Environmental exposure and leptospirosis, Peru

Michael A.S. Johnson, Hannah Smith, Priya Joseph, Robert H. Gilman, Christian T. Bautista, Kalina J. Campos, Michelle Cespedes, Peter Klatsky, Carlos Vidal, Hilja Terry, Maritza M. Calderon, Callos Coral, Lilia Cabrera, Paminder S. Parmar, Joseph M. Vinetz

Research output: Contribution to journalArticlepeer-review

108 Scopus citations


Human infection by leptospires has highly variable clinical manifestations, which range from subclinical infection to fulminant disease. We conducted a population-based, cross-sectional seroepidemiologic study in Peru to determine potential relationships of environmental context to human exposure to Leptospira and disease associated with seroconversion. Three areas were studied: a flooded, urban slum in the Peruvian Amazon city of Iquitos; rural, peri-Iquitos villages; and a desert shantytown near Lima. Seroprevalence in Belen was 28% (182/650); in rural areas, 17% (52/316); and in a desert shantytown, 0.7% (1/150). Leptospira-infected peridomestic rats were found in all locales. In Belen, 20 (12.4%) of 161 patients seroconverted between dry and wet seasons (an incidence rate of 288/1,000). Seroconversion was associated with history of febrile illness; severe leptospirosis was not seen. Human exposure to Leptospira in the Iquitos region is high, likely related both to the ubiquity of leptospires in the environment and human behavior conducive to transmission from infected zoonotic sources.

Original languageEnglish (US)
Pages (from-to)1016-1022
Number of pages7
JournalEmerging infectious diseases
Issue number6
StatePublished - Jun 2004

ASJC Scopus subject areas

  • Epidemiology
  • Microbiology (medical)
  • Infectious Diseases


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