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Pesquisa de anticorpos anti-Leptospira interrogans em trabalhadores do Saneamento básico da Região de Lisboa e Vale do Tejo
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Foram recolhidas amostras de sangue de 347 participantes deste setor laboral, aplicando-se igualmente um questionário clínico-epidemiológico, a fim de se descreverem algumas características sócio-demográficas, grau de conhecimento acerca da leptospirose, exposição a roedores, sintomatologia da doença, entre outras. Todos os participantes do estudo tiveram também a oportunidade de assistir a uma sessão de esclarecimento acerca da doença (características epidemiológicas, sintomas e medidas de prevenção).
As amostras foram testadas no laboratório para a Leptospirose e Borreliose de Lyme do IHMT/UNL, com o teste de rastreio MACROLepto, investigando-se os soros quanto à presença de anticorpos anti-L. interrogans s.l.. As amostras “Não Conclusivas” foram testadas de seguida na TAM, método de referência no diagnóstico da leptospirose.
Apesar do desconhecimento que a maioria dos trabalhadores possui em relação à L. interrogans s.l. e da presença regular de roedores no espaço onde exercem funções, a utilização dos EPI’s (Equipamentos de Proteção Individual) e medidas de higiene gerais, pela grande maioria dos participantes, bem como a desratização periódica, demonstraram ser ferramentas comumente utilizadas no seu quotidiano laboral.
Leptospirosis is an infectious disease, whose global importance has been increasing over time. Clinical manifestations due to Leptospira interrogans sensu lato infection are broad-spectrum and may be characterized by an inapparent infection, as well as fulminant cases, which are often fatal to the patient. The most common manifestation is the mild form, which resembles the symptoms of a flu-like illness by Influenza virus (fever, chills, headache, myalgia). For this reason, in most countries, leptospirosis remains an underestimated disease, which can lead to misdiagnosis, especially within populations considered under risk. The contact with the bacteria responsible for the infection is only detected by the antibodies titers against L. interrogans s.l., making it especially important in asymptomatic cases or the ones resembling Influenza syndrome. These antibodies can last in the infected person body from months to years, occurring a variable titer decline over time. Leptospirosis is an important zoonotic disease, infecting at least 160 species of mammals around the world. However, rodent, more particularly rats and mice, remains the most common reservoirs and therefore, of particular relevance in the spread of the disease’s agent. The transmission to humans occurs through direct contact with urine, blood or tissues of rodents or of an infected animal, per inlet port, which can be an abrasion on the skin or the mucous. There are occupational groups that for being frequently in contact with rodents are considered at risk to developing this disease. Veterinary, farmers, sanitation workers, and employees of slaughterhouses are examples. In this study, it was given special attention to sanitation workers, of which belong WWTP workers, town hall workers (waste water and solid waste) and also workers of private companies responsible for disinfestation or sewer cleaning. Blood samples were collected from 347 sanitation workers’ participants, being also applied a clinical-epidemiological survey in order to describe demographic data characteristics, the degree of leptospirosis knowledge, exposure to rodents, disease symptoms, among others. All participants also had the opportunity to attend an information session about the disease (epidemiological characteristics, symptoms and preventive measures). The samples were tested in the laboratory for leptospirosis and Lyme borreliosis of IHMT/UNL with Macro-agglutination test (screening), investigating the sera for the presence of antibodies against-L. interrogans s.l.. The “Non conclusive” samples were then tested with MAT, the reference method for the diagnosis of leptospirosis. Despite the lack of knowledge that most workers have in respect to L. interrogans s.l. and the regular presence of rodents in their labor area, the use of PPE (Personal Protective Equipment) and general hygiene measures by a wide range of participants, as well as a regular rodent extermination, shown to be tools commonly used in their daily work routine.
Leptospirosis is an infectious disease, whose global importance has been increasing over time. Clinical manifestations due to Leptospira interrogans sensu lato infection are broad-spectrum and may be characterized by an inapparent infection, as well as fulminant cases, which are often fatal to the patient. The most common manifestation is the mild form, which resembles the symptoms of a flu-like illness by Influenza virus (fever, chills, headache, myalgia). For this reason, in most countries, leptospirosis remains an underestimated disease, which can lead to misdiagnosis, especially within populations considered under risk. The contact with the bacteria responsible for the infection is only detected by the antibodies titers against L. interrogans s.l., making it especially important in asymptomatic cases or the ones resembling Influenza syndrome. These antibodies can last in the infected person body from months to years, occurring a variable titer decline over time. Leptospirosis is an important zoonotic disease, infecting at least 160 species of mammals around the world. However, rodent, more particularly rats and mice, remains the most common reservoirs and therefore, of particular relevance in the spread of the disease’s agent. The transmission to humans occurs through direct contact with urine, blood or tissues of rodents or of an infected animal, per inlet port, which can be an abrasion on the skin or the mucous. There are occupational groups that for being frequently in contact with rodents are considered at risk to developing this disease. Veterinary, farmers, sanitation workers, and employees of slaughterhouses are examples. In this study, it was given special attention to sanitation workers, of which belong WWTP workers, town hall workers (waste water and solid waste) and also workers of private companies responsible for disinfestation or sewer cleaning. Blood samples were collected from 347 sanitation workers’ participants, being also applied a clinical-epidemiological survey in order to describe demographic data characteristics, the degree of leptospirosis knowledge, exposure to rodents, disease symptoms, among others. All participants also had the opportunity to attend an information session about the disease (epidemiological characteristics, symptoms and preventive measures). The samples were tested in the laboratory for leptospirosis and Lyme borreliosis of IHMT/UNL with Macro-agglutination test (screening), investigating the sera for the presence of antibodies against-L. interrogans s.l.. The “Non conclusive” samples were then tested with MAT, the reference method for the diagnosis of leptospirosis. Despite the lack of knowledge that most workers have in respect to L. interrogans s.l. and the regular presence of rodents in their labor area, the use of PPE (Personal Protective Equipment) and general hygiene measures by a wide range of participants, as well as a regular rodent extermination, shown to be tools commonly used in their daily work routine.
Descrição
Palavras-chave
Leptospirose Roedores Características epidemiológicas Sintomas Prevenção Borreliose de Lyme MacroLepto Desratização Periódica Anticorpos Anti-Leptospira Interrogans
Contexto Educativo
Citação
Editora
Instituto de Higiene e Medicina Tropical