EVIDENCE OF RICKETTSIAL AND LEPTOSPIRA INFECTIONS IN ANDEAN NORTHERN PERU

PATRICK J. BLAIR U.S. Naval Medical Research Center Detachment, Lima, Peru; National Institute of Health, Ministry of Health, Lima, Peru; U.S. Naval Medical Research Center, Silver Spring, Maryland; Centers for Disease Control and Prevention, Atlanta, Georgia

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GEORGE B. SCHOELER U.S. Naval Medical Research Center Detachment, Lima, Peru; National Institute of Health, Ministry of Health, Lima, Peru; U.S. Naval Medical Research Center, Silver Spring, Maryland; Centers for Disease Control and Prevention, Atlanta, Georgia

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CECILIA MORON U.S. Naval Medical Research Center Detachment, Lima, Peru; National Institute of Health, Ministry of Health, Lima, Peru; U.S. Naval Medical Research Center, Silver Spring, Maryland; Centers for Disease Control and Prevention, Atlanta, Georgia

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ELIZABETH ANAYA U.S. Naval Medical Research Center Detachment, Lima, Peru; National Institute of Health, Ministry of Health, Lima, Peru; U.S. Naval Medical Research Center, Silver Spring, Maryland; Centers for Disease Control and Prevention, Atlanta, Georgia

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ROXANA CACEDA U.S. Naval Medical Research Center Detachment, Lima, Peru; National Institute of Health, Ministry of Health, Lima, Peru; U.S. Naval Medical Research Center, Silver Spring, Maryland; Centers for Disease Control and Prevention, Atlanta, Georgia

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MANUEL CESPEDES U.S. Naval Medical Research Center Detachment, Lima, Peru; National Institute of Health, Ministry of Health, Lima, Peru; U.S. Naval Medical Research Center, Silver Spring, Maryland; Centers for Disease Control and Prevention, Atlanta, Georgia

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CHRISTOPHER CRUZ U.S. Naval Medical Research Center Detachment, Lima, Peru; National Institute of Health, Ministry of Health, Lima, Peru; U.S. Naval Medical Research Center, Silver Spring, Maryland; Centers for Disease Control and Prevention, Atlanta, Georgia

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VIDAL FELICES U.S. Naval Medical Research Center Detachment, Lima, Peru; National Institute of Health, Ministry of Health, Lima, Peru; U.S. Naval Medical Research Center, Silver Spring, Maryland; Centers for Disease Control and Prevention, Atlanta, Georgia

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CAROLINA GUEVARA U.S. Naval Medical Research Center Detachment, Lima, Peru; National Institute of Health, Ministry of Health, Lima, Peru; U.S. Naval Medical Research Center, Silver Spring, Maryland; Centers for Disease Control and Prevention, Atlanta, Georgia

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ALFREDO HUAMAN U.S. Naval Medical Research Center Detachment, Lima, Peru; National Institute of Health, Ministry of Health, Lima, Peru; U.S. Naval Medical Research Center, Silver Spring, Maryland; Centers for Disease Control and Prevention, Atlanta, Georgia

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RICKY LUCKETT U.S. Naval Medical Research Center Detachment, Lima, Peru; National Institute of Health, Ministry of Health, Lima, Peru; U.S. Naval Medical Research Center, Silver Spring, Maryland; Centers for Disease Control and Prevention, Atlanta, Georgia

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LEONARDO MENDOZA U.S. Naval Medical Research Center Detachment, Lima, Peru; National Institute of Health, Ministry of Health, Lima, Peru; U.S. Naval Medical Research Center, Silver Spring, Maryland; Centers for Disease Control and Prevention, Atlanta, Georgia

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ALLEN L. RICHARDS U.S. Naval Medical Research Center Detachment, Lima, Peru; National Institute of Health, Ministry of Health, Lima, Peru; U.S. Naval Medical Research Center, Silver Spring, Maryland; Centers for Disease Control and Prevention, Atlanta, Georgia

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ZONIA RIOS U.S. Naval Medical Research Center Detachment, Lima, Peru; National Institute of Health, Ministry of Health, Lima, Peru; U.S. Naval Medical Research Center, Silver Spring, Maryland; Centers for Disease Control and Prevention, Atlanta, Georgia

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JOHN W. SUMNER U.S. Naval Medical Research Center Detachment, Lima, Peru; National Institute of Health, Ministry of Health, Lima, Peru; U.S. Naval Medical Research Center, Silver Spring, Maryland; Centers for Disease Control and Prevention, Atlanta, Georgia

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PABLO VILLASECA U.S. Naval Medical Research Center Detachment, Lima, Peru; National Institute of Health, Ministry of Health, Lima, Peru; U.S. Naval Medical Research Center, Silver Spring, Maryland; Centers for Disease Control and Prevention, Atlanta, Georgia

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JAMES G. OLSON U.S. Naval Medical Research Center Detachment, Lima, Peru; National Institute of Health, Ministry of Health, Lima, Peru; U.S. Naval Medical Research Center, Silver Spring, Maryland; Centers for Disease Control and Prevention, Atlanta, Georgia

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Between May and October 2002, a cluster of acute febrile illnesses occurred in the subtropical Andean foothills of Peru. Serologic evidence in villages where disease had been documented showed that the prevalence of IgM antibody to Leptospira ranged from 6% to 52%, that of IgM antibody to spotted fever group (SFG) rickettsia ranged from 10% to 19%, and that of IgM antibody to Coxiella burnetii from 1% to 15%. Measurement of IgG antibodies for SFG rickettsiae suggested that this disease was endemic. In contrast, IgG antibodies against C. burnetii were largely absent. In humans, microagglutination tests identified pathogenic variants of Leptospira. The presence of an SFG rickettsial infection was confirmed in four febrile patients following polymerase chain reaction and sequencing of the conserved 17-kD common antigen gene (htrA). Collectively, these analyses indicated that Rickettsia sp., C. burnetii, and Leptospira sp. were circulating in the region during the time of disease outbreak and implicate the involvement of an as yet undetermined SFG rickettsia in northwestern Peru.

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