Sera were processed from blood samples collected from subjects during house visits. The microscopic agglutination test (MAT) was performed to evaluate for serologic evidence of a prior Leptospira infection [34] . A panel of five reference strains (WHO Collaborative Laboratory for Leptospirosis, Royal Tropical Institute, Holland) and two clinical isolates [6] (link) were used which included L. interrogans serovars Autumnalis, Canicola and Copenhageni, L. borgspetersenii serovar Ballum, and L. kirschneri serovar Grippotyphosa. The use of this panel had the same performance in identifying MAT-confirmed cases of leptospirosis during surveillance in Salvador [6] (link),[16] (link) as did the WHO recommended battery of 19 reference serovars [34] . Screening was performed with serum dilutions of 1∶25, 1∶50 and 1∶100. When agglutination was observed at a dilution of 1∶100, the sample was titrated to determine the highest titer.
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