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Leptospirosis, caused by pathogenic spirochaetes belonging to the genus Leptospira, is a globally distributed zoonosis that can affect many species of domestic and wild animals, and humans. The red fox (Vulpes vulpes) is a native species in Croatia and, due to constant food availability and lack of interspecies competition, is becoming more abundant in urban and suburban areas. Although antibodies for Leptospira spp have been detected in red foxes, lethal disease has not been reported. We necropsied a young, male red fox that had jaundice, multifocal haemorrhages in the heart, lungs and urinary bladder, hepatomegaly, non-congestive splenomegaly and slight yellow discolouration of the renal cortex and medulla. Histology revealed multifocal haemorrhages in parenchymal organs, thrombi within lung septal capillaries and other blood vessels, interstitial lymphocytic and plasmacytic nephritis and erosions of the gastric mucosa. A microscopic agglutination test on the post-mortem cardiac blood clot revealed a high titre to Leptospira interrogans serovar Icterohaemorrhagiae, which implies contact with rats, which are natural reservoirs of this serovar in Croatia. The gross and histological findings in this fox were similar to those in dogs with leptospirosis, indicating that fatal leptospirosis can occur in foxes and suggesting that this species can act as a source of infection for other animals and humans.

The objective of this study was to analyze the eco-epidemiological aspects of Leptospira seroprevalence and seroincidence and its associated factors in two municipalities of northwest Colombia. A prospective study was performed in rural areas of Urabá, Antioquia, Colombia. The study enrolled 597 people between November 2015 and January 2016, of which 274 were followed up 1 year later. Serologic testing was performed by a microscopic agglutination. The outcomes were seroprevalent and seroincident cases, and the primary exposure was an outdoor occupation. A binary and mixed-effect multinomial logistic regression model was used to estimate factors associated with seroprevalent or seroincident cases of Leptospira infection. The overall Leptospira seroprevalence was 27.81% (95% confidence interval: 23.62–32.49), and the overall cumulative seroincidence for Leptospira was 14.60% (95% confidence interval: 10.33–20.23). Multivariable analysis showed that factors associated with L. interrogans serogroups seropositivity were outdoor occupation, male gender, older age, the presence of dirt floor in the household, and the presence of piglets and opossums. It also showed that factors associated with other Leptospira species serogroups were the presence of pit latrines and of turkeys. In addition, the multivariable model of seroincident cases of L. interrogans serogroups evidenced outdoor occupations, the presence of rats, and corn cultivation as risk factors. Likewise, the multivariable model for seroincident cases of other Leptospira species showed that the presence of hunting canines and cassava cultivation were risk factors. We found specific factors associated with the transmission of Leptospira serogroups contribute to the understanding of the epidemiology of Leptospira infection in rural areas of Urabá, Colombia.

Scrub typhus and leptospirosis are bacterial zoonotic diseases causing high morbidity and mortality. Both are important causes of acute febrile illness in India. The common epidemiology of both the diseases creates an opportunity of dual infections with these diseases. The present study was conducted at RG Kar Medical College and Hospital to determine simultaneous infection of leptospirosis and scrub typhus in sera of febrile patients and evaluate the cases of serological dual infections. IgM antibodies to both leptospira and scrub typhus were detected by Enzyme linked immunosorbant assay (ELISA). During the study period (August 2022-October 2022), serum samples of patients were received for serology for scrub typhus. Out of these samples, 5 patients diagnosed for scrub typhus infection also had IgM antibodies to leptospira, thus indicating co-infection of both diseases. The current study adds further tofewpreviously published reports on co-infection of scrub typhus with leptospirosis. As both leptospirosis and scrub typhus present with similar clinical features, co-infection of these two diseases is not uncommon and requires further confirmation at molecular level. Accordingly, cases of dual infections must be considered seriously and choice of therapy should include those drugs that cover for both the infections.

Leptospirosis is one of the most life-threatening tropical diseases caused by pathogenic

Leptospirosis is an infectious disease caused by Leptospira spp. and affects animals and humans. Reports of leptospirosis in bats have increased and prompted epidemiological research in Brazil. This study aimed to perform a molecular and epidemiological investigation of pathogenic Leptospira spp. in bat kidneys. The total DNA was extracted from 102 kidney samples from chiropterous of different species and cities in Rio Grande do Sul State (RS), Brazil. The polymerase chain reaction was used to amplify a fragment corresponding to lipL32 gene, which is only present in pathogenic Leptospira spp. lipL32 gene was detected in 22.5% (23/102) of the bat kidney tissues. Phylogenetic analysis showed that L. interrogans is circulating in bats in RS. Most species of the bats collected were insectivores. Pathogenic Leptospira spp. detection in bats demonstrated that these animals participate in the infection chain of leptospirosis and, therefore, may play as reservoirs and disseminators of this microorganism. Thus, it is important to monitor infectious agents, especially with zoonotic potential in bats.

Leptospirosis is a quintessential one health disease of humans and animals caused by pathogenic spirochetes of the genus Leptospira. Intra- and interspecies transmission is dependent on 1) reservoir host animals in which organisms replicate and are shed in urine over long periods of time, 2) the persistence of spirochetes in the environment, and 3) subsequent human-animal-environmental interactions. The combination of increased flooding events due to climate change, changes in human-animal-environmental interactions as a result of the pandemic that favor a rise in the incidence of leptospirosis, and under-recognition of leptospirosis because of nonspecific clinical signs and severe signs that resemble COVID-19 represents a “perfect storm” for resurgence of leptospirosis in people and domestic animals. Although often considered a disease that occurs in warm, humid climates with high annual rainfall, pathogenic Leptospira spp have recently been associated with disease in animals and humans that reside in semiarid regions like the southwestern US and have impacted humans that have a wide spectrum of socioeconomic backgrounds. Therefore, it is critical that physicians, veterinarians, and public health experts maintain a high index of suspicion for the disease regardless of geographic and socioeconomic circumstances and work together to understand outbreaks and implement appropriate control measures. Over the last decade, major strides have been made in our understanding of the disease because of improvements in diagnostic tests, molecular epidemiologic tools, educational efforts on preventive measures, and vaccines. These novel approaches are highlighted in the companion Currents in One Health by Sykes et al, AJVR, September 2022.

Hantavirus hemorrhagic fever with renal syndrome (HFRS) is an emerging zoonotic disease in Europe and Asia, which is clinically indistinguishable from leptospirosis. A total of 1,032 patients with clinical suspicion of HFRS-like illness were included in the analysis from March 2013 to March 2021. Of these, 168 were positive for hantavirus immunoglobulin M (IgM) antibodies. Thirty-one of 35 patients had a 4-fold increase in IgG antibody titer with paired serum, confirming acute hantavirus infections. The detected antibodies showed a diverse pattern, strongly cross-reacting with the Seoul, Hantaan, and Puumala virus antigens. All the IgM-positive patients had no serological evidence of acute dengue or leptospirosis and had classical features of HFRS, including fever, thrombocytopenia, and renal involvement. More than 90% of patients had a history of rodent exposure 2-3 weeks prior to the onset of the fever. The highest number of positive cases was diagnosed in the Western and North Central Provinces of Sri Lanka during the paddy harvesting seasons. A significant number of patients develop severe complications with high mortality rates. Therefore, hantavirus infection should be considered as a differential diagnosis for leptospirosis-like illnesses in Sri Lanka.

An interesting clinical case of leptospirosis infection in an elderly woman with a professional way of getting infection on the background of alcohol abuse has been described. The authors emphasized the clinical features of this bacterial zoonosis, considered aspects of differential diagnosis of leptospirosis with other common infectious diseases. It has been emphasized on the intricacies of a detailed epidemiological anamnesis taking in order to identify and evaluate biorisk factors for pathogenic leptospira con­tami­nation in a particular occupational environment. It has been pointed out the necessity of a complex laboratory-instrumental investigation in the infectious hospital, since the delay of hospitalization and adequate treatment can worsen the prognosis for a favorable outcome of the clinical case and recovery. Such specific laboratory methods for verifying leptospiras in the blood of patients as a reaction of microagglutination and lysis with a kit of leptospira and bacterioscopic examination of a smear in the dark field are of high sensitivity and specificity and therefore are widely used in clinical practice.

