Persistence of anti-leptospiral IgM, IgG and agglutinating antibodies in @entity1 presenting with XXXX in Barbados 1979-1989.

@entity1 @entity281 @entity221 @entity2926
The persistence of anti-leptospiral IgM and IgG antibodies and agglutinating antibodies was studied in serologically confirmed cases of severe @entity2926 during the acute illness and over periods of several years after recovery. The antibody response in non- @entity2926 @entity1 presenting to hospital with similar symptoms over the same period of time was used to estimate the background antibody level to @entity2926 in the community. All @entity1 enrolled in the study had blood samples collected twice in the acute stage of illness, once during convalescence and then annually from the time of initial hospitalisation until the end of the study period. Six hundred and thirty-eight @entity1 presented to hospital with @entity221 , of whom 321 were diagnosed with @entity2926 . @entity1 who had severe @entity2926 commonly remained seropositive, with IgM, IgG and agglutinating antibodies detectable for several years after @entity281 . A significant proportion of cases had high titres of agglutinating antibody detectable by the microscopic agglutination test (> or = 800). There were marked differences in the magnitude and duration of persistence of agglutinating antibodies directed against different serogroups. More than 20% of cases with evidence of @entity281 with serogroup Autumnalis retained titres of >800, 4 years after the acute illness. In one case a titre of 800 was detected 11 years after @entity281 . Persistence of agglutinating antibody titres can create problems in interpretation of serological results and make it impossible to estimate the time of @entity281 , given a specific titre. This study demonstrates that in endemic areas where seroprevalence is high, use of a single elevated titre is not reliable to define a current @entity281 .
