A cross sectional study of leptospirosis and fetal death in Yucatan, Mexico

Abstract

Introduction: Leptospirosis is a zoonotic disease affecting mainly to low income human population. Acute leptospiral infection during pregnancy has been associated with spontaneous abortion and fetal death during the first trimester and the abortion may occur as consequence of systemic failure. Objective: To estimate the frequency of Leptospira interrogans infection in women with spontaneous abortion in the state of Yucatan, Mexico. Methods: A cross sectional study on women with spontaneous abortion was conducted. Serum samples were tested for Leptospirosis by the microaglutination test, to estimate the frequency of the infecting serovar. The indirect ELISA IgM was used to detect recent infection by L. interrogans. DNA was extracted from paraffin-embedded tissue of placenta for PCR detection of L. interrogans. Results: Overall frequency of infection with L. interrogans in the 81 women with abortion was 13.6%. Five of the 12 serovars evaluated were found and included. Two of the 11 women with abortion and positive to microaglutination test were also positive to the ELISA IgM test. None samples were positive for PCR Leptospira diagnosis. Conclusion: two women could be associated with spontaneous abortion due to leptospirosis, because they showed antibodies against L. interrogans in the microaglutination test and ELISA IgM assays. Differences between regions were found with respect to the prevalences of lesptospirosis.

Leptospirosis in pregnancy: A systematic review

“…For the case reports, the majority of cases were in urban areas (70%, n = 23). One cross sectional study (Study 4, Table 1) based in Yucatan, Mexico found a higher frequency of leptospirosis in pregnancy leading to spontaneous miscarriage in rural areas (4%) compared to urban (1.3%) [17].…”

“…This was due to a general paucity of data on leptospirosis in pregnancy, combined with the heterogeneity of the study population which provided the denominator for the rates. Two studies looked at seroprevalence of leptospirosis in febrile pregnant women [18,20], two studies at seroprevalence of leptospirosis in jaundiced pregnant women [19,22], one explored cases of leptospirosis in women who had spontaneous abortion [17], another on leptospirosis as a cause of abortion, stillbirth or developmental anomalies [24]. One cross-sectional study looked at seroprevalence of leptospirosis in 442 healthy pregnant women across 10 Caribbean countries [17,20,21], and one investigating causes of fever and pulmonary syndrome in pregnant women, where no cases of leptospirosis were identified [22,23].…”

“…Two studies looked at seroprevalence of leptospirosis in febrile pregnant women [18,20], two studies at seroprevalence of leptospirosis in jaundiced pregnant women [19,22], one explored cases of leptospirosis in women who had spontaneous abortion [17], another on leptospirosis as a cause of abortion, stillbirth or developmental anomalies [24]. One cross-sectional study looked at seroprevalence of leptospirosis in 442 healthy pregnant women across 10 Caribbean countries [17,20,21], and one investigating causes of fever and pulmonary syndrome in pregnant women, where no cases of leptospirosis were identified [22,23]. Pooling together two datasets (Studies 1,3; Table 1 [18,20]), we PLOS NEGLECTED TROPICAL DISEASES calculated the incidence of leptospirosis in febrile pregnant patients to be 1.3 per 10,000 (95% CI 0.5 to 2.9 per 10,000).…”

Leptospirosis in COVID-19 Positive Pregnancy: A Rare Case Report Mimicking Hellp Syndrome

“…IgM ELISA, IgM/immunoglobulin G (IgG) ELISA, and real-time DNA polymerase chain reaction of blood, urine & CSF are some of the laboratory procedures used to detect for leptospirosis (CSF). A single titre of 1:200 IgM antibodies or a four-fold increase in microscopic agglutination testing titre collected during the 1st and 4th week of sickness, or body fluids or tissue cultures of leptospires are used to make a diagnosis of leptospirosis [4]. These patients have responded well to medicines such as penicillin G, streptomycin, chloramphenicol, doxycycline and erythromycin [4].…”

“…A single titre of 1:200 IgM antibodies or a four-fold increase in microscopic agglutination testing titre collected during the 1st and 4th week of sickness, or body fluids or tissue cultures of leptospires are used to make a diagnosis of leptospirosis [4]. These patients have responded well to medicines such as penicillin G, streptomycin, chloramphenicol, doxycycline and erythromycin [4]. According to the WHO, depending on the stage of pregnancy, leptospirosis can cause abortion, foetal death, stillbirth, or congenital leptospirosis in women [5].…”