This work is aimed at formulating and analyzing a compartmental mathematical model to investigate the impact of rodent-born leptospirosis on the human population by considering a load of pathogenic agents of the disease in an environment and the incidence rate of human infection due to the interaction between infected rodents and the environment. Firstly, the basic properties of the model, the equilibria points, and their stability analysis are studied. We also found the basic reproduction number R 0 of the model using the next-generation matrix approach. From the stability analysis, we obtained that the disease-free equilibrium (DFE) is globally asymptotically stable if R 0 < 1 and unstable otherwise. The local stability of endemic equilibrium is performed using the phenomenon of the center manifold theory, and the model exhibits forward bifurcation. The most sensitive parameters on the model outcome are also identified using the normalized forward sensitivity index. Finally, numerical simulations of the model are performed to show the stability behavior of endemic equilibrium and the varying effect of the human transmission rates, human recovery rate, and the mortality rate rodents on the model dynamics. The model is simulated using the forward fourth-order Runge-Kutta method, and the results are presented graphically. From graphical stability analysis, we observed that all trajectories of the model solutions evolve towards the unique endemic equilibrium over time when R 0 > 1 . Our numerical results revealed that decreasing the transmission rates and increasing the rate of recovery and reduction of the rodent population using appropriate intervention mechanisms have a significant role in reducing the spread of disease infection in the population.

Acute febrile illness is a common presentation for patients at hospitals globally. Assays that can diagnose a variety of common pathogens in blood could help to establish a diagnosis for targeted disease management. We aimed to evaluate the performance of the BioFire Global Fever Panel (GF Panel), a multiplex nucleic acid amplification test performed on whole blood specimens run on the BioFire FilmArray System, in the diagnosis of several pathogens that cause acute febrile illness.We did a prospective, multicentre, cross-sectional diagnostic accuracy study to evaluate the GF Panel. Consenting adults and children older than 6 months presenting with fever in the previous 2 days were enrolled consecutively in sub-Saharan Africa (Ghana, Kenya, Tanzania, Uganda), southeast Asia (Cambodia, Thailand), central and South America (Honduras, Peru), and the USA (Washington, DC; St Louis, MO). We assessed the performance of six analytes (chikungunya virus, dengue virus [serotypes 1-4], Leptospira spp, Plasmodium spp, Plasmodium falciparum, and Plasmodium vivax or Plasmodium ovale) on the GF Panel. The performance of the GF Panel was assessed using comparator PCR assays with different primers followed by bidirectional sequencing on nucleic acid extracts from the same specimen. We calculated the positive percent agreement and negative percent agreement of the GF Panel with respect to the comparator assays. This study is registered with ClinicalTrials.gov, NCT02968355.From March 26, 2018, to Sept 30, 2019, 1965 participants were enrolled at ten sites worldwide. Of the 1875 participants with analysable results, 980 (52·3%) were female and the median age was 22 years (range 0-100). At least one analyte was detected in 657 (35·0%) of 1875 specimens. The GF Panel had a positive percent agreement for the six analytes evaluated as follows: chikungunya virus 100% (95% CI 86·3-100), dengue virus 94·0% (90·6-96·5), Leptospira spp 93·8% (69·8-99·8), Plasmodium spp 98·3% (96·3-99·4), P falciparum 92·7% (88·8-95·6), and P vivax or P ovale 92·7% (86·7-96·6). The GF Panel had a negative percent agreement equal to or greater than 99·2% (98·6-99·6) for all analytes.This 1 h sample-to-answer, molecular device can detect common causative agents of acute febrile illness with excellent positive percent agreement and negative percent agreement directly in whole blood. The targets of the assay are prevalent in tropical and subtropical regions globally, and the assay could help to provide both public health surveillance and individual diagnoses.BioFire Defense, Joint Project Manager for Medical Countermeasure Systems and US Army Medical Materiel Development Activity, and National Institute of Allergy and Infectious Diseases.

This study attempts to evaluate the effect of different socio-environmental variables on the proliferation of rats and Leptospira in suburban areas of Dungun, Terengganu, Malaysia. We performed ten trapping sessions between April 2021 and January 2022, and captured 89 rodents from five species during the study. We tested the captured animals forLeptospira bacteria using PCR detection

Highly sensitive diagnostic tools are crucial for individual screening during an epidemic of leptospirosis. To aid in developing a diagnostic tool for the sensitive detection of pathogenic strains, a new approach targeting nucleic acid amplification that combines quantitative PCR (qPCR) and strand displacement isothermal amplification was evaluated. The effectiveness of the combined approach, a quantitative polymerase chain displacement reaction (qPCDR), was compared with a qPCR technique. The results showed that qPCDR presented higher sensitivity (at least tenfold) and shorter reaction time than the qPCR approach for pathogenic Leptospira spp. detection. Thus, the qPCDR-based technique developed in this study is a promising approach for pathogenic Leptospira spp. detection and the further development of a diagnostic kit.

The aim of this systematic review was to identify articles on prevalence of leptospirosis in stray and sheltered dogs worldwide and access the methodological quality of the recovered papers. Six databases (CABI, Cochrane, Pubmed, Scielo, Scopus and Web of Science) were searched, without restriction on year or location where the studies were performed. The search recovered 476 articles and 60 were selected for analysis according to quality criteria. None of the selected articles showed a complete explanation for the sample size adopted (probabilistic sampling), leading to the impossibility of recalculation of leptospirosis prevalence for stray or sheltered dogs. Among the analyzed papers 43.33% (26/60) showed five of the ten quality criteria analyzed, 16.67% (10/60) three, 15.00% (9/60) four, 10.00% (6/60) six, 6.67% (4/60) eight, only 5.00% (3/60) showed nine of the ten criteria analyzed, whereas two papers showed two [1.67% (1/60)] and seven [1.67% (1/60)] of the ten criteria assessed. The majority of the papers were published in the Americas [45.00% (27/60)] and in the last sixteen years (2003 to 2019) [81.67% (49/60)], and most of the sampled dogs were stray dogs [65.00% (39/60)]. The leptospirosis diagnostic test used more frequently was Micro Agglutination Test (MAT) [78.33% (47/60)] followed by polymerase Chain Reaction (PCR) [23.33% (14/60)], whereas the most common serovars identified were Canicola [71.43% (35/49)], Icterohaemohrragiae [65.31% (32/49)], Grippotyphosa [40.82% (20/49)] and Pomona [40.82% (20/49)]. In conclusion, our results showed that Leptospira spp. is present in stray and sheltered dogs worldwide, but the complete comprehension of the prevalence of leptospirosis in these populations could not be achieved due to the low methodologic quality of the recovered studies about leptospirosis in stray and sheltered dogs.

This 18-year-old boy presented to the hospital with symptoms of cerebellar dysfunction preceded by an acute febrile illness with rash. Examination showed evidence of left-sided cerebellar dysfunction and polyneuropathy. Empirical treatment for leptospirosis and scrub typhus was initiated. MRI was normal. Other organ dysfunctions in the form of thrombocytopenia and transaminitis were also observed. He recovered without sequelae. A diagnosis of acute cerebellar ataxia and polyneuropathy due to scrub typhus was made.

