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Background and Objectives: Leptospirosis is an infectious zoonotic disease that can result in severe complications. It is widespread, especially in hot and humid climates such as the northern region of Iran. The immune responses to leptospirosis are multifaceted. Lipl41 is an outer membrane protein that is expressed during infection and is highly conserved among pathogenic species. This makes it a good candidate for diagnosis and induction of specific immune responses. The aim of the present study was to evaluate immune responses against recombinant Lipl41 in mice. Materials and Methods: After immunizing of different groups of mice with recombinant Lipl41 (rLipl41), the levels of specific antibodies and cytokine profiles interferon-gamma/ interleukin-4 (IFN-γ/IL-4) were measured. Results: The results revealed that rLipl41 showed a significant increase in antibody levels compared with the control groups (P< 0.05). Although the level of IL-4 in the groups that received Lipl41 was similar to that in the other control groups, the IFN-γ levels showed a significant increase (P

Leptospirosis is a significant zoonosis worldwide, with disease severity ranging from a mild non-specific illness to multi-organ dysfunction and hemorrhage. The disease is caused by pathogenic bacteria of the genus Leptospira, which are classified into pathogenic and saprophytic clades. Bacterial binding to host molecules and cells, coordinated by adhesin proteins, is an important step in pathogenesis. While many leptospiral adhesins have been identified, the vast majority have not been characterized in vivo. Herein, we present an overview of the current methodologies and successes in identifying adhesins in Leptospira, including known biological roles in vivo. We will also identify and discuss potential areas for future research.

Leptospirosis is an endemic zoonosis in Brazil responsible for numerous reproductive and economic losses to the dairy industry. Brazil ranks fifth in the world's production of cow's milk and around 23 million cows are milked every day. The northwest region of the state of São Paulo has a considerable number of family farming settlements, with dairy farming being predominant. This article reports a seroepidemiological study to detect agglutinins against Leptospira spp. in 1,004 dairy cattle kept on 64 family farms producing milk in the northwest region of São Paulo. Management and environmental data for situation diagnosis were obtained with a questionnaire. Antibodies against Leptospira spp. were investigated by the microscopic seroagglutination test (SAM) and milk and urine samples were obtained from seroreactive animals with titer ? 400. These samples were submitted to molecular tests. Of the 64 properties studied, 63 (98%) had seroreactive animals. Of the 1,004 animals, 523 (52%) were reactive. According to the molecular tests, the presence of Leptospira spp. in the urine and milk of the seroreactive animals was negative. Wetlands, presence of rodents, occurrence of abortion, presence of dogs, presence of cats and presence of horses were variables associated with the risk of infection by Leptospira spp. In addition to its importance in animal health, leptospirosis poses a risk to human health, a situation that indicates the need for improvement of sanitary conditions in rural properties.

Introduction: Approximately 10% of human leptospirosis cases progress to severe forms, among which Weil syndrome stands out. This condition can be aggravated by complications associated with antibiotics, such as the Jarisch Herxeimer reaction (JHR) that intensifies inflammation. Treatment with Jusvinza may be an option for these states mediated by hyperinflammation. Objective: To describe the clinical evolution of a patient with leptospirosis and Weil's syndrome who developed the JHR and was treated with Jusvinza. Case Report: 50-year-old male patient was diagnosed with Leptospirosis, which progressed to a serious condition and Weil syndrome and received treatment with ceftriaxone, as result he developed JHR, which led to the use of mechanical ventilation and the compassionate use of Jusvinza. The clinical, radiological, and humoral improvement was evident 48 hours after starting treatment. Conclusions: Treatment with Jusvinza induced a decrease in several biomarkers of systemic inflammation and contributed to the patient's recovery. These results indicate that Jusvinza may be an effective option for the treatment of severe forms of Leptospirosis and its complications, associated with hyperinflammation.

Introduction: Leptospirosis is a life-threatening zoonotic infection and delayed seeking treatment has been associated with complications and poor prognosis. The aim of this study was to analyze socio-demographic factors associated with delays in seeking treatment of patients with leptospirosis in Monaragala District. Methods: A hospital-based descriptive cross-sectional study was conducted to analyze the factors associated with delays in seeking treatment of patients with leptospirosis using 450 clinically diagnosed leptospirosis patients admitted to base and above hospitals in Monaragala district, using a pretested interviewer administered questionnaire among laboratory confirmed leptospirosis. Results: The incidence of leptospirosis in Monaragala district during the study period from the present study was 59.8 per 100,000 population. Significant socio-demographic factors associate with delays in seeking treatment by laboratory confirmed patients in bi variable analysis was marital status (OR=1.85; CI=1.02-3.33), monthly income (OR=2.63; CI=1.02-7.14), time taken to reach a health care facility (OR=4.95; CI=1.48-16.62) and cost of travel (OR=2.73; CI=1.10-6.75), while age (OR=1.25; CI=0.68-2.28), sex (OR=1.44; CI=0.69-2.98), education (OR=1.5; CI=0.88-2.77), nationality (OR=1.64; CI=0.39-6.66), occupation (OR=1.01; CI=0.56-1.81), distance from home to a health care facility (OR=1.44; CI=0.79-2.59) and mode of travel (OR=1.78; CI=0.92-3.57) was not significant. After adjusting for the effect of confounders, only the source of infection of leptospirosis showed a significant association (AOR=3.65; 95% CI=1.48-8.98) with delay in seeking treatment. Conclusions and Recommendations: Awareness of the source of the leptospirosis infection should be more emphasized and raising awareness is needed all year to prevent medical complications and deaths.

Leptospirosis vaccine for dogs in the United States is considered a lifestyle or non-core vaccine, making individual veterinary practitioners responsible for determining if vaccination is necessary for their patients. Veterinary professionals often base their vaccination decisions on local rates of clinical cases. However, even subclinical leptospirosis infections have zoonotic potential. The microscopic agglutination test (MAT) is effective for screening unvaccinated animals, but previous vaccination can lead to inconsistent results and variable MAT titers over time. This prospective research survey evaluated if local experience was sufficient to justify selective vaccination for leptospirosis. MAT analyses were performed on sera collected from well-cared-for, unvaccinated dogs residing in five different geographies across the United States: South-Central (East Texas), New England, the Mid-Atlantic (North Carolina and Virginia), Midwest (Wisconsin/northern Illinois), and Southwest (southern California). Thirty-eight clinics participated, submitting a total of 1345 qualified samples from unvaccinated dogs over 1 year of age. 11.6% of these unvaccinated dogs had MAT titers for one or more serogroups of Leptospira. While seropositivity does not necessarily indicate that disease will result or that a specific serovar is involved, these MAT-positive cases do indicate that the potential for exposure exists and clinical signs or a carrier-state could result from infection. These survey results would indicate that a more aggressive vaccination protocol for leptospirosis should be considered.

