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The epidemiologic status of leptospirosis in Egypt has not been well defined because of difficulties in disease diagnosis. A retrospective study was conducted to detect leptospiral antibodies among undiagnosed acute febrile illness (AFI) and hepatitis cases. Approximately 16% of both AFI (141/886) and acute hepatitis (63/392) cases showed seroreactivity to Leptospira IgM by ELISA and microscopic agglutination test (MAT). Canicola, Djasiman, Grippotyphosa, Pyrogenes, Icterohemorrhagiae, and Pomona were the most commonly reactive serovars among patients with AFI. Djasiman, Grippotyphosa and Icterohemorrhagiae were the most reactive among patients with acute hepatitis. This study represents the first systematic report of Leptospira associated with patients with AFI and hepatitis in Egypt. Physicians need to have increased awareness about the importance of leptospirosis in the differential diagnosis of AFI and acute hepatitis in Egypt. In addition, laboratory capacity should be developed at fever hospitals to diagnose leptospirosis.
Received August 6, 2006. Accepted for publication August 24, 2006.
Acknowledgment: The authors thank Dr Mary Bajani, CDC, Atlanta, GA, for providing the Leptospira serovars.
Financial support: This work was supported by the US Agency for International Development and the Global Emerging Infectious Surveillance System, United States Department of Defense (Work unit MA896).
Disclaimer: The opinions and assertions contained herein are the private ones of the authors and are not to be construed as official or reflecting the views of the Navy Department or the naval services at large, the Department of Defense, the Department of the Army, or the Egyptian Ministry of Health and Population. The study protocol was approved by the US Naval Medical Research Unit No.3 Institutional Review Board (Protocol NAMRU3.1999.0001 [DoD 30969]) in compliance with all Federal regulations governing the protection of human subjects.
Copyright statement: Some of the authors are employees of the US Government. This work was prepared as part of their official duties. Title 17 U.S.C.
105 provides that "Copyright protection under this title is not available for any work of the United States Government." Title 17 U.S.C. 101 defines a US Government work as a work prepared by a military service member or employee of the US Government as part of that person’s official duties.
* Address correspondence to Tharwat F. Ismail, PSC 452, Box 5000 (Attn: Code 304A), FPO AE 09835-0007. E-mail: ismailt{at}namru3.med.navy.mil
Authors’ addresses: Tharwat F. Ismail, E-mail: ismailt{at}namru3.med.navy.mil. Momtaz O. Wasfy, E-mail: wasfym{at}namru3.med.navy.mil. Bassem Abdul-Rahman, E-mail: bassemr{at}namru3.med.navy.mil. Clinton K. Murray, E-mail: Clinton.Murray{at}AMEDD.ARMY.MIL. Duane R. Hospenthal, Brooke Army Medical Center, 3851 Roger Brooke Drive, 7 East, Fort Sam Houston, TX 78234, Telephone: 1-210-916-8752, Fax: 1-210-916-0388, E-mail: Duane.Hospenthal{at}CEN.AMEDD.ARMY.MIL. Moustafa Abdel-Fadeel, E-mail: fadeelm{at}namru3.med.navy.mil. Mohamed Abdel-Maksoud, E-mail: aelmaksoud{at}namru3.med.navy.mil. Ahmed Samir, Faculty of Veterinary Medicine, Cairo University, Tel: 011-202-573-5318, Fax: 011-202-572-5240, E-mail: ahmedsamir121 @hotmail.com. Mahmoud E. Hatem, E-mail: essamhatem @yahoo.com. John Klena, E-mail: klenaj{at}namru3.med.navy.mil. Guillermo Pimentel, US Naval Medical Research Unit-3 PSC 452, Box 5000 (Attn: Code 304A) FPO AE 09835-0007, Telephone: +2-02-348-0372, Fax: +2-02-342-7121, E-mail: pimentelg{at}namru3.med.navy.mil. Nasr El-Sayed, First Undersecretary, Ministry of Health and Population, Cairo, Egypt, Telephone: 011-202-794-2555, E-mail: nasr_elsayed{at}hotmail.com. Rana Hajjeh, CC, DBMD, MS C-09, 1600 Clifton Rd, NE, Atlanta, GA 30333, Telephone: (404) 639-2819, Fax: (404) 639-0070, E-mail: rfh5{at}cdc.gov.
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