During the monsoon season of 2020, the coastal areas of South India were endemic to both leptospirosis and coronavirus disease 2019 (COVID-19). This study aimed to investigate the clinical features and outcomes of patients infected with both infections. A retrospective review of charts of all patients with COVID-19 who were also diagnosed with leptospirosis by immunoglobulin M enzyme-linked immunosorbent assay was undertaken. The clinical features, laboratory report, treatment details, and outcomes of all the included patients were recorded. The collected data were summarized as the frequency with percentage for categorical data and the mean or median for continuous data. Twenty-four cases of coinfections were admitted between July and November 2020. Most of these patients were categorized as severe COVID-19 (n = 15, 62.5%). Acute kidney injury was seen in 79.2% (n = 19) patients, while raised bilirubin was present in 79.2% (n = 19) of the patients. All patients had raised C-reactive protein, while all but one had raised procalcitonin. Thrombocytopenia, leucocytosis, and leukocytopenia were seen in 91.7% (n = 22), 45.8% (n = 11), and 12.5% (n = 3) of the patients. The median duration of hospital stay was 11 (8.25-15) days. A total of 79.2% (n = 19) of the patients improved and were discharged, while 20.8% (n = 5) died during the hospital stay. In conclusion, patients with fever and atypical manifestations such as hepatic dysfunction, renal dysfunction, and thrombocytopenia should be evaluated for leptospirosis even if they are COVID positive.

Introduction: Leptospirosis is a neglected zoonotic disease, affecting mainly poor and vulnerable populations. Methodology: A cross sectional-study was carried out in 557 subjects from Olavarría county (Argentina) to estimate the seroprevalence of leptospirosis and the factors associated with seropositivity. A survey was carried out to obtain clinical and epidemiological data. Serum was tested for anti-leptospiral antibodies by Microscopic Agglutination Test (MAT). Chi-square or Fisher Exact tests were used to assess association between the MAT results and the exploratory variables. For the variables statistically associated, odds ratios (ORs) and 95% confidence intervals (95% CI) were calculated. Individuals from Olavarría city were georeferenced to describe the spatial distribution and to detect clusters of seropositivity for leptospiral antibodies. Results: The overall prevalence of leptospirosis infection was 7.00%, higher in rural (19.66%) than in urban populations (3.64%) (p < 0.001). Sejroe was the most predominant serogroup in rural communities while Icterohaemorrhagiae was the most prevalent in urban populations. The factors associated with Leptospira infection were the presence of rodents inside households (OR = 3.9) in rural populations, while contact with cats (OR = 4.97) and male gender (OR = 7.75) represented higher risk of infection for the urban ones. Cases with positive serology have been found near Tapalqué stream or in the peripheral areas of Olavarría city. Conclusions: The results from data obtained during the study period were similar to other reports and demonstrate the importance of continuous epidemiological surveillance system and specific community educational campaigns to prevent the leptospirosis infection in Olavarría county and other communities with similar characteristics especially in rural areas.

Changes were made to the original formulation of the EMJH medium (Ellinghausen-McCullough-Johnson-Harris) enrichment and some aspects such as growth time of Leptospira and utilization in the microscopic agglutination test (MAT) were evaluated and compared to the original enrichment and to a commercially available enrichment (DIFCOÔ). Leptospira samples (24 antigens) that make up our panel of antigens used in MAT were used, among them, reference and autochthonous strains isolated in Brazil. The samples were grown individually in the EMJH medium under the three previously mentioned conditions (adapted enrichment, original enrichment and commercial enrichment). In addition, 89 blood serums from domestic and wild animals were analyzed by MAT using the antigens grown in these media. All samples tested grew efficiently with the adapted enrichment, and the MAT results were satisfactory. Therefore, other laboratories could also benefit from the use of this adapted enrichment when culturing the Leptospira strains applied in their MAT panels. Resumen Realizamos cambios en la formulación original del enriquecimiento del medio Ellinghausen-McCullough-Johnson-Harris y evaluamos algunos aspectos, como el tiempo de crecimiento de Leptospira y la utilización en la prueba de aglutinación microscópica (MAT), comparándolos con el enriquecimiento original y un medio de enriquecimiento comercialmente disponible (DIFCOÔ). Se usaron muestras de Leptospira (24 antígenos) que componen nuestro panel de antígenos utilizados en la MAT, entre ellos, cepas autóctonas y de referencia aisladas en Brasil. Las muestras se cultivaron individualmente en medio Ellinghausen-McCullough-Johnson-Harris en las tres condiciones mencionadas (enriquecimiento adaptado, enriquecimiento original y enriquecimiento comercial). Adicionalmente, 89 sueros de sangre de animales domésticos y salvajes fueron analizados por MAT usando los antígenos cultivados en estos medios. Todas las muestras analizadas crecieron eficientemente con el enriquecimiento adaptado y los resultados de la MAT fueron satisfactorios. Por lo tanto, otros laboratorios también podrían beneficiarse del uso de este enriquecimiento adaptado al cultivar las cepas de Leptospira aplicadas en sus paneles MAT.

To investigate seroprevalence of anti-Leptospira antibodies in equines and associated workers in Uruguay, 891 equine and 150 human sera were drawn; 212 equine urine samples were also taken for culture. Environmental conditions and equine raising or managing practices were recorded in all 72 visited establishments; epidemiological information was obtained from each worker. Microscopic agglutination technique (MAT) was performed with 10 Leptospira strains for equines and 18 for human sera, that were also studied with IgM indirect immunofluorescence (IgM-IIF). Equine titres ≥100 were considered positive, and human sera titres ≥200 suggested probable recent or past infection. Urines were cultured in Ellinghausen-McCullough-Johnson-Harris (EMJH) media; local identification of one obtained isolate with lipL32 PCR, Multiple Locus Variable number tandem repeat Analysis and partial rrs gene sequencing, were completed at Institut Pasteur, Paris. Estimated reactivity was 61.3% for equines, which was higher than the studied bovine national levels (21%) and mainly observed with Icterohaemorrhagiae serogroup (40.3%), Sejroe, Canicola, Pomona or Ballum. Aged animals from slaughterhouses and cattle farms were the most frequently positive. Multiple regression analysis confirmed a significant association between seropositivity and equine age. Only one positive culture could be fully studied, and confirmed to be Leptospira interrogans serogroup Canicola; it was added to the MAT antigen panel and revealed fairly frequent reaction with equine and human sera. Three workers (2%) showed titres = 200 with Icterohaemorrhagiae or Canicola serogroups, without recent clinical manifestations. Their attended equines reacted with the same serogroups, suggesting common source infections or infection transmitted by equines. Three other humans yielded titres = 100, and none of the 150 showed an IgM-IIF-positive result. Equines seem not to be an important origin of regional human leptospirosis, except perhaps during acute animal infection. More culture work is required to study intensity and lapses of leptospiruria, as well as to further identify circulating strains.

CASE DESCRIPTION A 12-year-old sexually intact male zoo-managed Sumatran tiger (Panthera tigris sumatrae) was evaluated for a 3-day history of vomiting, hyporexia, and lethargy. Radiographs were supportive of gastrointestinal obstruction, and an exploratory laparotomy was performed. CLINICAL FINDINGS Diffuse tan foci were present on the liver parenchyma, and the tiger became icteric throughout the procedure. Hepatic histopathology and immunohistochemistry resulted in a diagnosis of leptospirosis. Serum microagglutination testing for Leptospira spp antibody titers were positive for L kirschneri serovar Grippotyphosa, rising from 1:400 to 1:3,200 in 2 days. TREATMENT AND OUTCOME The tiger was treated with antimicrobials, ursodiol, and mirtazapine, and increased biosecurity measures were instituted. Free-ranging wildlife on grounds were trapped, euthanized, and submitted for necropsy to screen for disease vectors. The tiger’s urine was intermittently opportunistically collected from the enclosure and remained PCR assay negative for Leptospira spp until being positive once again on day 595. Although the tiger was without clinical signs at that time, antimicrobial therapy and increased biosecurity protocols were instituted a second time until urinary Leptospira shedding was confirmed to have stopped. By 1,071 days after initial presentation, the tiger remained nonclinical, with no additional urinary shedding episodes. CLINICAL RELEVANCE While domestic and nondomestic free-ranging felids have been reported as subclinical Leptospira spp carriers, this report indicates the clinical importance of leptospirosis when a tiger presents with generalized gastrointestinal signs and icterus. Due to the zoonotic potential, biosecurity measures are necessary. This patient had a clinically successful outcome with antimicrobial therapy and supportive care.

