The chest radiograph in leptospirosis in Jamaica.

A consecutive series of 44 patients with proven leptospirosis was studied to document the radiographic pulmonary abnormalities, assess their prevalence, correlate them with the clinical signs and symptoms and determine their prognostic significance. Abnormalities were found in ten patients (23%), this prevalence being less than previously noted. The abnormalities shown were non-segmental opacification (consolidation-eight cases), basal linear opacities (collapse-five cases) and pleural effusions (four cases). The first radiographic demonstration of a large pleural effusion in leptospirosis is recorded. Non-jaundiced patients had a higher prevalence (43%) of these abnormalities than jaundiced (13%). No other correlation with clinical signs or symptoms was found. The presence of these abnormalities had no prognostic significance. It is concluded that the presence of radiographic pulmonary abnormality in in-patients with leptospirosis is common. These abnormalities are non-specific and can mimic other diseases leading to diagnostic difficulty. Such abnormalities may be extensive in the absence of clinical signs and symptoms.

Human leptospirosis infective serogroups and serotypes in Jamaica.

Of a total of 5,021 samples of sera tested in Jamaica between 1960-1978, 651 (12.9%) were positive in significant to microscopic agglutination for leptospirosis. There were 50 (5.9%) positive isolates of 845 cultures. Six serogroups and 13 serotypes of pathogenic leptospiral strains were identified. The serogroup icterohaemorrhagiae serovar icterohaemorrhagiae accounted for 57% of infections and the serogroup hebdomadis, serovar jules accounting for 31% of cases. Human leptospirosis is grossly under-reported in Jamaica and only systematic surveys and surveillance can define the true incidence of the public health problem of this disease.

Fluorescent Vi antibody test in the screening of typhoid carriers.

The comparative efficacies of direct bacterial agglutination and immunofluorescent antibody for the estimation of serum Vi antibody were determined in the detection of typhoid carriers. Sera from all 12 typhoid carriers gave significant titers of 1/10 or more in the direct bacterial agglutination test; however, 26 of 119 (21.8%) sera from culture-negative individuals were also falsely positive. In the fluorescent Vi antibody test, 11 of 12 typhoid carriers showed significant serum antibody levels, while only two of 119 (1.7%) culture-negative subjects had significant antibody titers. In view of the much lower false-positive rate, the immunofluorescent Vi antibody test is considered to be superior to the direct bacterial agglutination test in the screening of typhoid carriers.