Key Clinical Message Leptospirosis is an important zoonosis worldwide. Due to nonspecific clinical manifestation and poor recognition in non‐epidemic area, there is often a delay in diagnosis and treatment. Early diagnosis from Metagenomic next‐generation sequencing test is crucial for timely intervention. Abstract We presented a case of a 19‐year‐old male patient who developed leptospirosis infection characterized by acalculous cholecystitis and septic shock after typhoon events. Metagenomic next‐generation sequencing (mNGS) helped to early diagnose leptospirosis infection. Finally, the patient achieved full recovery following the antibiotic treatment in addition to supportive care and was discharged.

Leptospirosis is caused by bacteria that are members of the Leptospira genus. This illness can occur in a variety of environments, although it is more prevalent in tropical regions where humidity and wetness greatly aid in its spread. Geographically broad, leptospirosis primarily affects tropical, temperate, and subtropical regions. Bacteria can enter the body through the vaginal system, mucosa, conjunctiva, and tiny abrasions. Hazardous germs are released into the urine when the bacteria settle in the complex kidney pathways. Leptospirosis symptoms are similar to those of other diseases, making diagnosis challenging. The majority of leptospirosis patients are resolved without problems. Laboratory techniques are used to research leptospirosis in humans and animals. Humans are classified as accidental hosts because they have had direct or indirect interaction with leptospirosis-infected animals. Leptospirosis infection can occur in at-risk groups who work in contaminated environments or animal shelters, such as abattoir and sewer workers, coal mines, plumbers, salver workers, agricultural workers, veterinarians, military personnel, abattoir employees, animals, meat handlers, and fishing industry workers. Antimicrobial therapy is one way to treat leptospirosis. Among the antibiotics are doxycycline, amoxicillin, ceftriaxone, ampicillin, penicillin, and erythromycin. Reducing the incidence of leptospirosis in domestic and wild animals can help manage the disease in people. Leptospirosis in wild animals is difficult to control, but in domesticated animals, vaccinations using inactivated whole cells or outer membrane preparations can effectively manage the disease.

Leptospirosis is an infection with multiorgan involvement and a high mortality rate. Extreme hyperbilirubinemia in leptospirosis has been reported to exert multiple cellular toxic effects on kidney and liver cells. We describe a young man with leptospirosis who had extreme hyperbilirubinemia, acute liver injury, coagulopathy, hepatic encephalopathy, and pulmonary haemorrhages. Early initiation of therapeutic plasma exchange (PEX) dramatically improved patient’s clinical and biochemical parameters. We conclude that, in addition to the mortality benefit provided by PEX in severe pulmonary hemorrhage syndrome in leptospirosis, PEX is also beneficial in reducing systemic toxic insults of hyperbilirubinemia.

OBJECTIVES: Leptospirosis is a re-emergent zoonotic bacterial disease associated with renal and hepatic injury. In free-roaming cats in some regions, a high prevalence of Leptospira antibodies has been identified, and pathogenic leptospires have been detected in renal tissue, indicating that they may play a role in Leptospira epidemiology. The objective of this study was to determine the prevalence of Leptospira seroreactivity and urinary shedding of Leptospira DNA in free-roaming cats from northern California and southern Texas. A secondary objective was to compare the results of a point-of-care (POC) assay, designed to detect Leptospira antibodies, with the results of the microscopic agglutination test (MAT) when applied to serum samples from feral cats. METHODS: Specimens were obtained from free-roaming cats from northern California (n = 52; 2020) and southern Texas (n = 75; 2017). Leptospira quantitative PCR was performed on blood and urine specimens from Californian cats. Serum samples from Californian and Texan cats were subjected to MAT to categorize them as Leptospira antibody-positive or antibody-negative. The performance of the POC assay was assessed using the MAT as the gold standard. RESULTS: Leptospira DNA was not detected in the blood or urine of any cats tested. The results of the MAT were positive in 17.3% (n = 9) of Californian cats and 10.7% (n = 8) of Texan cats (P = 0.3). The median MAT titer was 1:100 (range 1:100-1:200) in Californian cats and 1:200 (range 1:100-1:800) in Texan cats. The POC assay was negative in all specimens. CONCLUSIONS AND RELEVANCE: Free-roaming cats in California and Texas are exposed to Leptospira species and may have the potential to act as sentinel hosts. No cats had evidence of current infection, as determined using PCR on blood and urine specimens. The POC test did not reliably detect anti-Leptospira antibodies in these cats. The role of cats in the maintenance or shedding of pathogenic leptospires requires further investigation.

Leptospirosis is a bacterial disease that affects humans and animals and is caused by Leptospira. The recommended treatment for leptospirosis is antibiotic therapy, which should be given early in the course of the disease. Despite the use of these antibiotics, their role during the course of the disease is still not completely clear because of the lack of effective clinical trials, particularly for severe cases of the disease. Here, we present the characterization of L. interrogans Lsa45 protein by gel filtration, protein crystallography, SAXS, fluorescence and enzymatic assays. The oligomeric studies revealed that Lsa45 is monomeric in solution. The crystal structure of Lsa45 revealed the presence of two subdomains: a large α/β subdomain and a small α-helical subdomain. The large subdomain contains the amino acids Ser122, Lys125, and Tyr217, which correspond to the catalytic triad that is essential for β-lactamase or serine hydrolase activity in similar enzymes. Additionally, we also confirmed the bifunctional promiscuity of Lsa45, in hydrolyzing both the 4-nitrophenyl acetate (p-NPA) and nitrocefin β-lactam antibiotic. Therefore, this study provides novel insights into the structure and function of enzymes from L. interrogans, which furthers our understanding of this bacterium and the development of new therapies for the prevention and treatment of leptospirosis.

Purpose: Leptospirosis is a waterborne zoonotic disease prevalent in tropical regions, causing significant morbidity and mortality. It can involve any organ in its primary stage, and uveitis is its late complication. While advanced laboratory diagnosis is available only in tertiary care centers globally, a cost-effective bedside assessment of clinical signs and their scoring could offer a provisional diagnosis. Aim: To analyze the diagnostic potential of demographic and clinical signs in a large cohort of serologically confirmed leptospiral uveitis patients. Methods: In this retrospective study, demographic and clinical parameters of 876 seropositive leptospiral uveitis patients and 1042 nonleptospiral uveitis controls were studied. Multivariable logistic regression analysis with bootstrap confidence interval (CI) characterized the diagnostic predictors. The performance of the model was evaluated using the area under the receiver operating curve (AUROC). Results: Presence of nongranulomatous uveitis (odds ratio [OR] = 6.9), hypopyon (OR = 4.6), vitreous infiltration with membranous opacities (OR = 4.3), bilateral involvement (OR = 4), panuveitis (OR = 3.3), vasculitis (OR = 1.9), disc hyperemia (OR = 1.6), absence of retinochoroiditis (OR = 15), and absence of cystoid macular edema (OR = 8.9) emerged as predictive parameters. The AUROC value was 0.86 with 95% CI of 0.846–0.874. At a cut-off score of 40, the sensitivity and specificity were 79.5 and 78.4, respectively. Conclusion: The study demonstrates that ocular signs can serve as diagnostic predictors for leptospiral uveitis, enabling primary care ophthalmologists to make bedside diagnosis. This can be further confirmed by laboratory methods available at tertiary care centers.