Leptospirosis is a zoonotic disease caused by pathogenic species of Leptospira. Due to the similarity with clinical signs of other febrile diseases, early diagnosis remains challenging. Real-time PCR has been used for direct detection of Leptospira, but it requires thermocyclers and highly trained personnel. Loop-mediated isothermal amplification (LAMP) is a simple and rapid DNA-based assay. Therefore, here we have developed PCR and LAMP assays targeting two novel genes, lic13162 and lic20239, and also lipL32 gene to detect pathogenic Leptospira. Analytical and diagnostic performances were compared with bacterial isolates (including different Leptospira species and serovars) and clinical samples. The results demonstrated that PCR assays targeting lic13162 and lic20239 were successful to amplify Leptospira, but LAMP not. However, both PCR and LAMP targeting lipL32 could detect pathogenic Leptospira. LAMP lipL32 could be performed in 30 min with a detection limit of 156 cells/mL. Diagnostic performance of lipL32-LAMP presented 84.2% sensitivity and 93.2% specificity. In conclusion, lipL32 PCR and LAMP are effective methods to detect pathogenic Leptospira directly from clinical samples. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s42770-022-00698-1.

Freshwater sports expose practitioners to pathogens in the water environment and may result in infection. In French Brittany, these infections are particularly worrying, especially since 2016 with an increase in the incidence of leptospirosis reaching 1 case per 100,000 inhabitants, which represents the highest incidence observed since 1920. We aimed to estimate the prevalence of infectious diseases related to freshwater sports practice and to identify the factors associated with these infections among freshwater sports licensees in Brittany, France. From March 18, 2019, to May 8, 2019, we interviewed freshwater sports licensees (online study) and club presidents and instructors (phone study) in Brittany. Licensee participants were 18 years old or more and practiced at least one freshwater sport in one of the 79 Brittany clubs. We used logistic regression models to study the association between our variables of interest and potential risk factors. In total, 551 licensees (20.3% of the total number of licensees) and 38 clubs (48.1%) were surveyed. Among the licensees, 29 (5.3%) reported being diagnosed with leptospirosis, of which 12 (41.3%) occurred in the last 5 years. The most reported symptoms were skin irritation/itchy skin (24.3%) and 39 individuals (7.1%) reported at least one hospitalization in their lifetime for a disease related to freshwater sports. The occurrence of leptospirosis was negatively associated with boarding from a pontoon (odds ratio (OR)=0.20, 95% confidence interval (95% CI) 0.06–0.56), practicing for less than 4 years (OR=0.17, 95% CI 0.04–0.56) compared to more than 10 years, and the occurrence of leptospirosis was positively associated with taking a soapy shower after practice (OR=4.38, 95% CI 1.90–10.51). Eskimo roll was positively associated with the occurrence of otitis and conjunctivitis (OR=3.22, 95% CI 1.82–6.03), and skin irritation/itchy skin (OR=1.66, 95% CI 0.99–2.84). Otitis, conjunctivitis, and skin irritation/itchy skin are the most commonly reported freshwater sport-related diseases in French Brittany. Despite a good level of knowledge of prevention measures, their implementation by licensees and clubs remains low. Further studies are needed to identify practices associated with infectious risk in freshwater sports.

A 2-year-old male mongoose-scat-detection dog was diagnosed with leptospirosis by urine PCR. The patient developed acute renal failure, hepatic dysfunction, and disseminated intravascular coagulation. Treatment with antibiotics was administered, including ampicillin and doxycycline, and supportive care management was provided. Seroconversion against serogroup Hebdomadis was observed on day 8. The leptospiral gene flaB was detected only in urine collected on day 1, from which Leptospira interrogans ST329 was identified by multilocus sequence typing using seven housekeeping genes. L. interrogans serogroup Hebdomadis ST329 has been isolated from mongooses and humans in Okinawa, Japan. This patient received early treatment with antibiotics, which may have contributed to the early recovery of renal function and removal of L. interrogans from kidney tissue.

Chulalongkorn Medical Journal, 67, 2, 153-159

Leptospirosis is a zoonosis that can infect buffaloes and other mammalians, and it’s caused by Gram-negative bacteria of the genus Leptospira spp. The infection occurs through contact with urine or a contaminated environment with the mucous membranes of the animals, and the disease has two phases: leptospiremia and leptospiruria. The objective of this study was to determine the frequency of leptospirosis in buffaloes in the state of Paraná, Brazil, as well as the main serovars present in this area. A total of 276 blood samples were collected from buffaloes from 18 properties located in different cities and mesoregions of Paraná state. A microscopic agglutination test (MAT) was performed to detect the presence of anti-Leptospira spp. antibodies and to identify its serovars. The prevalence was 77.17% (213/276) of buffaloes seropositive for at least one serovar. The most frequent serovar was Icterohaemorrhagiae, followed by the Pomona serovar and serovar Hardjo. This study seems to be the first to determine the frequency of buffaloes with leptospirosis in the state of Paraná. Prevention and control measures are important to control the disease in herds. RESUMO: Leptospirose é uma zoonose que infecta búfalos e outros mamíferos e é causada por bactérias Gram-negativas do gênero Leptospira spp. A infecção ocorre por meio do contato com a urina ou ambiente contaminado com as membranas mucosas dos animais e a doença possui duas fases: leptospiremia e leptospirúria. O objetivo deste trabalho foi determinar a frequência da leptospirose em bubalinos provenientes do estado do Paraná, assim como determinar os principais sorovares presentes no estado. Um total de 276 amostras de sangue foram coletados de búfalos provenientes de 18 propriedades localizadas em 14 municípios de diferentes mesorregiões do estado do Paraná. O teste de soroaglutinação microscópica (SAM) foi realizado para detecção da presença de anticorpos anti-Leptospira spp. e identificação dos respectivos sorovares. A prevalência de búfalos soropositivos para ao menos um sorovar foi de 77,17% (213/276). O sorovar mais frequente identificado nestes búfalos foi o Icterohaemorrhagiae, seguido pelos sorovares Pomona e Hardjo. Este é o primeiro estudo a determinar a frequência de búfalos com leptospirose no estado do Paraná. Medidas de controle e prevenção são importantes para o controle do agente nos rebanhos.

Resumen Introducción: La leptospirosis es una zoonosis emergente, endémica en Colombia, que afecta tanto animales domésticos como silvestres. Es considerada de riesgo laboral, ya que la transmisión al ser humano está asociada a la exposición con animales o ambientes infectados. En el departamento de Nariño, la producción de cuyes para el consumo humano se realiza en sistemas de crianza tradicionales que podrían favorecer la infección por Leptospira interrogans en esta especie. Objetivo: Detectar molecularmente la infección natural por especies patógenas del género Leptospira en cuyes que son destinados para el consumo humano en el municipio de Pasto. Materiales y métodos: Se tomaron 270 muestras de tejido renal en cuyes sacrificados en dos mataderos. Las muestras fueron analizadas mediante Reacción en Cadena de la Polimerasa (PCR) convencional y coloración diferencial de Warthin Starry (W-S). Resultados: En la evaluación de las 270 muestras, 4 (1,5%) fueron positivas para PCR y una de las muestras demostró la presencia de Leptospira bajo tinción W-S. Conclusiones: Mediante el uso de técnicas moleculares se evidenció L. interrogans en el tejido renal de Cavia porcellus. La circulación del patógeno en esta población representa un riesgo de infección para humanos y animales domésticos en contacto con estos sistemas productivos. Abstract Introduction: Leptospirosis is an emerging zoonosis that is endemic in Colombia and affects both domestic and wild animals. It is considered an occupational risk since human transmission is associated with exposure to infected animals or environments. In the department of Nariño, the production of guinea pigs for human consumption applies traditional rearing systems that could cause animals to get infected with Leptosipira interrogans. Objective: To molecularly identify natural infection by pathogenic species of the genus Leptospira in guinea pigs used for human consumption in the municipality of Pasto (Colombia). Materials and methods: 270 kidney tissue samples were taken from guinea pigs slaughtered in two facilities. Samples were analyzed through conventional polymerase chain reaction (PCR) and Warthin Starry (W-S) differential staining. Results: While 4 (1.5%) out of the 270 samples were categorized as positive using PCR, only 1 sample showed the presence of Leptospira through W-S staining. Conclusions: Molecular techniques were useful to identify L. interrogans in kidney tissue of Cavia porcellus. Dissemination of this pathogen within this population represents an infection risk for humans and domestic animals that are in close proximity to these productive systems.

