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Leptospirosis among Dengue-Negative Febrile Patients in Selangor, Malaysia

Shih Keng LoongTropical Infectious Diseases Research & Education Centre, Universiti Malaya, Kuala Lumpur, Malaysia;

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Mohamad Azlan Abd-MajidTropical Infectious Diseases Research & Education Centre, Universiti Malaya, Kuala Lumpur, Malaysia;

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Boon Teong TeohTropical Infectious Diseases Research & Education Centre, Universiti Malaya, Kuala Lumpur, Malaysia;

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Mi Jing ChehTropical Infectious Diseases Research & Education Centre, Universiti Malaya, Kuala Lumpur, Malaysia;

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Chee Sieng KhorTropical Infectious Diseases Research & Education Centre, Universiti Malaya, Kuala Lumpur, Malaysia;

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Chien Chung ChaoNaval Medical Research Center, Silver Spring, Maryland;
Department of Preventive Medicine and Biostatistics, Uniformed Services University of the Health Sciences, Bethesda, Maryland;

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Jing Jing KhooTropical Infectious Diseases Research & Education Centre, Universiti Malaya, Kuala Lumpur, Malaysia;

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Sazaly AbuBakarTropical Infectious Diseases Research & Education Centre, Universiti Malaya, Kuala Lumpur, Malaysia;
Department of Medical Microbiology, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia

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ABSTRACT.

In recent years, the number of leptospirosis cases, including the number of deaths, has exponentially increased in Malaysia. From June 2016 to February 2018, blood samples of 321 febrile patients with the presumptive diagnosis of dengue-like illness were examined for possible exposure to Leptospira. Two hundred fifty-five blood samples were tested as negative for dengue. Seminested polymerase chain reaction (PCR) and IgM ELISA for leptospirosis were performed. From the samples, an overall prevalence for leptospirosis based on PCR of 4.7% (12/255) was obtained. Eighteen percent (46/255) were positive for anti-Leptospira IgM antibodies. The genome sequences of six of 12 Leptospira PCR-positive samples showed > 97.0% similarity to Leptospira interrogans. One patient’s sample consisted of Leptospira and chikungunya virus, suggesting a coinfection. Findings from the study suggest that leptospirosis is prevalent among dengue-negative febrile patients in Malaysia.

Author Notes

Address correspondence to Sazaly AbuBakar, Tropical Infectious Diseases Research & Education Centre, Universiti Malaya, 50603 Kuala Lumpur, Malaysia. E-mail: sazaly@um.edu.my

Financial support: We acknowledge the Ministry of Higher Education, Malaysia, for funding this work under the niche area research of the Higher Institution Centre of Excellence program (MO002-2019). The opinions and assertions contained herein are those of the authors and do not necessarily reflect the official policy or position of the U.S. Department of the Navy, U.S. Department of Defense, or the U.S. Government.

Disclosure: Author C. C. C. is an employee of the U. S. Government. This work was prepared as part of 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 U.S. Government work as a work prepared by an employee of the U.S. Government as part of that person’s official duties. This study was approved by the Medical Research and Ethics Committee (NMRR15-2141-27145 [IIR]).

Authors’ addresses: Shih Keng Loong, Mohamad Azlan Abd-Majid, Boon Teong Teoh, Mi Jing Cheh, Chee Sieng Khor, Jing Jing Khoo, and Sazaly AbuBakar, Tropical Infectious Diseases Research & Education Centre, Universiti Malaya, 50603 Kuala Lumpur, Malaysia, E-mails: loongsk@um.edu.my, azlanbinmajid@gmail.com, boonteong@um.edu.my, mjcheh1995@hotmail.com, khor_cs@um.edu.my, khoojj@gmail.com, and sazaly@um.edu.my. Chien Chung Chao, Naval Medical Research Center, Silver Spring, MD, and Department of Preventive Medicine and Biostatistics, Uniformed Services University of the Health Sciences, Bethesda, MD, E-mail: ch3chao@gmail.com.

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