Objective: The Case Fatality Rate (CFR) of Leptospirosis in Semarang City has shown a tendency to increase from 2019 to 2022. In 2022, there were 30 cases reported, with 8 deaths (CFR 27%). The purpose of this study was to detect Leptospira sp. bacteria in rats and analyze the risk factors for leptospirosis in Semarang City. Methods: This study employed an observational approach with a Case-Control Study design. The research was conducted in Semarang City from November to December 2023. Non-random sampling techniques were used, specifically the total sampling method, resulting in a sample size of 45 case groups and 45 control groups. Bivariate analysis was performed using the Chi-square test, with a significance level set at

Abstract Background Leptospirosis is an underdiagnosed infectious disease with non-specific clinical presentation that requires laboratory confirmation for diagnosis. The serologic reference standard remains the microscopic agglutination test (MAT) on paired serum samples. However, reported estimates of MAT’s sensitivity vary. We evaluated the accuracy of four index tests, MAT on paired samples as well as alternative standards for leptospirosis diagnosis: MAT on single acute-phase samples, polymerase chain reaction (PCR) with the target gene Lfb1, and ELISA IgM with Leptospira fainei serovar Hurstbridge as an antigen. Methods We performed a systematic review of studies reporting results of leptospirosis diagnostic tests. We searched eight electronic databases and selected studies that tested human blood samples and compared index tests with blood culture and/or PCR and/or MAT (comparator tests). For MAT selection criteria we defined a threshold for single acute-phase samples according to a national classification of leptospirosis endemicity. We used a Bayesian random-effect meta-analysis to estimate the sensitivity and specificity of MAT in single acute-phase and paired samples separately, and assessed risk of bias using the Quality Assessment of Studies of Diagnostic Accuracy Approach- 2 (QUADAS-2) tool. Results For the MAT accuracy evaluation, 15 studies were included, 11 with single acute-phase serum, and 12 with paired sera. Two included studies used PCR targeting the Lfb1 gene, and one included study used IgM ELISA with Leptospira fainei serovar Hurstbridge as antigen. For MAT in single acute-phase samples, the pooled sensitivity and specificity were 14% (95% credible interval [CrI] 3–38%) and 86% (95% CrI 59–96%), respectively, and the predicted sensitivity and specificity were 14% (95% CrI 0–90%) and 86% (95% CrI 9–100%). Among paired MAT samples, the pooled sensitivity and specificity were 68% (95% CrI 32–92%) and 75% (95% CrI 45–93%) respectively, and the predicted sensitivity and specificity were 69% (95% CrI 2–100%) and 75% (2–100%). Conclusions Based on our analysis, the accuracy of MAT in paired samples was not high, but it remains the reference standard until a more accurate diagnostic test is developed. Future studies that include larger numbers of participants with paired samples will improve the certainty of accuracy estimates.

Isac Rodrigues Comia,1– 3,&ast; Leonardo Manuel,1– 3,&ast; Regina Daniel Miambo,3,4 Awa Abdul Carimo,3,5 Percílio da Floca Manjate,3,5 Ana Edith Maholela,3,6 Lucas Raimundo Banze,2,3 Titos Paulo Buene,2,3 Noémia Nhancupe,2,3 Irina M Sousa,3,7 Constance A Benson,8 Robert T Schooley,9 Jahit Sacarlal,2 Emília Virgínia Noormahomed2,3,9 1Department of Research and Extension, Faculty of Health Sciences, Lúrio University, Nampula, Mozambique; 2Department of Microbiology, Faculty of Medicine, Eduardo Mondlane University, Maputo, Mozambique; 3Mozambique Institute for Health Education and Research (MIHER), Maputo, Mozambique; 4Department of Para-Clinics, Faculty of Veterinary, Eduardo Mondlane University, Maputo, Mozambique; 5Department of Medicine, Eduardo Mondlane University, Maputo, Mozambique; 6Department of Medicine, Maputo Central Hospital, Maputo, Mozambique; 7Department of Biological Sciences, Faculty of Sciences, Eduardo Mondlane University, Maputo, Mozambique; 8Department of Medicine, Division of Infectious Diseases and Global Public Health, University of California, San Diego, CA, USA; 9Department of Medicine, Division of Infectious Diseases, University of California, San Diego, CA, USA&ast;These authors contributed equally to this workCorrespondence: Emília Virgínia Noormahomed, Av. Salvador Allende, 702, Maputo, Mozambique, Tel +258828810907, Fax +25821304684, Email enoormahomed@gmail.comIntroduction: This study aims to determine the baseline seroprevalence of leptospirosis, a zoonotic and neglected disease, in people living with HIV (PWH) in Maputo, Mozambique, and to evaluate the relationship between selected HIV-related factors that might influence risk of coinfection with leptospirosis, such as degree of immunosuppression, as assessed by CD4 cell count, World Health Organization (WHO) HIV/AIDS clinical stage and antiretroviral therapy (ART) intake.Methods: This was a descriptive cross-sectional analysis of 157 PWH, aged over 18 years old, admitted to the Maputo Central Hospital, in Maputo, Mozambique, between March 2020 and October 2021. The study participants were recruited as a convenience sample regardless of the reasons for their admission. We collected sociodemographic and clinical data, including ART and WHO HIV/AIDS clinical stage, and blood for CD4 cell count and detection of Leptospira IgG antibodies using a commercial Kit ab247199 Leptospira IgG ELISA (www.abcam.com/ab247199) with sensitivity and specificity of 100% and 97.3%, respectively. Laboratory testing was performed at the Faculty of Medicine, Eduardo Mondlane University and Laboratory of Clinical Analysis, in Maputo.Results: Participants were aged 18 to 72 years (median age 39 years; SD ± 10.5), the majority were female 100 (63.7%), from urban areas 138 (87.9%), with secondary-level education 80 (51%). The overall seroprevalence of Leptospira IgG antibodies was 40.1%. The median CD4 cell count was 385 cells/μl (02 to 2297; SD ± 378.47). Higher seroprevalence of Leptospira antibodies was found among participants with CD4 cell counts < 250 cells/μl (54.8%), WHO HIV/AIDS stage IV (70.2%) and those on ART (92%), though there were no statistically significant differences between groups with and without Leptospira antibodies.Conclusion: Our study confirmed that Leptospira antibodies are highly prevalent in PWH in Maputo; however, Leptospira infection was not associated with the degree of immunosuppression, WHO HIV/AIDS clinical stage, or the use of ART. Our data support the need for routine screening for leptospirosis in PWH in Mozambique. Future studies are warranted to characterize the incidence and outcomes of symptomatic leptospirosis in this patient population and to identify circulating serovars and species in the country and region, as well as the implicated reservoirs.Keywords: leptospirosis, co-infection Leptospira and HIV, Leptospira IgG, Mozambique

