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Am. J. Trop. Med. Hyg., 69(1), 2003, pp. 53-57
Copyright © 2003 by The American Society of Tropical Medicine and Hygiene

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AN OUTBREAK OF LEPTOSPIROSIS AMONG PERUVIAN MILITARY RECRUITS

KEVIN L. RUSSELL, MARCO A. MONTIEL GONZALEZ, DOUGLAS M. WATTS, ROBERTO C. LAGOS-FIGUEROA, GLORIA CHAUCA, MARIANELA ORE, JOSE E. GONZALEZ, CECILIA MORON, ROBERT B. TESH, AND JOSEPH M. VINETZ
United States Naval Medical Research Center Detachment, Lima, Peru; Department of Infectious Diseases, Military Hospital, Lima, Peru; Technical School, Peruvian Army, Lima, Peru; Center for Tropical Diseases, Department of Pathology, University of Texas Medical Branch, Galveston, Texas

Acute undifferentiated febrile illnesses are common in tropical developing countries but are difficult to diagnose on clinical grounds alone. Leptospirosis is rarely diagnosed, despite evidence that sporadic cases and epidemics continue to occur worldwide. The purpose of this study was to diagnose an outbreak of acute undifferentiated febrile illness among Peruvian military recruits that developed after a training exercise in the high jungle rainforest of Peru. Of 193 military recruits, 78 developed an acute febrile illness with varied manifestations. Of these, 72 were found to have acute leptospirosis by a microscopic agglutination test (MAT). An enzyme-linked immunosorbent assay using Leptospira biflexa antigen was insensitive for the detection of anti-leptospiral IgM antibodies compared with the MAT (20 of 72, 28%). This outbreak of acute undifferentiated febrile illness among Peruvian military recruits was due to leptospirosis. High clinical suspicion, initiation of preventative measures, and performance of appropriate diagnostic testing is warranted in similar settings to identify, treat, and prevent leptospirosis.

Received February 12, 2003. Accepted for publication April 26, 2003.

Acknowledgments: We sincerely thank Carolina Guevara and Vidal Felices for their extensive laboratory processing of samples from this outbreak. We also thank Juan Perez for data analysis and Monica Barrera for expertise and patience with the graphic arts.

Financial support: This work was supported by the U.S. Department of Defense, the Naval Medical Research and Development Command (Work Unit No. 62787 A870 1612), the Texas Higher Education Coordinating Board, Advanced Technology Program, and the National Institutes of Health, Fogarty International Center (grant 1R01TW005860-01).

Disclaimer: The opinions and assertions contained herein are the private ones of the writers and are not to be construed as official or as reflecting the views of the Navy Department or the naval service at large.

Authors’ addresses: Kevin L. Russell, Naval Health Research Center, Department of Defense Center for Deployment Health Research, PO Box 85122, San Diego, CA 92186-5122, Telephone: 619-553-7628, Fax: 619-553-7601, E-mail: russell{at}nhrc.navy.mil. Marco A. Montiel Gonzalez, Roberto C. Lagos-Figueroa, Gloria Chauca, and Marianela Ore, c/o Naval Medical Research Center Detachment, APO AA 3800, Lima, Peru. Douglas M. Watts, Jose E. Gonzalez, and Robert B. Tesh, Center for Tropical Diseases, Department of Pathology, University of Texas Medical Branch, 301 University Boulevard, Galveston, TX 77555-0609, Telephone: 409-747-2962, Fax: 409-747-2437, E-mail: jovinetz{at}utmb.edu. Cecilia Moron, Instituto Nacional de Salud, Capac Yupanqui 1400, Jesús Maria, Lima, Peru. Joseph M. Vinetz, University of California San Diego School of Medicine, Division of Infectious Diseases, 9500 Gilman Drive, 0640, Cellular and Molecular Medicine-East, Room 2052, La Jolla, CA 92093-0640. Telephone: 858-822-4469, Fax: 858-534-6020, E-mail: jvinetz{at}ucsd.edu.




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