Incidence of leptospirosis in a select population in Nepal

Myint, Khin Saw Aye; Murray, Clinton K.; Scott, Robert McNair; Shrestha, Mrigendra P.; Mammen, Mammen P.; Shrestha, Sanjaya K.; Kuschner, Robert A.; Joshi, Durga M.; Gibbons, Robert V.

doi:10.1016/j.trstmh.2010.04.001

« Previous Next »Transactions of the Royal Society of Tropical Medicine and Hygiene
Volume 104, Issue 8 , Pages 551-555, August 2010

Incidence of leptospirosis in a select population in Nepal

Khin Saw Aye Myint
- Armed Forces Research Institute of Medical Sciences (AFRIMS), Bangkok, Thailand
Clinton K. Murray
- Infectious Disease Service, San Antonio Military Medical Center, Brooke Army Medical Center, 3851 Roger Brooke Drive, Fort Sam Houston, Texas 78234, USA
- Corresponding author. Tel.: +1 210 916 8752; fax: +1 210 916 0388.
Robert McNair Scott
- Walter Reed/AFRIMS Research Unit-Nepal, P.O. Box 295, Kathmandu, Nepal
Mrigendra P. Shrestha
- Walter Reed/AFRIMS Research Unit-Nepal, P.O. Box 295, Kathmandu, Nepal
Mammen P. Mammen Jr
- Walter Reed/AFRIMS Research Unit-Nepal, P.O. Box 295, Kathmandu, Nepal
Sanjaya K. Shrestha
- Walter Reed/AFRIMS Research Unit-Nepal, P.O. Box 295, Kathmandu, Nepal
Robert A. Kuschner
- Walter Reed Army Institute of Research (WRAIR), 503 Robert Grant, Silver Spring MD 20910, USA
Durga M. Joshi
- Shree Birendra Hospital, Chhauni, Kathmandu, Nepal
Robert V. Gibbons
- Armed Forces Research Institute of Medical Sciences (AFRIMS), Bangkok, Thailand

Received 28 September 2009; received in revised form 14 April 2010; accepted 14 April 2010.

Abstract

The geographic distribution of leptospirosis is widespread but no national surveillance program exists in Nepal to establish the incidence of leptospirosis or the disease burden. This study reports the incidence of symptomatic leptospirosis in military personnel participating in an efficacy study of a hepatitis E virus vaccine in Nepal. Among the 1566 study volunteers who completed follow-up, we evaluated 271 illnesses over 2.2 years for the presence of leptospira IgM antibodies by ELISA. Positive ELISA results were confirmed by the microscopic agglutination test. The annual incidence of disease was between 3.5 and 6.1 cases/1000. The prevalence of confirmed leptospirosis was 9% among hepatitis cases and 8% among febrile cases. The most reactive serovars were Bratislava, Autumnalis, Icterohaemorrhagiae, and Sejroe. Leptospirosis should be considered in the differential diagnosis of febrile illnesses and icteric syndromes in Nepal. Additional studies are needed to establish the broader distribution and the spectrum of disease in Nepal.

Keywords: Nepal, Leptospirosis, ELISA, MAT, hepatitis E, serovar