - Dumler, J. Stephen
AU - Woods, Christopher W.
PY - 2011/9
Y1 - 2011/9
N2 - To determine the proportion of fevers caused by leptospirosis, we obtained serum specimens and epidemiologic and clinical data from patients in Galle, Sri Lanka, March-October 2007. Immunoglobulin M ELISA was performed on paired serum specimens to diagnose acute (seroconversion or 4-fold titer rise) or past (titer without rise) leptospirosis and seroprevalence (acute). We compared (individually) the diagnostic yield of acute-phase specimens and clinical impression with paired specimens for acute leptospirosis. Of 889 patients with paired specimens, 120 had acute leptosoirosis and 241 had past leptospirosis. The sensitivity and specifi city of acute-phase serum specimens were 17.5% (95% confi dence interval [CI] 11.2%-25.5%) and 69.2% (95% CI 65.5%-72.7%), respectively, and of clinical impression 22.9% (95% CI 15.4%-32.0%) and 91.7% (95% CI 89.2%-93.8%), respectively. For identifying acute leptospirosis, clinical impression is insensitive, and immunoglobulin M results are more insensitive and costly. Rapid, pathogen-based tests for early diagnosis are needed.
AB - To determine the proportion of fevers caused by leptospirosis, we obtained serum specimens and epidemiologic and clinical data from patients in Galle, Sri Lanka, March-October 2007. Immunoglobulin M ELISA was performed on paired serum specimens to diagnose acute (seroconversion or 4-fold titer rise) or past (titer without rise) leptospirosis and seroprevalence (acute). We compared (individually) the diagnostic yield of acute-phase specimens and clinical impression with paired specimens for acute leptospirosis. Of 889 patients with paired specimens, 120 had acute leptosoirosis and 241 had past leptospirosis. The sensitivity and specifi city of acute-phase serum specimens were 17.5% (95% confi dence interval [CI] 11.2%-25.5%) and 69.2% (95% CI 65.5%-72.7%), respectively, and of clinical impression 22.9% (95% CI 15.4%-32.0%) and 91.7% (95% CI 89.2%-93.8%), respectively. For identifying acute leptospirosis, clinical impression is insensitive, and immunoglobulin M results are more insensitive and costly. Rapid, pathogen-based tests for early diagnosis are needed.
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U2 - 10.3201/eid1709.100915
DO - 10.3201/eid1709.100915
M3 - Article
C2 - 21888794
AN - SCOPUS:80052150410
SN - 1080-6040
VL - 17
SP - 1678
EP - 1684
JO - Emerging infectious diseases
JF - Emerging infectious diseases
IS - 9
ER -