TY - JOUR
T1 - Mesoamerican nephropathy
T2 - A neglected tropical disease with an infectious etiology?
AU - Murray, Kristy O.
AU - Fischer, Rebecca S.B.
AU - Chavarria, Denis
AU - Duttmann, Christiane
AU - Garcia, Melissa N.
AU - Gorchakov, Rodion
AU - Hotez, Peter J.
AU - Jiron, William
AU - Leibler, Jessica H.
AU - Lopez, Job E.
AU - Mandayam, Sreedhar
AU - Marin, Alejandro
AU - Sheleby, Jessica
N1 - Publisher Copyright:
© 2015 Institut Pasteur.
PY - 2015/10
Y1 - 2015/10
N2 - An outbreak of unexplained and severe kidney disease, "Mesoamerican Nephropathy," in mostly young, male sugar cane workers emerged in Central America in the late 1990's. As a result, an estimated 20,000 individuals have died, to date. Unfortunately, and with great consequence to human life, the etiology of the outbreak has yet to be identified. The sugarcane fields in Chichigalpa, Chinandega, Nicaragua, have been involved in the outbreak, and during our initial investigation, we interviewed case patients who experienced fever, nausea and vomiting, arthralgia, myalgia, headache, neck and back pain, weakness, and paresthesia at the onset of acute kidney disease. We also observed a heavy infestation of rodents, particularly of Sigmodon species, in the sugarcane fields. We hypothesize that infectious pathogens are being shed through the urine and feces of these rodents, and workers are exposed to these pathogens during the process of cultivating and harvesting sugarcane. In this paper, we will discuss the epidemic in the Chichigalpa area, potential pathogens responsible for Mesoamerican Nephropathy, and steps needed in order to diagnose, treat, and prevent future cases from occurring.
AB - An outbreak of unexplained and severe kidney disease, "Mesoamerican Nephropathy," in mostly young, male sugar cane workers emerged in Central America in the late 1990's. As a result, an estimated 20,000 individuals have died, to date. Unfortunately, and with great consequence to human life, the etiology of the outbreak has yet to be identified. The sugarcane fields in Chichigalpa, Chinandega, Nicaragua, have been involved in the outbreak, and during our initial investigation, we interviewed case patients who experienced fever, nausea and vomiting, arthralgia, myalgia, headache, neck and back pain, weakness, and paresthesia at the onset of acute kidney disease. We also observed a heavy infestation of rodents, particularly of Sigmodon species, in the sugarcane fields. We hypothesize that infectious pathogens are being shed through the urine and feces of these rodents, and workers are exposed to these pathogens during the process of cultivating and harvesting sugarcane. In this paper, we will discuss the epidemic in the Chichigalpa area, potential pathogens responsible for Mesoamerican Nephropathy, and steps needed in order to diagnose, treat, and prevent future cases from occurring.
KW - Acute interstitial nephritis
KW - Acute kidney injury
KW - Chronic kidney disease of unknown etiology, CKDu
KW - Hantavirus
KW - Leptospirosis
KW - Mesoamerican nephropathy
KW - Nicaragua
KW - Sugarcane
UR - http://www.scopus.com/inward/record.url?scp=84943521179&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84943521179&partnerID=8YFLogxK
U2 - 10.1016/j.micinf.2015.08.005
DO - 10.1016/j.micinf.2015.08.005
M3 - Editorial
C2 - 26320026
AN - SCOPUS:84943521179
SN - 1286-4579
VL - 17
SP - 671
EP - 675
JO - Microbes and Infection
JF - Microbes and Infection
IS - 10
ER -