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ACI Avances en Ciencias e Ingenierías

SECTION B: LIFE SCIENCES

Vol. 5 No. 1 (2013)

Difficulties in the differential diagnosis of dengue and leptospirosis in Guayaquil

DOI
https://doi.org/10.18272/aci.v5i1.116
Submitted
September 29, 2015
Published
2013-04-08

Abstract

Leptospirosis and dengue fever are infectious diseases that co-occur during rainy seasons and both produce similar clinical signs. The purpose of this study was to assess the relative frequency of leptospirosis and dengue fever during a rainy season and the clinical difficulty to distinguish them. Blood samples from febrile patients in Guayaquil were obtained during the rainy season of 2008 and were analyzed by IgM ELISA for both diseases. Additionally, retrospective data (2003-2007) from febrile patients who attended one of largest public hospitals in Guayaquil were obtained. From 135 febrile patients samples, 15 (11.1%) were positive to leptospirosis; 36 (26,7%) to dengue fever; 3 (2.2%) to both pathogens and 81 (60%) were negative for both. Based on clinical diagnosis, cases were classified 68.1% as dengue fever; 20.7% as leptospirosis; 9.6% as malaria and 1.5% as other. However, 60% of patients clinically diagnosed as dengue had only antibodies against Leptospira and 25% patients diagnosed as leptospirosis had antibodies to dengue virus. The hospital archives indicated that 72.8% of patients clinically diagnosed as dengue fever had antibodies to Leptospira and not to dengue virus. The results suggest the two diseases are often misidentified which is a serious problem because both diseases require different medical treatment.