Leptospirosis, also known as Weil’s disease, is a febrile tropical disease of humans and diverse animals. The maintenance hosts of the infectious pathogen, Leptospira spp., are primarily rodents, while other warm-blooded animals and some reptiles are secondary or transient hosts of this pathogen. African giant pouched rats (Cricetomys spp.) have been identified to be important maintenance hosts of pathogenic leptospires in the tropical and subtropical regions of the world. This study assessed the seroprevalence of Leptospira spp. in the African giant pouched rats of the Ngorongoro Conservation Area (NCA), Tanzania, where there is close human, domestic animal, and wildlife interaction. A total of 50 African giant pouched rats were sampled between July 2020 and December 2021. Blood sera were screened for specific leptospiral antibodies using a microscopic agglutination test (MAT), while urine and kidney tissues were examined for the pathogen and pathogen-specific genes using cultures and polymerase chain reactions (PCR), respectively. The pathogen detection varied from 0% in cultures to 6% via the MAT and 20% via PCR. The Fisher exact test was applied to compare positive cases detected through the diagnostic tests, and showed a significant difference in the indirect and direct detection of Leptospira serovars via the MAT and PCR. We conclude that pathogenic Leptospira serovar are found in the NCA and recommend that the NCA authority raises awareness of the existence of the Leptospira serovar in giant African pouched rats, and possibly other rodents. The NCA should initiate appropriate management strategies, including the guided disposal of household garbage, which is the major attractant of rodents to residential areas. Where necessary, the NCA should carry out limited rodent control and periodic monitoring of the pathogen carrier (rodent) populations.

Leptospirosis has a complex transmission, involving rodents and many species of domestic and wild animals. Carrier animals spread leptospires, contaminating soil and water, the main sources of human infection. The risk of infection is modulated by socio-economic factors, environment and host animals and has changed, historically linked to agriculture but now prevalent in recreational environments. Leptospirosis also reveal gender-specific exposure patterns that determine infection risks. Emphasizing the interconnectedness of humans, animals, and the environment, the One Health approach highlights the ecosystem dynamics through which leptospires interact with hosts and abiotic factors, ensuring their survival and transmission.We advocate for integrating gender considerations into the ecosystem dynamics of complex zoonoses, such as leptospirosis, through a One Health perspective. This approach, yet to be fully explored, may enhance our understanding of the infection and its modulating factors. A scoping review of the literature was conducted across Embase and Pubmed databases to collect information on sex and gender-specific drivers, sources of infections, environmental drivers, and related risks of leptospirosis. Quantitative data were extracted from the articles selected according to a list of criteria, and analyzed to discern sex and gender disparities and identify primary drivers of leptospirosis. We confirmed that the excess of male leptospirosis cases described in many parts of the world is also present in Europe. Furthermore, we identified environmental and sociocultural drivers and hypothesized their interactions between and within human, animal, and environmental sectors. These interactions modulate direct and indirect exposure to Leptospira, heightening infection risks across the ecosystem. Based on our findings, utilizing leptospirosis as a model, we advocate for integrating One Health and gender approaches in public health practices to better plan and implement more effective and timely intervention measures.

ABSTRACTBackground The pathogenic Leptospira is maintained in renal tubules of certain animals, mostly rodents, and excreted in the urine which can contaminate the environment. It is necessary to detect pathogenic Leptospira in environmental samples. Knowing the survival of Leptospira in the environment (water and soil) can provide an overview of where and how they can be transmitted to humans.Objective Therefore, this study aimed to provide a systematic overview of pathogenic Leptospira presence in water and soil environment, the various species of pathogenic Leptospira that are harmful for human, and the ability to survive using a systematic review method.Methods The search process used four databases: PubMed, Science Direct, Scopus, and ProQuest. Furthermore, the articles sought were published from 2000 to July 2021, and 38 were analysed.Results The pathogenic Leptospira contamination in water was higher in urban areas, while soil samples were higher in rural areas. Various pathogenic Leptospira detected in the environment were L. alstonii, L. kmetyi, L. noguchii, and L. interrogans. Those pathogenic Leptospira can survive in water at 4–30°C and at pH < 7; in soil, it can survive at a humidity of < 20% and a pH < 6.Conclusion Urban and rural areas have the same risk for leptospirosis disease because pathogenic Leptospira (P1).

The objective of this study was to determine the etiology of febrile illnesses among patients from October 1, 1993 through September 30, 1999, in the urban community of Iquitos in the Amazon River Basin of Peru. Epidemiological and clinical data as well as blood samples were obtained from consenting patients at hospitals, health clinics and private residences. Samples were tested for arboviruses in cell cultures and for IgM and IgG antibodies by ELISA. Blood smears were examined for malaria, and sera were tested for antibodies to Leptospira spp. by ELISA and microscopic agglutination. Among 6,607 febrile patients studied, dengue viruses caused 14.6% of the cases, and Venezuelan equine encephalitis virus caused 2.5%, Oropouche virus 1.0%, Mayaro virus 0.4%, and other arboviruses caused 0.2% of the cases. Also, 22.9% of 4,844 patients tested were positive for malaria, and of 400 samples tested, 9% had evidence of acute leptospirosis. Although the study was not designed to assess the importance of these pathogens as a cause of human morbidity in the total population, these results indicate that arboviruses, leptospirosis, and malaria were the cause of approximately 50% of the febrile cases. Although the arboviruses that were diagnosed can produce asymptomatic infections, our findings increased the overall understanding of the relative health burden of these infections, as well as baseline knowledge needed for designing and implementing further studies to better assess the health impact and threat of these pathogens in the Amazon Basin of Peru.

Leptospirosis is the most widespread zoonosis in the world. The disease is more prevalent in tropical regions where the majority of developing countries are located. Leptospirosis is considered a protean manifestation zoonosis with severity of the disease ranging from a mild febrile illness to a severe and life-threatening illness. Clinical symptoms of leptospirosis overlap with other tropical febrile illnesses. Early, rapid, and definitive diagnosis is important for effective patient management. Since Polymerase Chain Reaction (PCR)-based assays are not readily available in most clinical settings, there is a need for an affordable, simple, and rapid diagnostic test. Quantitative PCR (qPCR) and Recombinase Polymerase Amplification (RPA) were implemented at the Faculty of Medicine, University of Kelaniya, and a prospective study to evaluate RPA for diagnosis of acute phase of leptospirosis was conducted. Results indicate that RPA and qPCR were positive in 81% (98/121) of the total positive and acute clinical samples. Of the 81 positive MAT confirmed patients 60 (74%) and 53 (65%) were positive with qPCR and RPA respectively. Retrospective evaluation revealed a high diagnostic accuracy (sensitivity-70% and specificity-87%) of RPA compared to MAT as the reference gold standard. Results further suggest that there is no significant difference between the two assays, qPCR and RPA-SwiftX (P = 0.40). Laboratory procedures for the extraction and detection by qPCR in the laboratory have been optimized to obtain results within 6 hours. However, the RPA-SwiftX method under field conditions took 35 minutes. The RPA-SwiftX method could replace the qPCR which shows similar sensitivity and specificity. Therefore, RPA established under the current study presents a powerful tool for the early and rapid diagnosis of leptospirosis at point-of-care. [ABSTRACT FROM AUTHOR]

