Mesoamerican nephropathy: a neglected tropical disease with an infectious etiology?

Microbes and Infection
Kristy O MurrayJessica Sheleby

Abstract

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.

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Citations

Nov 1, 2016·Clinical Journal of the American Society of Nephrology : CJASN·Warren L Kupin
Jul 30, 2017·Applied and Environmental Microbiology·Veronica BarraganTalima Pearson
May 9, 2019·The New England Journal of Medicine·Richard J JohnsonLee S Newman
Jun 11, 2019·Workplace Health & Safety·Roxana ChicasLinda McCauley
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Jun 27, 2019·Renal Failure·Nadezda PetejovaVladimir Teplan
Jan 31, 2020·Revista Panamericana De Salud Pública = Pan American Journal of Public Health·Catharina WesselingKristina Jakobsson
Dec 18, 2018·Frontiers in Medicine·Narayan Prasad, Manas Ranjan Patel
Mar 12, 2021·Journal of Agromedicine·Daniel J SmithVicki S Hertzberg

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