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Leptospirosis in the Caribbean : a study on short and long term pathological consequences


Leptospirosis, an infectious disease of humans and animals, is often difficult to diagnose in the clinical situation and in the laboratory. consequently various aspects (mortality, damage to the pancreas, and persistence of leptospires in tissues, notably cns) are not or not well known.
This project aims at the investigation of the possible role of leptospires as a cause of death in acute leptospirosis, pancreatic damage in acute leptospirosis, and long term damage to the CNS caused by persisting leptospires. These issues will be investigated bY performing culturing, histopathology and PCR on post mortem tissues of humans and animals. The results of these three methods will be compared. With presently available culturing methods (veterinary Research laboratory (VRL), UK) it is possible to detect acute and chronic infection bY fastitious leptospira serovars. Damage to tissues in particular the pancreas will be investigated bY histopathological methods (Queen Elizabeth Hospital and leptospira laboratorys Barbados (LLB); CAREC, Trinidad) and the presence of leptospires in tissues will be detected by immunofluorescence (VRL). With pcr (Royal Tropical Institute (KIT), NL and LLB) very small quantities of leptospires can be detected in blood and urine (current CEC project, number Ts2-0113-NL) enabling quick and early diagnosis. The method will be adapted for the detection oE leptospirain tissues. The three methods will be performed on Barbados and Trinidad, both endemic areas for leptospirosis, (a) on post mortem tissues of humans who died of an acute disease suspected to be leptospisosis,(b) on humans who died of another cause but having suffered likely or certainly from leptospirosis in the past, (c) on dogs and horses (only in Barbados) that have suffered in the past from leptospisosis. The PCR will be improved (KIT) bY optimizing procedures and by generating new primer sets that are applicable for all pathogenic leptospires. Finally, the diagnostic value of the PCR for leptospisosis as developed in the current project will be evaluated in comparison with culturing and serology in a prospective study on Barbados and Trinidad in patients suspected of leptospisosis.


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Koninklijk Instituut voor de Tropen
1092 AD Amsterdam

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