Simple Summary: Leptospirosis is an infectious zoonotic disease caused by pathogenic Leptospira and affects both humans and animals throughout the world. Domestic animals, such as dogs, can act as potential reservoirs of leptospires for human or animal infections and environmental contamination. Due to the different varieties of the predominant local circulating pathogenic serovars in several regions, serodiagnosis tests, such as conventional microscopic agglutination tests (MATs) or others that do not include local serovars and their protein antigens, have limitations, and may fail to detect the disease and carry out antibody surveillance in certain regions. This study aimed to develop a more accurate antibody detection tool for canine leptospirosis in our region by using an indirect enzyme-linked immunosorbent assay (ELISA) using relevant local isolates of leptospiral serovars from asymptomatic dogs. All the modified IgG-ELISAs with the local isolates gave positive results for all infected dogs, especially outer membrane protein (OMP)-based IgG-ELISAs that showed negative results for all dogs from non-endemic areas, demonstrating improved accuracy and reduced limitations over those of the standard MAT and providing an enhanced method for leptospirosis detection in the study area. This improvement is crucial when investigating the epidemiology of the disease and preventing its spread. The article highlights the requirement and significance of utilising local circulating isolates in serological approaches to accurately diagnose and monitor leptospirosis. Leptospirosis is a zoonotic disease of significant concern for human and animal health, with domestic animals, including dogs, acting as reservoirs for human infection. Serology is widely used for leptospirosis diagnosis, even though the standard microscopic agglutination test (MAT) using a panel of serovars lacks specificity and can lead to detection limitations in certain regions. In this study, we aimed to develop an antibody detection tool for dogs using an indirect enzyme-linked immunosorbent assay (ELISA) with a set of local serovar isolates, including Paidjan, Dadas, and Mini, to enhance the accuracy of leptospirosis surveillance in our region. The specificity and sensitivity of various antigen preparations, namely leptospiral whole-cell protein (WCP), total membrane protein (TMP), and outer membrane protein (OMP), were assessed using sera from infected and non-infected dogs, as well as negative puppy sera. Leptospirosis diagnosis was supported using a genus-specific nested polymerase chain reaction test on all collected sera. Protein preparations were validated using SDS-PAGE and Western blotting analysis. In the results, the standard MAT failed to detect antibodies in any of the dogs confirmed as being infected using PCR and isolation, highlighting its limitations. In contrast, the OMP-based ELISAs using local isolates of Leptospira serovars gave positive results with sera from all infected dogs, and negative results with sera from all dogs from non-endemic areas. IgG titres of infected and unvaccinated dogs from endemically affected areas were significantly higher than those in non-endemic regions. Using the OMP-based IgG/ELISAs with the local serovar Dadas resulted in higher specificity and lower sensitivity than when using the WCP- and TMP-based IgG/ELISAs. Agreement analysis revealed fair and moderate concordance between OMP-based IgG/ELISAs and PCR results, whereas slight and fair agreement was observed between OMP-based ELISAs and the MAT. Overall, the modified OMP-based IgG/ELISAs, utilising relevant local serovar isolates from dogs, demonstrated improved accuracy in detecting leptospirosis in the study area, overcoming the limitations of the MAT. This study highlights the importance of identifying and incorporating these local circulating serovar isolates into serological techniques for leptospirosis diagnosis and surveillance. [ABSTRACT FROM AUTHOR]

Leptospirosis, a re-emerging zoonotic disease, remains a significant global health concern, especially amid floods and disasters such as the Kakhovka Dam destruction. As is known, the stress that occurs in the conditions of military conflicts among civilian and military personnel significantly affects susceptibility to infectious diseases and possibly even influences their course. This review aims to explore how the gut microbiome and stress mediators (such as catecholamines and corticosteroids) might impact the leptospirosis disease course. The review opens new horizons for research by elucidating the connections between the gut microbiome, stress, and leptospirosis. [ABSTRACT FROM AUTHOR]

Aim and background: Leptospirosis is common in India, especially in the southern states. Mortality is high among untreated cases. Diagnosis of leptospirosis remains a challenge in India as polymerase chain reaction (PCR), which is more sensitive than Immunoglobulin M (IgM) is not widely available. This study aimed to find out the difference in diagnostic yield with PCR and IgM in early leptospirosis. Materials and methods: This retrospective, single-center study included 67 adults with laboratory-confirmed leptospirosis (IgM, PCR, or both) who presented within 7 days of symptom onset and were admitted to the intensive care unit (ICU). The difference in the diagnostic yield with PCR and IgM ELISA was studied. Results: About 77.6% of the patients tested positive by PCR and 55.2% tested positive by IgM. There was a statistically significant difference in the detection of leptospirosis by PCR and IgM (p-value = 0.036). In the subgroup of patients who presented within 3 days of onset of symptoms, PCR positivity was 90.32% whereas IgM positivity was only 25.8%. Conclusion: Our study showed that the sensitivity of leptospira PCR is significantly higher than IgM in the first week of illness. It also showed that among the subset of patients who died, a majority were detected only by PCR. Since PCR is not widely available, leptospirosis remains underdiagnosed and mortality from the same is underestimated. Polymerase chain reaction, if routinely done along with IgM for all suspected cases of leptospirosis that present within the first week of illness helps in prompt diagnosis and treatment. [ABSTRACT FROM AUTHOR]

Background: Outcomes of dogs with acute kidney injury secondary to leptospirosis (AKI‐L) treated using renal replacement therapies (RRT) are poorly characterized. Hypothesis/Objectives: Describe survival to discharge, short (≤30 days) and long‐term (≥6 months) outcomes of AKI‐L dogs receiving RRT and determine if there is a significant difference in maximum blood urea nitrogen (maxBUN), maximum creatinine (maxCr), maximum bilirubin (maxBili) and the number of body systems affected between survivors and non‐survivors. Animals: Twenty‐two client‐owned dogs with AKI‐L receiving RRT. Methods: Retrospective medical record review of dogs with AKI‐L that received RRT between 2018 and 2021. Results: Sixteen of 22 (73%) dogs survived to discharge. Of the survivors, 13 (81%) were alive >30 days from discharge and 12 (75%) were alive at 6 months from discharge. Factors significantly higher in non‐survivors included number of body systems affected (survivors: 1 (19%), 2 (50%), 3 (25%) and 4 (6%) vs non‐survivors: 3 (33.3%), and 4 (66.7%); P =.01) and median maxBili (survivors: 1.9 mg/dL; range, 0.1‐41.6 vs non‐survivors: 21.0 mg/dL; range, 12.3‐38.9; P =.02). There was no significant difference in median maxBUN (survivors: 153.0 mg/dL; range, 67‐257 vs non‐survivors: 185.5 mg/dL; range, 102‐218; P =.44) and median maxCr (survivors: 9.8 mg/dL; range, 6.2‐15.9 vs non‐survivors: 9.8 mg/dL; range, 8.4‐13.5; P =.69) between survivors and non‐survivors. Conclusions and Clinical Importance: Regardless of azotemia severity, dogs with AKI‐L receiving RRT have a good survival rate to discharge. The number of body systems affected and hyperbilirubinemia might be associated with worse outcomes. [ABSTRACT FROM AUTHOR]