Leptospirosis is an emerging infectious disease caused by pathogenic Leptospira spp. A universal vaccine against leptospirosis is likely to require highly conserved epitopes from pathogenic leptospires that are exposed on the bacterial surface and that generate a protective and sterilizing immune response. Our group recently identified several genes predicted to encode TonB-dependent receptors (TBDR) in Leptospira interrogans using a reverse vaccinology approach. Three leptospiral TBDRs were previously described and partially characterized as ferric-citrate, hemin, and cobalamin transporters. In the current study, we designed a fusion protein composed of predicted surface-exposed epitopes from three conserved leptospiral TBDRs. Based on their three-dimensional structural models and the prediction of immunogenic regions, nine putative surface-exposed fragments were selected to compose a recombinant chimeric protein. A Mycobacterium bovis BCG strain expressing this chimeric antigen encoded in the pUP500/PpAN mycobacterial expression vector was used to immunize Syrian hamsters. All animals (20/20) vaccinated with recombinant BCG survived infection with an endpoint dose of L. interrogans (p

Leptospira interrogans is one of the causative agents of human leptospirosis, a zoonotic disease with worldwide distribution. Nowadays, this zoonosis is considered one of the biggest in terms of morbidity and mortality (even considering Dengue, the major arbovirosis affecting humans), having in Brazil 3,800 human cases per year. Currently, difficulties imposed by the absence of a rapid, sensitive diagnostic test that can be used as a routine test for the detection of leptospirosis lead to misdiagnosis and underreported cases. The gold standard diagnostic test for leptospirosis is the microscopic agglutination test (MAT), which presents difficulties in execution and interpretation. Therefore, this review proposes a general view of the epidemiologic situation of the disease in Brazil, in addition to the current contributions in the literature for the development of new diagnostic methods. Amongst them, the gene sequences polymorphism analysis, which presents potential for phylogenetic and populational analysis and genotyping of Leptospira spp. Leptospira interrogans é uma das bactérias causadoras da leptospirose, uma zoonose de ampla distribuição mundial. Atualmente, essa zoonose é considerada uma das que apresenta maiores taxas de morbidade e mortalidade no Brasil (mesmo considerando a Dengue, a maior arbovirose em humanos), com cerca de 3.800 casos humanos por ano documentados. Porém, devido às dificuldades impostas pela ausência de um ensaio de diagnóstico rápido, sensível e que possa ser empregado como teste de rotina para a detecção da leptospirose, essa doença é comumente subnotificada e diagnosticada erroneamente. O teste diagnóstico padrão ouro para a leptospirose é a aglutinação microscópica, o qual apresenta dificuldade de execução e interpretação. Dessa forma, propomos nesta revisão uma visão geral da situação epidemiológica da doença no Brasil, além das contribuições presentes na literatura para o desenvolvimento de novas abordagens diagnósticas. Dentre elas, a análise de polimorfismos de sequências gênicas a qual apresenta potencial para análises filogenéticas, populacionais e de genotipagem de Leptospira spp.

Background Acute febrile illnesses (AFIs), including dengue, scrub typhus and leptospirosis, cause significant morbidity and mortality in Southeast Asia. Serological surveillance can be used to investigate the force and distribution of infections. Dried blood spot (DBS) samples are an attractive alternative to serum because they are easier to collect and transport and require less cold storage. We conducted a pilot study to determine the feasibility of integrating serological surveillance for dengue, scrub typhus and leptospirosis into a population-representative lymphatic filariasis seroprevalence survey in Timor-Leste using DBSs. Methods A total of 272 DBSs were collected from healthy community participants. DBSs were analysed at the National Health Laboratory using commercially available enzyme-linked immunosorbent assays. To validate assays for DBSs, 20 anonymised serum samples of unknown serostatus were used to create dried serum spots (DSSs). These were analysed with optical densities compared with those of serum. Where low variance was observed (dengue assay) the published kit cut-offs for serum were applied to the analysis of DBSs. For the other assays (scrub typhus and leptospirosis), index values (IVs) were calculated and cut-offs were determined to be at 2 standard deviations (SDs) above the mean. Results Of the 272 samples analysed, 19 (7.0% [95% confidence interval {CI} 4.3 to 10.7]) were positive for dengue immunoglobulin G (IgG), 11 (4.0% [95% CI 2.1 to 7.1]) were positive for scrub typhus IgG and 16 (5.9% [95% CI 3.4 to 9.4%]) were positive for leptospira IgG. Conclusions While dengue seroprevalence was lower than in nearby countries, results represent the first evidence of scrub typhus and leptospirosis transmission in Timor-Leste. Integrated programmes of serological surveillance could greatly improve our understanding of infectious disease epidemiology in remote areas and would incur minimal additional fieldwork costs. However, when planning such studies, the choice of assays, their validation for DBSs and the laboratory infrastructure and technical expertise at the proposed location of analysis must be considered.

Spirochaetes comprise a heterogenous group of gram negative, motile, spiral shaped bacteria. Some of these pathogens are known to cause numerous human diseases such as Lyme disease, relapsing fever, syphilis and leptospirosis. However, intestinal spirochetosis is a rare condition. Patients frequently present with long-term complaints of loose stools, abdominal pain and weight loss and rectal bleeding. Hence to establish a diagnosis an endoscopy with biopsy is required. In this article, we describe four such cases, having different ages and socio- economic background, successfully treated with a short course of metronidazole.

Leptospirosis is known to determine reproductive disorders on livestock, and Leptospira interrogans and Leptospira borgpetersenii are the most frequently reported species. Leptospira noguchii is an emerging pathogen, but its association with reproductive disease is unclear. We have detected L. noguchii as the agent of an outbreak with reproductive disorders in a Brazilian dairy goat flock. In the kidding season, five out of 10 Saanen had abortions in the final month of pregnancy and two newborn kids had acute clinical signs. After necropsy of three foetuses and one newborn kid, fragments of liver, lung and kidney were submitted to lipL32-PCR. It yielded positive results in at least one fragment from each animal. After, a nested secY-PCR, followed by sequencing, could identify L. noguchii, with 99-100% of identity with sequences obtained from cattle in the same region. For the first time, L. noguchii was detected in goats and, most importantly, the association of this leptospiral species with reproductive failures in ruminants has been demonstrated.

Background The pathogenic Leptospira can survive and contaminate surface water based on physicochemical factors. This study aimed to determine how the physicochemical properties of water sources influence the growth and effect of iron on the gene expression of Leptospira spp. P47. Methods Surface water samples (n=55) were collected and used for Leptospira spp. P47 cultivation. Physicochemical factors, including iron, calcium, magnesium and pH, were analyzed. The association between Leptospira spp. P47 viability at days 5, 10 and 15 with the physicochemical factors were analyzed. In addition, this bacterium was cultured in six selected water samples. The effect of iron in water on HemO and LipL32 gene expression was determined by relative quantification real-time PCR. Results Leptospira viability at day 5 was not significantly correlated with physicochemical factors, while Leptospira viability at day 10 was associated with both pH and iron. The Leptospira viability rate at day 15 had a significantly positive association with pH and iron and a negative association with calcium. HemO expression was significantly increased, mostly in selected water samples and under iron-depleted conditions. Conversely, LipL32 expression was significantly decreased in all water samples. Conclusions Physicochemical factors in natural surface waters are key factors for bacterial survival in the environment, which may increase the chance of Leptospira infection in humans.

