household transmission of leptospira infection in urban slum communities在城市贫民窟社区家庭钩端螺旋体感染的传播.pdfVIP

Household Transmission of Leptospira Infection in Urban Slum Communities 1 1 1,2 1,3 Elves A. P. Maciel , Ana Luiza F. de Carvalho , Simone F. Nascimento , Rosan B. de Matos , Edilane L. 1 1 1,4 Gouveia , Mitermayer G. Reis , Albert I. Ko * ˜ ´ ´ 1 Centro de Pesquisas Gonc¸alo Moniz, Fundac¸ao Oswaldo Cruz, Ministerio da Saude, Salvador, Bahia, Brazil, 2 Municipal Secretary of Health for Salvador, Salvador, Bahia, Brazil, 3 State Secretary of Health for Bahia, Salvador, Bahia, Brazil, 4 Division of International Medicine and Infectious Disease, Weill Medical College of Cornell University, New York, New York, United States of America Abstract Background: Leptospirosis, a spirochaetal zoonotic disease, is the cause of epidemics associated with high mortality in urban slum communities. Infection with pathogenic Leptospira occurs during environmental exposures and is traditionally associated with occupational risk activities. However, slum inhabitants reside in close proximity to environmental sources of contamination, suggesting that transmission during urban epidemics occurs in the household environment. Methods and Findings: A survey was performed to determine whether Leptospira infection clustered within households located in slum communities in the city of Salvador, Brazil. Hospital-based surveillance identified 89 confirmed cases of leptospirosis during an outbreak. Serum samples were obtained from members of 22 households with index cases of leptospirosis and 52 control households