Leptospirosis is a worldwide zoonosis responsible for highly diverse clinical presentations with a wide range of severity. Variable environment exposures to infected urines of rodents have been described. We report five cases of serologically confirmed leptospirosis leading to hospitalization in an intensive care unit (ICU) of a French center. These patients displayed neurological, respiratory, and abdominal presentation of leptospirosis with variable level of severity. Either professional, leisure related, or daily living exposures have been retrieved. These cases underline the diversity of clinical presentation and environmental exposure of this infectious disease. They highlight the interest of an exhaustive anamnesis with collection of professional activity, environmental exposures, and leisure activities. [ABSTRACT FROM AUTHOR]

Background: Leptospirosis is a zoonotic disease caused by pathogenic Leptospira spp., posing a significant public health threat globally. Understanding the clinicopathological profile of leptospirosis and identifying reliable diagnostic markers are crucial for effective disease management. Objective: This study aimed to investigate the clinicopathological profile of human leptospirosis in a tertiary care center in Kerala, India, and evaluate the utility of serum albumin as a diagnostic marker. Methods: A retrospective analysis of medical records was conducted for patients diagnosed with leptospirosis. Demographic data, clinical symptoms, laboratory findings, and outcomes were collected and analyzed. Serum albumin levels were compared between leptospirosis patients and controls. Statistical analyses were performed to assess correlations and associations. Results: A total of 41 patients with confirmed leptospirosis were included in the study. Fever (90.2%), myalgia (82.9%), and headache (70.7%) were common clinical manifestations. Thrombocytopenia (82.9%) and hypoalbuminemia (97.6%) were prevalent laboratory findings. Serum albumin levels were significantly lower in leptospirosis patients compared to controls (p < 0.05). Lower serum albumin levels were associated with increased disease severity and complications, including acute kidney injury. Conclusion: This study provides insights into the clinicopathological characteristics of leptospirosis in Kerala and highlights the potential diagnostic utility of serum albumin. Incorporating serum albumin levels into the diagnostic workup of leptospirosis patients could aid in early detection and risk stratification, ultimately improving clinical outcomes. Further prospective studies are warranted to validate these findings and explore the clinical implications of serum albumin as a prognostic marker for leptospirosis. [ABSTRACT FROM AUTHOR]

Acute Kidney Injury (AKI) associated with Scrub typhus is an emerging health problem which is more common in the tropics including India. This study intended to find out the occurrence of Scrub typhus among the Community Acquired Acute Kidney Injury patients in a tertiary care hospital in Assam, North East India. AKI patients with acute febrile illness admitted to Gauhati Medical College and Hospital, Guwahati, Assam were included in the study and demographic characteristics along with clinical features were recorded. The detection of Scrub typhus was done by IgM Enzyme Linked Immunosorbent Assay (ELISA) test (Optical Density > 0.5) and polymerase chain reaction (PCR) analysis. Routine haematological and biochemical tests were performed. Molecular characterization of Orientia tsutsugamushi was done followed by phylogenetic analysis. The Graph Pad Prism software 9 was used for statistical analysis. Out of 221 AKI patients admitted to hospital, 45 patients (20.4%) were confirmed to be Scrub typhus positive and among them, 4 cases were co-infected with leptospirosis. Majority of Scrub typhus positive AKI patients were in Stage I (82.2%) under KDIGO guideline. "Karp" was the predominant circulating serotype. The study showed cases of Scrub typhus associated Acute Kidney Injury was high and mortality was 11.1%. Hence, in this region, further studies need to be done with large number of population and more emphasis need to be given on differential diagnosis. [ABSTRACT FROM AUTHOR]

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Leptospirosis is a reemerging zooanthroponosis with a worldwide distribution, though it has a higher incidence in areas with tropical climate. A characteristic finding of the disease is its wide spectrum of symptoms and organ involvement, as it can appear either with very mild flu-like manifestations or with multiorgan failure, affecting the central nervous system (CNS) with a concomitant hepatorenal dysfunction (Weil's syndrome) and significant high mortality rate. We report herein a fatal case of a 25 years old female, previously healthy, with impaired neurological status. She had high fever and severe multiorgan failure. The clinical data and the epidemiological factors were not conclusive for the diagnosis, and the first serology test from the cerebrospinal fluid (CSF) and sera samples were negative. When the repetition of the blood test showed elevated IgM antibodies, Leptospirosis was the presumptive diagnosis. Although CNS involvement is rare, the diagnosis should be considered when there is an elevated risk of exposure. The diagnostic protocol should encompass direct evidence of the bacterium and indirect measurement of antibodies. Timely detection and management are imperative to forestall complications and fatality associated with the disease. [ABSTRACT FROM AUTHOR]

Simple Summary: This study has investigated the presence of Leptospira bacteria in urine, kidney, and blood samples from African giant pouched rats (Cricetomys spp.) in the Ngorongoro Conservation Area (NCA), Tanzania. The giant rat is an important maintenance host of leptospires; understanding their abundance and distribution in this environment is important to help prevent the transmission of the bacteria from rodents to other animals and humans co-existing in the area. This study demonstrates that Cricetomys spp. in the NCA are infected with the spirochete, and are hence a potential threat to public health. This study calls for an enhanced awareness of the presence of Leptospira spp. in Cricetomys spp. and calls for a one-health approach to protect both humans and animals from the pathogens. Leptospirosis, also known as Weil's disease, is a febrile tropical disease of humans and diverse animals. The maintenance hosts of the infectious pathogen, Leptospira spp., are primarily rodents, while other warm-blooded animals and some reptiles are secondary or transient hosts of this pathogen. African giant pouched rats (Cricetomys spp.) have been identified to be important maintenance hosts of pathogenic leptospires in the tropical and subtropical regions of the world. This study assessed the seroprevalence of Leptospira spp. in the African giant pouched rats of the Ngorongoro Conservation Area (NCA), Tanzania, where there is close human, domestic animal, and wildlife interaction. A total of 50 African giant pouched rats were sampled between July 2020 and December 2021. Blood sera were screened for specific leptospiral antibodies using a microscopic agglutination test (MAT), while urine and kidney tissues were examined for the pathogen and pathogen-specific genes using cultures and polymerase chain reactions (PCR), respectively. The pathogen detection varied from 0% in cultures to 6% via the MAT and 20% via PCR. The Fisher exact test was applied to compare positive cases detected through the diagnostic tests, and showed a significant difference in the indirect and direct detection of Leptospira serovars via the MAT and PCR. We conclude that pathogenic Leptospira serovar are found in the NCA and recommend that the NCA authority raises awareness of the existence of the Leptospira serovar in giant African pouched rats, and possibly other rodents. The NCA should initiate appropriate management strategies, including the guided disposal of household garbage, which is the major attractant of rodents to residential areas. Where necessary, the NCA should carry out limited rodent control and periodic monitoring of the pathogen carrier (rodent) populations. [ABSTRACT FROM AUTHOR]