La importancia de las cabras en México radica en que su producción se concentra en zonas áridas y semiáridas del norte y el centro del país, y particularmente en la región de la Mixteca en los estados de Oaxaca, Guerrero y Puebla, donde prevalece la pobreza y donde la especie, es capaz de sobrevivir y producir leche y cabritos. El estudio de las enfermedades de las cabras en México es escaso; el INIFAP se ha caracterizado por nunca haber dejado de lado la investigación en esta especie. En esta revisión, se abordan las principales enfermedades que afectan a las cabras en México y se describen las investigaciones que sobre ellas ha desarrollado el INIFAP. Los problemas de salud que enfrentan la mayoría de los rebaños caprinos en los que se ha realizado investigación, demuestran que algunos trastornos reproductivos son causados por enfermedades como brucelosis, leptospirosis y clamidiasis, todas éstas consideradas endémicas y con potencial zoonótico. Por otra parte, los problemas de tipo respiratorio y digestivo son los principales padecimientos que afectan a los cabritos. En las cabras en etapa productiva del territorio nacional, se ha demostrado una frecuencia elevada de animales con artritis encefalitis, enfermedad causada por la infección de Lentivirus de los pequeños rumiantes, paratuberculosis y linfadenitis caseosa, estas últimas de origen bacteriano; una particularidad de estas tres enfermedades es su característica de cronicidad, lo que hace pensar de manera equívoca al productor que su presencia no tiene mayor impacto dentro de los rebaños. Finalmente, se ha logrado detectar la presencia de la fiebre Q, una enfermedad zoonotica actualmente considerada exótica en México, y que en otros países es frecuentemente asociada con trastornos reproductivos, abortos y ocasionalmente, problemas respiratorios en los animales. En las aportaciones del INIFAP hay que destacar el diagnóstico y el control de la brucelosis, que es la principal zoonosis bacteriana en nuestro país; además de haber contribuido a que enfermedades consideradas exóticas en México, se determine que ya son endémicas, y se cuente con las herramientas para su diagnóstico, siendo un reto para nuestro instituto realizar la transferencia de estas tecnologías a los laboratorios de diagnóstico de nuestro país.

A leptospirose é causada por bactérias que pertencem ao gênero Leptospira, afetando diversas espécies animais e os seres humanos. Os cães por conviverem em proximidade com os seres humanos, participam ativamente da cadeia epidemiológica da doença. Para tanto, objetivou-se denotar a leptospirose subclínica em cães de Bom Jesus, Piauí. Foram coletadas amostras de sangue de 125 cães para realização da técnica de Soroaglutinação Microscópica (SAM). Dos 125 cães, 15 (12%) foram soropositivos, onde, 8 (oito) foram reagentes para o sorovar Icterohaemorrhagiae, 3 (três) para o sorovar Autumnalis, 2 (dois) para Copenhageni e 2 (dois) para o Canícola. Os resultados mostram que os cães podem atuar na transmissão da enfermidade para os humanos, e que, mesmo sororeagentes para sorovares não adaptados a esta espécie, não manifestaram sinais clínicos característicos da leptospirose.

International audience; Spirochetes can be distinguished from other bacteria by their spiral-shaped morphology and subpolar periplasmic flagella. This study focused on FlhF and FlhG, which control the spatial and numerical regulation of flagella in many exoflagellated bacteria, in the spirochete Leptospira. In contrast to flhF which seems to be essential in Leptospira, we demonstrated that flhG- mutants in both the saprophyte L. biflexa and the pathogen L. interrogans were less motile than the wild-type strains in gel-like environments but not hyperflagellated as reported previously in other bacteria. Cryo-electron tomography revealed that the distance between the flagellar basal body and the tip of the cell decreased significantly in the flhG- mutant in comparison to wild-type and complemented strains. Additionally, comparative transcriptome analyses of L. biflexa flhG- and wild-type strains showed that FlhG acts as a negative regulator of transcription of some flagellar genes. We found that the L. interrogans flhG- mutant was attenuated for virulence in the hamster model. Cross-species complementation also showed that flhG is not interchangeable between species. Our results indicate that FlhF and FlhG in Leptospira contribute to governing cell motility but our data support the hypothesis that FlhF and FlhG function differently in each bacterial species, including among spirochetes.

Neuroleptospirosis is a rare disease caused by pathogenic Leptospira interrogans in humans; however, it has not been fully studied in animals. A young wild raccoon dog was found convulsing in the recumbent position and died the next day. Histologic examination revealed nonsuppurative meningoencephalitis in the cerebrum, cerebellum, midbrain, and medulla oblongata. The lesions consisted of mixed infiltrates of Iba1-positive macrophages and CD3-positive T cells, with a small number of CD79α-positive B cells and myeloperoxidase-positive neutrophils. In the frontal cortex, perivascular cuffs and adjacent microglial nodules were distributed diffusely, especially in the molecular layer. Glial nodules were comprised of Iba1- and myeloperoxidase-positive activated microglia. Immunohistochemistry revealed leptospires in mononuclear cell perivascular cuffs, but not in glial nodules. Neuroleptospirosis was accompanied by Leptospira-related nonsuppurative interstitial nephritis, pulmonary edema and hemorrhage, and coronary periarteritis, as well as Toxocara tanuki in the small intestine and nonspecific foreign-body granulomas in the lungs and stomach.

The purpose of the research to create a concept for diagnostics and therapy of hemostasis disorders of patients with severe leptospirosis.Patients and Methods. The study included 474 patients with severe serologically confirmed leptospirosis with a favorable outcome of the disease and 31 patients with fatal outcome (total 505 people). Variant of coagulopathy was determined by using a set of special methods for studying hemostasis. The influence of platelet concentrate transfusion, plasma exchange and various tactics of glucocorticoid therapy on patient survival and correction of hemostasis disorders was evaluated. Survival analysis was made using Kaplan-Meyer method with a Cox proportional intensity model. Relative risk (RR) was calculated with a 95% confidence interval (CI).Results: the use of early diagnosis of coagulopathy variants and the use of a differentiated therapy regimen in the choice of the variant of hemostasis disorder led to a decrease of mortality from 16.45% to 11.5% and decrease in the consumption of platelet concentrate and fresh frozen plasma.Conclusion: patients with severe leptospirosis develop a multivariate hemostatic pathology: isolated thrombocytopenia (38%) with thrombotic microangiopathy (20,5%), disseminated intravascular coagulopathy (37,1%), uremic coagulopathy (4,9%), hepatic coagulopathy (3,4%). Plasma exchange in thrombotic microangiopathy is pathogenetically justified. Also, plasma exchange is pathogenetically justified in order to reduce plasma volume in DIC syndrome with consumption coagulopathy and hepatic coagulopathy. The use of GCS in isolated thrombocytopenia can be effective and safe in both “medium doses” and in the form of “pulse therapy” if the following conditions are met: acute renal injury (AKI) III stage according to AKIN and the absence of renal replacement therapy (RRT). The main indication for platelet concentrate transfusion in severe leptospirosis is extremely severe thrombocytopenia (grade 4) with active life-threatening bleeding at the time of transfusion.