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References

  1. Ellis, T.; Imrie, A.; Katz, A.; Effler, P. 2008. "Underrecognition of leptospirosis during a dengue fever outbreak in Hawaii". Vector Borne Zoonotic Dis, 8: 541-547.
  2. Ko, A.; Galvao, M.; Ribeiro, C.; Johnson, W.; Riley, L. 1999. "Urban epidemic of severe leptospirosis in Brazil, Salvador leptospirosis study Group". Lancet, 354: 820-825.
  3. Levett, P.; Branch, S.; Edwards, C. 2000. "Detection of dengue infection in patients investigated for leptospirosis in Barbados". Am J Trop MedHyg, 62: 112-114.
  4. McBride, A.; Athanazio, D.; Reis, M.; Ko, A. 2005. "Leptospirosis". Curr Opin Infect Dis, 18: 376-386.
  5. Xue, F.; Yan, J.; Picardeau, M. 2009. "Evolution and pathogenesis of Leptospira spp.: lessons learned from the genomes". Microbes Infect, 11: 328-333.
  6. Levett, P. 2001. "Leptospirosis". Clin. Microbiol Rev, 14: 296-326.
  7. Vinetz, J. 2001. "Leptospirosis". Curr Opin Infect Dis, 14: 527-538.
  8. Benschop, J.; Heuer, C.; Jaros, P.; Collins-Emerson, J.; Midwinter, A.; Wilson, P. 2009. "Sero-prevalence of leptospirosis in workers at a New Zealand slaughter-house". NZMedJ, 122: 39-47.
  9. Faine, S.; Adler, B.; Bolin, C.; Perolat, P. 1999. "Leptospira and leptospirosis". Medisci: Melbourne - Australia.
  10. Morgan, J.; Bornstein, S.; Karpati, A.; Bruce, M.; Bolin,; Austin, C.; Woods, C.; Lingappa, J.; Langkop, C.; Davis, B.; Graham, D.; Proctor, M.; Ashford, D.; Bajani, M.; Bragg, S.; Shutt, K.; Perkins, B.; Tappero, J. 2002. "Outbreak of leptospirosis among triathlon participants and community residents in Springfield, Illinois, 1998". Clin Infect Dis, 34: 1593-1599.
  11. Narita, M.; Fujitani, S.; Haake, D.; Paterson, D. 2005. "Leptospirosis after recreational exposure to water in the Yaeyama Islands; Japan". Am J Trop Med Hyg, 73: 652-656.
  12. Vanasco, N.; Fusco, S.; Zanuttini, J.; Manattini, S.; Dalla-Fontana, M.; Prez, J.; Cerrano, D.; Sequeira, M. 2002. "Outbreak of human leptospirosis after a flood in Reconquista; Santa Fe, 1998". Rev Argent Microbiol, 34: 124-131.
  13. Edwards, C. 2005. "Leptospirosis: the need for clinical research". Am J Trop Med Hyg, 73: 651.
  14. Ricaldi, J.; Vinetz, J. 2006. "Leptospirosis in the tropics and in travelers". Curr Infect Dis Rep, 8: 51-58.
  15. Effler, P.; Pang, L.; Kitsutani, P.; Vorndam, V; Nakata, M.; Ayers, T.; Elm, J.; Tom, T.; Reiter, P.; Rigau-Perez, J.; Hayes, J.; Mills, K.; Napier, M.; Clark, G.; Gubler, 2005. "Dengue fever, Hawaii 2001-2002". Emerg Infect Dis, 11: 742-749.
  16. Wilder-Smith, A.; Gubler, D. 2008. "Geographic expansion of dengue: the impact of international travel". Med Clin North Am, 92: 1377-1390.
  17. Wilder-Smith, A.; Ooi, E.; Vasudevan, S.; Gubler, D. 2010. "Update on dengue: epidemiology, virus evolution, antiviral drugs, and vaccine development". Curr Infect Dis Rep, 12: 157-164.
  18. Deparis, X.; Maréchal, V; Matheus, S. 2009. "Pathophysiological mechanisms of dengue fever: critical review of current concepts". Med Trop, 69: 351-357.
  19. Halstead, S. 2008. "Dengue virus-mosquito interactions". Annu Rev Entomol, 53: 273-291.
  20. Hales, S.; Weinstein, P.; Souares, Y.; Woodward, A. 1999. "El Nino and the dynamics of vectorborne disease transmission". Environ Health Perspect, 107: 99-102.
  21. Schwartz, E.; Weld, L.; Wilder-Smith, A.; von Sonnenburg, F.; Keystone, J.; Kain, K. 2008. "Seasonality, annual trends, and characteristics of dengue among ill returned travelers, 1997-2006". Emerg Infect Dis, 14: 1081-1988.
  22. Libraty, D.; Myint, K.; Murray, C.; Gibbons, R.; Mammen, M.; Endy, T.; Li, W.; Vaughn, D.; Nisalak, A.; Kalayanarooj, S.; Hospenthal, D.; Green, S.; Rothman, A.; Ennis, F. 2007. "A comparative study of leptospirosis and dengue in Thai children". PLoS Negl Trop Dis, 3: doi: 10.1371/j ournal. pntd.0000111.
  23. Sanders, E.; Rigau-Pérez, J.; Smits, H.; Deseda, C.; Vorndam, V; Aye, T.; Spiegel, R.; Weyant, R.; Bragg, S. 1999. "Increase of leptospirosis in dengue-negative patients after a hurricane in Puerto Rico in 1996". Am J Trop Med Hyg, 61: 399-404.
  24. Toyokawa, T.; Ohnishi, M.; Koizumi, N. 2011. "Diagnosis of acute leptospirosis". Expert Rev Anti Infect Ther, 9: 111-121.
  25. Parker, S.; Cubitt, W. 1999. "The use of the dried blood spot sample in epidemiological studies". J Clin Pathol, 52: 633-639.
  26. Mei, J.; Alexander, J.; Adam, B.; Hannon, W. 2001. "Use of filter paper for the collection and analysis of human whole blood specimens". J Nutr, 131: 1631S-1636S.
  27. Ruangturakit, S.; Rojanasuphot, S.; Srijuggravanvong, A.; Duangchanda, S.; Nuangplee, S.; Igarashi, A. 1994. "Storage stability of dengue IgM and IgG antibodies in whole blood and serum dried on filter paper strips detected by ELISA". Southeast Asian J Trop Med Public Health, 25: 560-564.
  28. UNAIDS/WHO Working Group on Global HIV/AIDS/STI Surveillance. 2001. "Guidelines for Using HIV Testing Technologies in Surveillance: Selection, Evaluation, and Implementation". World Health Organization: Geneva Switzerland.
  29. Cole, J.; Sulzer, C.; Pursell, A. 1973. "Improved microtechnique for leptospiral microscopic agglutination test". ApplMicrobiol, 25: 976-980.
  30. Monahan, A.; Miller, I.; Nally, J. 2009. "Leptospirosis: risks during recreational activities". J Appl Microbiol, 107: 707-716.
  31. Manock, S.; Jacobsen, K.; deBravo, N.; Russell, K.; Negrete, M.; Olson, J.; Sanchez, J.; Blair, P.; Smalligan, R.; Quist, B.; Espín, J.; Espinoza, W.; MacCormick, F.; Fleming, L.; Kochel, T. 2009. "Etiology of acute undifferentiated febrile illness in the Amazon basin of Ecuador". Am J Trop Med Hyg, 81: 146-151.
  32. Leake, J. 2013. "Outbreak of leptospirosis in Ecuador associated with the El Niño Southern Oscillation [ENSO]". Personal communication.

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