Leptospirosis is a neglected zoonotic disease transmitted by contact with the urine of animals infected with pathogenic species of the bacteria Leptospira or by contact with environments contaminated with the bacteria. Domestic dogs and cats may act as reservoirs or as sentinels of environmental contamination with leptospires, posing a public health concern. There is a great diversity of leptospires, and one common way to classify them is into serogroups that provide some information on the host species they are associated with. The aims of this study were: (1) to quantitatively summarize the overall prevalence and serogroup-specific prevalence of antibodies against pathogenic leptospires in asymptomatic dogs and cats and (2) to identify environmental and host characteristics that may affect the prevalence. Three electronic databases and the reference lists of eligible articles were screened, for epidemiological studies conducted between the years 2012-2022. We estimated overall and serogroup-specific prevalence using three-level meta-analysis models and assessed potential sources of heterogeneity by moderator analysis and meta-regression. Eighty-four studies met the inclusion criteria (dog studies 66.7%, cat studies 26.2%, and both species 7.1%). There were significant differences between dogs and cats in the overall prevalence model (P < 0.001), but not in the serogroup-specific model (P>0.05). In dogs, the prevalence of Leptospira interrogans serogroup Canicola was significantly higher than the other pathogenic serogroups (P < 0.001), while in cats there were no significant differences among serogroups (P = 0.373). Moderator analysis showed that the prevalence of L. kirschneri serogroup Grippotyphosa was significantly higher in stray/sheltered dogs than in domiciled dogs (P = 0.028). These results suggest that pathogenic serogroups associated with small mammals are circulating among asymptomatic pets and should be taken into account in the transmission cycle of leptospires, as well as in the standard MAT panel for diagnosis in dogs and cats. It also highlights the importance of including both dogs and cats as potential reservoirs when conducting eco-epidemiological studies in different geographical and ecological areas. [ABSTRACT FROM AUTHOR]

Leptospirosis is caused by pathogenic bacteria of the genus Leptospira and is one of causative agents of reproductive problems leading to negative economic impact on bovine worldwide. The goal of this study was to investigate the seroprevalence of Leptospira spp. in cattle in some governorates of Egypt's Nile Delta and assess the risk factors for infection. A total of 410 serum samples were collected from cattle and examined using microscopic agglutination test. The overall seroprevalence was 10.2% and the most prevalent serovars were Icterohaemorrhagiae, Pomona and Canicola. In addition, the potential risk factors were associated Leptospira spp. infection were age, herd size, history of abortion, presence of dogs and rodent control. Thus, leptospirosis is common in dairy cattle in the Nile Delta and the presence of rodents in feed and dog-accessible pastures increases the risk of Leptospira spp. infection among animals. [ABSTRACT FROM AUTHOR]

Leptospirosis is a globally distributed zoonotic disease. The standard serological test, known as Microscopic Agglutination Test (MAT), requires the use of live Leptospira strains. To enhance its sensitivity and specificity, the usage of locally circulating strains is recommended. However, to date, no local strain is available from Austria. This study aimed to isolate circulating Leptospira strains from cattle in Austria to enhance the performances of the routine serological test for both humans and animals. We used a statistical approach combined with a comprehensive literature search to profile cattle with greater risk of leptospirosis infection and implemented a targeted sampling between November 2021 and October 2022. Urine and/or kidney tissue were sampled from 410 cattle considered at higher risk of infection. Samples were inoculated into EMJH-STAFF culture media within 2–6 h and a real-time PCR targeting the lipL32 gene was used to confirm the presence/absence of pathogenic Leptospira in each sample. Isolates were further characterised by core genome multilocus sequence typing (cgMLST). Nine out of 429 samples tested positive by PCR, from which three isolates were successfully cultured and identified as Leptospira borgpetersenii serogroup Sejroe serovar Hardjobovis, cgMLST cluster 40. This is the first report on the isolation and genotyping of local zoonotic Leptospira in Austria, which holds the potential for a significant improvement in diagnostic performance in the country. Although the local strain was identified as a cattle-adapted serovar, it possesses significant zoonotic implications. Furthermore, this study contributes to a better understanding of the epidemiology of leptospirosis in Europe. [ABSTRACT FROM AUTHOR]

Background: Leptospirosis is an underdiagnosed infectious disease with non-specific clinical presentation that requires laboratory confirmation for diagnosis. The serologic reference standard remains the microscopic agglutination test (MAT) on paired serum samples. However, reported estimates of MAT's sensitivity vary. We evaluated the accuracy of four index tests, MAT on paired samples as well as alternative standards for leptospirosis diagnosis: MAT on single acute-phase samples, polymerase chain reaction (PCR) with the target gene Lfb1, and ELISA IgM with Leptospira fainei serovar Hurstbridge as an antigen. Methods: We performed a systematic review of studies reporting results of leptospirosis diagnostic tests. We searched eight electronic databases and selected studies that tested human blood samples and compared index tests with blood culture and/or PCR and/or MAT (comparator tests). For MAT selection criteria we defined a threshold for single acute-phase samples according to a national classification of leptospirosis endemicity. We used a Bayesian random-effect meta-analysis to estimate the sensitivity and specificity of MAT in single acute-phase and paired samples separately, and assessed risk of bias using the Quality Assessment of Studies of Diagnostic Accuracy Approach- 2 (QUADAS-2) tool. Results: For the MAT accuracy evaluation, 15 studies were included, 11 with single acute-phase serum, and 12 with paired sera. Two included studies used PCR targeting the Lfb1 gene, and one included study used IgM ELISA with Leptospira fainei serovar Hurstbridge as antigen. For MAT in single acute-phase samples, the pooled sensitivity and specificity were 14% (95% credible interval [CrI] 3–38%) and 86% (95% CrI 59–96%), respectively, and the predicted sensitivity and specificity were 14% (95% CrI 0–90%) and 86% (95% CrI 9–100%). Among paired MAT samples, the pooled sensitivity and specificity were 68% (95% CrI 32–92%) and 75% (95% CrI 45–93%) respectively, and the predicted sensitivity and specificity were 69% (95% CrI 2–100%) and 75% (2–100%). Conclusions: Based on our analysis, the accuracy of MAT in paired samples was not high, but it remains the reference standard until a more accurate diagnostic test is developed. Future studies that include larger numbers of participants with paired samples will improve the certainty of accuracy estimates. [ABSTRACT FROM AUTHOR]

Background and Aim: Leptospirosis in felids (domestic and wild cats) presents an ongoing challenge in our understanding. Numerous studies have reported the detection of Leptospira spp. in these feline populations, highlighting their potential as zoonotic carriers. This systematic review and meta-analysis aimed to provide insight into the global prevalence of leptospirosis in domestic and wild cats. Materials and Methods: We conducted extensive searches across five databases (PubMed, Scopus, Web of Science, Science Direct, and Google Scholar) following the Preferred Reporting Items for Systematic Reviews and Meta-analyses Protocols guidelines. Random-effect meta-analyses were performed using R software version 4.3.0 to estimate pooled prevalence rates. Subgroup meta-analyses were conducted based on continents, diagnostic methods, sample types, and wildcat genera. Results: A total of 71 articles on leptospirosis in domestic cats and 23 articles on leptospirosis in wild cats met the eligibility criteria. Our findings indicated a significantly higher pooled seroprevalence of leptospirosis in domestic cats compared with infection prevalence (9.95% [95% confidence interval (CI), 7.60%-12.54%] vs. 4.62% [95% CI, 2.10%-7.83%], p = 0.01). In contrast, no significant difference was observed in pooled seroprevalence and infection prevalence among wild cats (13.38% [95% CI, 6.25%-21.93%] vs. 2.9% [95% CI, 0.00%-18.91%], p = 0.21). A subgroup meta-analysis of domestic cats revealed significant differences in seroprevalence across continents, sample types, and diagnostic methods. On the contrary, wild cats had no significant differences in any of the subgroups. Conclusion: Leptospira spp. have evidently been exposed to both domestic and wild cats, highlighting their potential roles as reservoir hosts for leptospirosis. These findings highlight the importance of considering felids as a possible public health threat. [ABSTRACT FROM AUTHOR]