Leptospirosis is a zoonotic disease, it arises worldwide but it is most frequent in tropical and subtropical zone. It is one of the notifiable and treatable disease. Leptospirosis is a plague caused by species of bacteria called Leptospira the bacteria shed into the nature via urine of infected animals. Rats are the most recurrent source of human sepsis. Rivers are the assumption to be a predominant risk factor for transmission of disease to humans. It possesses an extensive variation of mechanisms that allow them to avoid the host immune system and cause infection. The infection is extremely vast ranging from subclinical to multi organ infection with elevated mortality. It is frequently mild but can be terminal, it is likely to be serious and the serious alignment form known as Weils disease and can easily steer to death. The mingling of renal failure, hemorrhage and jaundice is known as Weils disease. It is the most affection pattern associated with critical leptospirosis. It is accumulating as a serious problem worldwide and superficially existing as co-infections with various unrelated diseases, including malaria and dengue. Laboratory diagnostic tests are not always accessible and usually diagnosis is executed by enzyme linked immunosorbent assay (ELISA) serology and microscopic agglutination test, rapid test are also feasible. The MAT (microscopic agglutination test) is known as Gold standard. Serological tests are most frequently used for the diagnosis of leptospirois. The carcinogenesis of human disease and mechanism of cell membrane injuries which take place mainly due to the occupancy of leptospirosis along with their antigen in host tissues many molecules hand out to the ability of leptospira to invade, colonize and to adhere. In most of the cases antibiotics are preferred to reduce the symptoms of leptospirosis.

Leptospira interrogans spirochetes belong to a group of pathogens of particularly dangerous infections that cause leptospirosis in many species of wild, farm and domestic animals, as well as humans. Significant economic damage caused by this disease to livestock around the world, numerous cases of death from leptospirosis, and mainly waterborne transmission of the infection determine the topicality of studying all the aspects of the existence of L. interrogans in freshwater ecosystems. The objective of our study was to determine the nature of ecological relationships between L. interrogans and green algae. We used green algae of the Desmodesmus brasiliensis species as a model object. In the experiments, sterile algae culture filtrates were added to L. interrogans containers grown at 27–28 °C. Comparison of the content of spirochete cells in the experiment and control samples, conducted 24 hours after exposure, showed that the reproduction of L. interrogans is markedly inhibited in the samples containing algae secretions at the dilutions of 1:10 and 1:100. In order to reduce resistance to the allelopathic influence of D. brasiliensis algae, leptospira strains were located as follows: Pomona, Australis, Hebdomadis, Canicola, Sejroe, Icterohaemorrhagiae, Grippotyphosa, Tarassovi. The obtained results indicate a complex intraspecific structure of L. interrogans and their high ecological plasticity. In addition, experimental data indicate that, due to the release of biologically active substances into the aquatic environment, green algae have the potential to affect the dynamics of a number of leptospirosis pathogens in situ. Given the important epidemiological and epizootic significance of pathogenic leptospira, further research is necessary to determine the patterns of their interactions and existence in the environment.

Приведен клинический случай лептоспироза у юноши, жителя Тернопольской области, который был госпитализирован в инфекционно-диагностическое отделение Тернопольской областной детской клинической больницы. Особенностью данного клинического случая является то, что у пациента была безжелтушная форма, которая сопровождалась лихорадкой с литическим снижением температуры, острой почечной недостаточностью, болями в икроножных мышцах, гепатоспленомегалией, тромбоцитопенией. У мальчика развился характерный геморрагический синдром, сопровождавшийся петехиальной сыпью на груди. При наличии острой почечной недостаточности, которая сопровождается тромбоцитопенией, гипертрансаминаземией, следует исключить лептоспироз.

В статье представлен анализ территориального распределения лептоспироза в наиболее эндемичных зонах Одесской области. Установлено, что очень высокая заболеваемость лептоспирозом наблюдалась на территории Савранского района, с превышением среднего многолетнего уровня в десятки раз. В период сезонного по­дъема, который продолжался с июля по сентябрь, происходило 97,73 % всех случаев заболевания.

Introduction: Leptospirosis is an international zoonotic condition relay and rising prevalencethe causes of the infection Leptospira spirochete with popular exhibition of polluted clean water.Most asymptomatic diseases, but the symptoms are moderate, autonomous, specific febrile and respiratory non-specific disorder high mortality rates of renal failure. Case: A 33-years-old woman from rural area came to the hospital in casualty with a history of high grade fever (40 degree Celsius), with chilling, headache, stiff neck. Urinary retention along with productive cough for three days. Intervention: The patient underwent inpatient management, which included tablet Ceftriaxone 1gm twice a day, Tablet Doxycycline 100 mg bd given and intravenous fluids 5% dextrose and dextrose/sodium chloride solution, Injection Furosemide20 mg intravenously twice a day were given to the patients. Nursing management: monitoring the vital sign, maintain the O2 levels as well as the consumption and output. All basic nursing care has been provided. Her symptoms cured after two weeks of treatment, she was discharged. Results: Fever has been minimized. The therapy is reacted to and restored. Conclusion: Management was mainly aimed at protecting patient wellbeing, preventing complications and improving the quality of life. The patient received all medical therapy and the results show that the therapy and care was effective.

Leptospirosis in pregnancy is often underdiagnosed and not commonly reported due to its unusual appearance and rarity. It looks like HELLP syndrome, obstetric cholestasis, viral hepatitis & pregnancy-related acute fatty liver. Miscarriages in the first trimester, stillbirths, and neonatal leptospirosis are serious complications that necessitate a high degree of concern, heightened sensitivity, and prompt diagnosis and treatment. We have one such incidence of leptospirosis in a COVID-19 positive pregnant female. A 21-year-old Primigravida with a predisposition of serious anaemia & thrombocytopenia, presented with fever, haematemesis, malena and sore throat at 38 weeks and 2 days gestation, during the COVID-19 pandemic. She had pallor, oedema, and haematuria on catheterization, rest all investigations were within normal limits. Proteinuria, haemolysis, low platelets, and elevated bilirubin were discovered during the investigation. Due to the lack of hypertension and elevated transaminases, the working diagnosis was atypical haemolysis, low platelets (HELLP) syndrome. The patient was tested for COVID-19 RT-PCR, came out to be positive and the fever spikes continued, leading to further investigations for Dengue, Malaria, Scrub Typhus, and Leptospirosis due to the ongoing Covid-19 pandemic. After the EIA (Enzyme Immunoassay) IgM antibody (confirmatory for Leptospirosis) tested positive for Leptospirosis, the decision to start Doxycycline was made. Meanwhile, the patient's CTG (Cardio tocograph) revealed signs of foetal distress, and a decision for an emergency LSCS was taken (Lower Segment Caesarean Section). The histology of the placenta after the section revealed normal findings. Doxycycline was initiated with a neonatal feeding regimen that was acceptable. On day two of life, the newborn had no indications of inherited leptospirosis and was removed from Neonatal Intensive Care. Within one week, the patient's symptoms had disappeared, and her biochemistry had went back to normal within 2 weeks.

The present article addresses issues related to feline leptospirosis. The causative agent of the infection is reviewed, alongside its morphology and up-to-date taxonomic classification including the concepts of serogroup and serovar. The fact that leptospirae can infect cats is confirmed. Reservoirs and sources of the infection are listed, as well as transmission routes represented as schemes courtesy of the world’s leading institutions specialising in research into human and animal leptospirosis. Taking into account current statutory regulations and scientific knowledge on leptospirosis, the present article offers an analysis of common myths and misconceptions regarding leptospirae, clinical manifestation of the infection in cats and pertinent issues related to the diagnosis of leptospirosis, including differential diagnosis. Cats’ resistance to leptospirosis on the level of the species is reviewed, and data are presented substantiating that treating leptospirosis in cats is unnecessary and might have detrimental impact on their welfare. Additionally, the absence of tools for the specific prophylaxis of feline leptospirosis worldwide is highlighted.

