Detection of leptospirosis and dengue in patients with acute undifferentiated febrile illness in the northern coast of Ecuador

Description: Dengue fever is a serious health problem worldwide, the global distribution is estimated to be over 100 countries (Slifka, 2014). In 2009 the World Health Organization (WHO) estimated 50 million cases per year reported in 2009 (WHO W. H., 2009), however recent studies have suggested global infection at closer to 390 million infections per year (Bhatt S., 2013). This phenomenon may be related to the vector´s adaptation to different climates and ecosystems (Gubler, 1998). The causative agent of dengue fever is dengue virus belonging to the genus Flavivirus, family Flaviviridae, there are four dengue serotypes appointed from Dengue-1 to Dengue-4 (Gubler, 1998). These serotypes differ based on the envelope protein (E) and different serotypes vary approximately 30% in the polyprotein (Tuiskunen A., 2013). Infection with dengue virus may be asymptomatic or present varied symptoms as a flu-like syndrome and correspond to dengue fever (DF), severe cases present coagulopathy, increased vascular fragility and permeability and correspond to dengue hemorrhagic fever (DHF). Some cases progress to hypovolemic shock and result in dengue shock syndrome (DSS) (Martina B., 2009).