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. 2013 Sep;107(6):329-34.
doi: 10.1179/2047773213Y.0000000112.

Leptospirosis and malaria as causes of febrile illness during a dengue epidemic in Jamaica

John Lindo  1 , Paul D Brown, Ivan Vickers, Michelle Brown, Sandra T Jackson, Eva Lewis-Fuller
Affiliations

Leptospirosis and malaria as causes of febrile illness during a dengue epidemic in Jamaica

John Lindo et al. Pathog Glob Health. 2013 Sep.

Abstract

Background: Epidemics of febrile illnesses are often associated with rainy seasons in the tropics. During 2007-2008 an epidemic of dengue was identified in Jamaica based on serological testing of sera.

Methods: A subset of 3165 of 5400 sera submitted for dengue analysis was tested for Leptospira IgM and malaria IgG using ELISA to determine their role in causing epidemic fever.

Findings: Seropositivity for dengue, leptospirosis, and malaria were 38·4 and 6·0 and 6·5%, respectively, indicative of three concurrent epidemics. Mixed exposure to all three diseases was rare (0·1%), as were mixed dengue/malaria (2·4%); dengue/leptospirosis (1·6%), and leptospirosis/malaria (0·03%) exposure. Exposure to dengue and malaria appeared to occur most frequently among children while leptospirosis was more common among adults.

Conclusion: While serological diagnosis definitively established that dengue was the main cause of the epidemic febrile illness, the data suggested that there may be other causes of fever, which may occur simultaneously. Consequently, leptospirosis and malaria should be considered as causes of fever during epidemics of dengue in endemic areas.

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Figures

Figure 1
Figure 1
Map of Jamaica showing regional health authorities (RHA) (courtesy of Ralph Robinson, UWI, Jamaica).
Figure 2
Figure 2
Age-prevalence profile of dengue, leptospirosis, and malaria among (A) Jamaican children and (B) Jamaicans during an epidemic of dengue (2007–2008).
Figure 3
Figure 3
Epidemic curves for dengue, leptospirosis, and malaria among Jamaicans during an epidemic of dengue (2007–2008) and monthly rainfall pattern for Jamaica from July 2007 to February 2008.
Figure 4
Figure 4
Geographic distribution of dengue, leptospirosis, and malaria in Jamaicans during an epidemic of dengue (2007–2008), Jamaica.
See this image and copyright information in PMC

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