This study attempts to summarize epidemiological characteristics of human leptospirosis and to determine the seroprevalence of this disease among domestic animals in the Autonomous Province of Vojvodina, for the period 2009-2018. Chronological, demographic and topographic characteristics of human cases were analyzed. Pearson's correlation was used to explore correlations between different meteorological factors and trends in time-series of human cases. Overall 87 human cases of leptospirosis and five subsequent deaths (CFR: 5.75%) were recorded in the ten-year period. The average annual incidence rate was 0.45/100,000 (range: 0.16-1.50/100,000). The disease was more prevalent in males (M/F=16.40:1), with the majority of cases reported in August (N=23; 26.44%), September (N=20; 23.00%) and October (N=15; 17,24%). A statistically significant weak positive correlation was observed between the mean monthly air temperature and the number of human cases of leptospirosis of the same month (r=0.30, p

The recombinant, modified leucine-rich repeat protein rhKU_Sej_LRR_2271 has been suggested as a candidate for leptospiral vaccine development since it was predicted to be a transmembrane protein containing leucine-rich repeat motifs and immunogenic epitopes. The immunogenic epitopes showed binding affinities with lower IC50 values than peptides of known antigenic proteins, e.g., LipL32. Moreover, this protein was immunoreactive with hyperimmune sera against several serovars. In this study, we aimed to develop a lateral flow strip test using the rhKU_Sej_LRR_2271 protein for the detection of anti-leptospiral IgG in dogs. The lateral flow assay was performed with 184 dog plasma samples and evaluated with a culture method, 16S ribosomal RNA gene (rss) analysis real-time PCR, and LipL32 ELISA. The culture method failed to detect leptospires in the dog blood samples. Six of nine symptomatic dogs gave positive results with the real-time PCR assay. The lateral flow assay and LipL32 ELISA gave positive results with 59 and 50 dogs, respectively. The sensitivity, specificity, and accuracy of the rhKU_Sej_LRR_2271 lateral flow strip test were 70.00, 82.09, and 78.80%, respectively, when compared with LipL32 ELISA. There was a significant association between the LipL32 ELISA and the rhKU_Sej_LRR_2271 lateral flow assay. The rhKU_Sej_LRR_2271 lateral flow strip test has therefore demonstrated a good potential to detect anti-leptospiral IgG in dogs.

Background Leptospirosis infection can lead to serious renal and cardiopulmonary complications and can be fatal. Following heavy rainfall and localised flooding in early 2021, Tropical Public Health Services in Cairns were alerted to an increase in leptospirosis cases in the region, with notifications almost three times higher than usual by mid-February. An epidemiological investigation was undertaken. Methods Leptospirosis notification data were obtained from the Queensland Notifiable Conditions System. Confirmed and probable cases residing in the Cairns region, with an onset date between 1 January and 31 May 2021, were included in the investigation. Case demographics, pathology results, symptoms, hospital stay information and presumed exposure sources were obtained from Queensland Health records; local rainfall data was obtained from the Australian Bureau of Meteorology. Case characteristics and rainfall were compared to the prior ten-year period and the distribution of cases by week of onset, address, exposure source and infecting serovar analysed. Results A total of 43 leptospirosis cases were notified between January and May 2021, the highest number recorded for the region since 2011. Presumed exposure sources were available for 40 cases (93.0%), with 33 cases (82.5%) exposed occupationally, including 25 cases working on banana farms. Infecting Leptospira serovars were identified for five cases (11.6%), with four infected with serovar Australis and one with serovar Zanoni. Limited information about the specific exposure sites for each case and a low serovar detection rate hampered the ability to confirm the presence or absence of a leptospirosis outbreak. While heavy rainfall is likely to have contributed to the spike in cases, no factors were identified as clearly associated with the increase. Conclusions A number of pathways are proposed to improve the collection of exposure site data and the identification of infecting serovars, in order to strengthen local leptospirosis surveillance and the ability to detect outbreaks in the Cairns region.

Background Leptospirosis is an emerging zoonotic infection worldwide and a cause of life-threatening disease in dogs. Seroprevalence in Swedish dogs is unknown. The aims of the present study were to estimate seroprevalence of pathogenic Leptospira in healthy dogs in Sweden using the microagglutination test (MAT) and a rapid point-of-care enzyme-linked immunosorbent assay (ELISA), and to evaluate risk factors of Leptospira exposure in Swedish dogs. Results Positive MAT titres (≥ 1:50) were detected in 27/369 (7.3%) of included dogs. Five different serovars were represented of which the Saxkoebing serovar was the most common (64.3%), followed by Copenhagi (14.3%), Bratislava (10.7%), Icterohaemorrhagiae (7.1%), and Canicola (3.6%). The ELISA test (SNAP® Lepto) was positive in 3/316 (0.9%) dogs. Living in urban areas and contact with stagnant water were found to be risk factors for Leptospira seropositivity (p Conclusion In this first seroprevalence study of Leptospira in Swedish dogs, it was shown that healthy dogs without recent (24 months) travel history and antileptospira vaccination had been exposed to pathogenic Leptospira interrogans serovars. Contact with stagnant water and living in urban areas were independent risk factors for seropositivity.

Leptospirosis is a neglected disease of man and animals that affects nearly half a million people annually and causes considerable economic losses. Current human vaccines are inactivated whole-cell preparations (bacterins) of Leptospira spp. that provide strong homologous protection yet fail to induce a cross-protective immune response. Yearly boosters are required, and serious side-effects are frequently reported so the vaccine is licensed for use in humans in only a handful of countries. Novel universal vaccines require identification of conserved surface-exposed epitopes of leptospiral antigens. Outer membrane β-barrel proteins (βb-OMPs) meet these requirements and have been successfully used as vaccines for other diseases. We report the evaluation of 22 constructs containing protein fragments from 33 leptospiral βb-OMPs, previously identified by reverse and structural vaccinology and cell-surface immunoprecipitation. Three-dimensional structures for each leptospiral βb-OMP were predicted by I-TASSER. The surface-exposed epitopes were predicted using NetMHCII 2.2 and BepiPred 2.0. Recombinant constructs containing regions from one or more βb-OMPs were cloned and expressed in Escherichia coli. IMAC-purified recombinant proteins were adsorbed to an aluminium hydroxide adjuvant to produce the vaccine formulations. Hamsters (4-6 weeks old) were vaccinated with 2 doses containing 50 – 125 μg of recombinant protein, with a 14-day interval between doses. Immunoprotection was evaluated in the hamster model of leptospirosis against a homologous challenge (10 – 20× ED50) with L. interrogans serogroup Icterohaemorrhagiae serovar Copenhageni strain Fiocruz L1-130. Of the vaccine formulations, 20/22 were immunogenic and induced significant humoral immune responses (IgG) prior to challenge. Four constructs induced significant protection (100%, P < 0.001) and sterilizing immunity in two independent experiments, however, this was not reproducible in subsequent evaluations (0 – 33.3% protection, P > 0.05). The lack of reproducibility seen in these challenge experiments and in other reports in the literature, together with the lack of immune correlates and commercially available reagents to characterize the immune response, suggest that the hamster may not be the ideal model for evaluation of leptospirosis vaccines and highlight the need for evaluation of alternative models, such as the mouse.

Systemic leptospirosis exists worldwide. But leptospiral uveitis, an important late complication is not identified by ophthalmologists in several countries.In the last 18 months numerous publications, especially on epidemiology, surveillances, and novel rapid diagnostic kits to test at the point of care site on leptospirosis have been published from all over the world. However, publications from ophthalmologists are very scarce. Remarkably ophthalmologists should know the global burden of leptospirosis, prevalence of the disease in their country, demographic factors associated, risk factors, and systemic signs to elicit relevant history and travel history. They should be aware of recent advances in investigations to confirm their clinical diagnosis.It is quite evident from this work that leptospirosis is prevalent worldwide. Ophthalmologists' awareness has to improve to identify the etiological diagnosis. They should have access to simple, less expensive, and less cumbersome laboratory tests.