Leptospirosis as frequent cause of acute febrile illness in southern Sri Lanka

Megan E. Reller, Champika Bodinayake, Ajith Nagahawatte, Vasantha Devasiri, Wasantha Kodikara-Arachichi, John J. Strouse, Judith E. Flom, J. Stephen Dumler, Christopher W. Woods

Research output: Contribution to journalArticle

Abstract

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.

Original languageEnglish (US)
Pages (from-to)1678-1684
Number of pages7
JournalEmerging infectious diseases
Volume17
Issue number9
DOIs
StatePublished - Sep 2011

ASJC Scopus subject areas

  • Epidemiology
  • Microbiology (medical)
  • Infectious Diseases

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    Reller, M. E., Bodinayake, C., Nagahawatte, A., Devasiri, V., Kodikara-Arachichi, W., Strouse, J. J., Flom, J. E., Dumler, J. S., & Woods, C. W. (2011). Leptospirosis as frequent cause of acute febrile illness in southern Sri Lanka. Emerging infectious diseases, 17(9), 1678-1684. https://doi.org/10.3201/eid1709.100915