Risk of Severe Leptospirosis from Urban Water Sources
Author Information
Author(s): Ganoza Christian A, Matthias Michael A, Collins-Richards Devon, Brouwer Kimberly C, Cunningham Calaveras B, Segura Eddy R, Gilman Robert H, Gotuzzo Eduardo, Vinetz Joseph M
Primary Institution: Instituto de Medicina Tropical Alexander von Humboldt, Universidad Peruana Cayetano Heredia, Lima, Peru
Hypothesis
Concentrations of more virulent Leptospira would be higher in urban than in rural environmental surface waters.
Conclusion
Urban severe leptospirosis in the Peruvian Amazon is linked to higher concentrations of pathogenic leptospires in environmental waters.
Supporting Evidence
- Pathogenic Leptospira species were found only in urban slum water sources.
- The concentration of pathogen-related Leptospira was higher in urban than rural water sources.
- Human isolates of L. interrogans were significantly associated with urban acquisition.
Takeaway
This study found that dirty water in cities has more germs that can make people very sick with leptospirosis than water in the countryside.
Methodology
A quantitative real-time PCR assay was used to compare levels of Leptospira in urban and rural environmental surface waters.
Potential Biases
Potential cross-reactivity in PCR assays may lead to misidentification of non-pathogenic leptospires.
Limitations
The study could not identify leptospiral serovars in the water samples due to technical limitations.
Participant Demographics
Participants included patients with acute febrile illness from urban and rural health posts in Iquitos, Peru.
Statistical Information
P-Value
p = 0.013
Confidence Interval
95% CI, 463–1,445 leptospires/ml
Statistical Significance
p < 0.05
Digital Object Identifier (DOI)
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