Leptospirosis is a zoonotic infection with significant morbidity and mortality. As an occupational disease, it has become a global concern due to its disease burden in endemic countries and rural areas. The aim of this study was to assess disease burden in terms of Disability‐adjusted life years (DALYs) of leptospirosis.A hospital‐based descriptive cross‐sectional study was conducted using 450 clinically diagnosed leptospirosis patients admitted to base and above hospitals in Monaragala District, Sri Lanka, using a pre‐tested interviewer‐administered questionnaire. The patients were followed up until normal day‐to‐day life after discharge. Estimation of DALYs was done using laboratory‐confirmed leptospirosis patients. Leptospirosis disease burden in Monaragala District was 44.9 DALYs per 100,000 population, which includes 33.18 Years of life losts and 10.9 YLDs. The incidence of leptospirosis in Monaragala District during the study period was 59.8 per 100,000 population, and the case fatality rate (CFR) was 1.5% and 75% of deaths were among males.The disease burden of leptospirosis in Monaragala District was significantly high and urgent efforts to control and prevent leptospirosis should be a priority. [ABSTRACT FROM AUTHOR]

Background: Leptospirosis is a zoonosis of worldwide incidence, with a broad spectrum of health risk factors. Aim: The objective was to determine risk factors associated with acute human leptospirosis and to explore predictive variables of risk to human leptospirosis. Methods: The study was carried out in the Department of Córdoba, in the north of Colombia. We conducted a longitudinal prospective descriptive study with non‐probabilistic sampling, which included 339 patients suspected of leptospirosis. Positive cases were confirmed by MAT and PCR. The determination of social and environmental risk factors was done with a survey on epidemiological and environmental variables to establish an association between cases of leptospirosis and risk factors as well as predictive variables. Results: We found 19.8% (67/339) cases of acute leptospirosis, and the seroprevalence was 27.1% (92/339). The most frequent serogroups were Sejroe, Australis, Pomona, Batavie, Pyrogenes and Grippotyphosa. We identified the following risk factors: age between 10 and 19 years (OR = 2.571; 95% CI); pig ownership (OR = 2.019; 95% CI); bathing or recreational activities in lake/lagoon (OR = 3.85; 95% CI) and in dams (OR = 3.0; 95% CI); floodings 30 days before the onset of symptoms (OR = 2.019; 95% CI), and a mean temperature of 28°C (p 0.044; 95%CI). As significant predictor variables, we identified age (10–19 years), bathing or recreational activities in the lake/lagoon, and flooding 30 days before symptoms were again evidenced. This region presents classic risk factors (pig ownership) and emerging environmental risk factors (recreational practice or bathing in a lake/lagoon and flooding 30 days before the onset of symptoms), and demographic factors such as young age (10–19 years). Conclusions: These factors are also predictors of human cases of acute leptospirosis and provide contextual information on environmental and public health that should be considered for epidemiological surveillance in this endemic area. [ABSTRACT FROM AUTHOR]

Background: Leptospirosis is a serious infectious disease affecting dogs, caused by the spirochete bacterium Leptospira. Understanding the prognosis and severity of the disease is essential for effective clinical management. This study aimed to assess the use of the PIRO and SAPS scales in predicting the outcome of leptospirosis in dogs. Methods: The study involved 24 dogs diagnosed with leptospirosis and a control group of 22 healthy dogs. Clinical assessments were conducted, and scores on the PIRO and SAPS scales were assigned within 24 hours of admission. Statistical analyses, including correlation and regression, were employed to evaluate the relationship between scale scores and disease outcomes. Results: In dogs with leptospirosis, SAPS scale scores exhibited a strong positive correlation with disease outcomes, indicating a robust association. Scores on the SAPS scale were associated with the severity of the disease, with specific score ranges indicative of a moderate, severe, or fatal outcome. The PIRO scale also demonstrated a substantial correlation with SAPS scores and disease prognosis. In cases where the immune system was compromised, protective mechanisms activated with a delay, increasing the risk of fatality. Conclusion: The PIRO and SAPS scales provide valuable tools for assessing the severity and predicting the outcome of leptospirosis in dogs. These scales offer clinicians a means to promptly evaluate the risk of physiological disruptions and sepsis complications in dogs with leptospirosis, ultimately aiding in clinical decision-making and treatment planning. [ABSTRACT FROM AUTHOR]

Leptospirosis, caused by pathogenic spirochetes of the Leptospira genus, is a common zoonosis in tropical and subtropical regions and can lead to an epidemic following heavy rainfall or flooding. The primary reservoirs of Leptospira include rodents, wild animals, dogs, cats, amphibians, and others, but the brown rat (Rattus norvegicus) remains the main source of human Leptospirosis. Humans are often accidental hosts and they can be infected through cuts, abrasions, mucosa, conjunctiva, or by ingesting contaminated water. The clinical manifestation of leptospirosis can vary from mild, nonspecific symptoms to a fatal outcome involving liver and renal failure, pulmonary hemorrhage, meningitis, and septic shock. The severity of fatal outcomes is likely to be due to virulence factors, host susceptibility, and epidemiological conditions. L. interrogans are associated with high-risk individuals, particularly patients older than 60 years of age in clinical settings. The current case study showed a foreign worker who presented with rapidly deteriorating clinical signs of fever, jaundice, impaired consciousness, and oliguric acute renal failure. Drawing from our experience, it is advisable to consider the possibility of leptospirosis diagnosis in patients who show clinical symptoms such as fever, hepatic failure with jaundice, and acute renal failure. This is particularly important for those individuals with a prior history of pathogen exposure. This case study had a strong suspicion of leptospirosis, which was confirmed by the microscopic agglutination test (MAT) and, later, the patient's recovery following treatment. [ABSTRACT FROM AUTHOR]

This article discusses a case of severe leptospirosis in a 76-year-old man who was bitten by a rat in an urban setting. The patient experienced symptoms such as fever, headache, and abdominal pain and was admitted to the ICU for treatment. The article highlights the challenges in diagnosing leptospirosis and rat-bite fever, as well as the importance of considering these infections in cases of acute febrile illness after a rat bite. Treatment typically involves antibiotics, but the efficacy of antibiotic prophylaxis for rat bites is still uncertain and requires further research. [Extracted from the article]

Simple Summary: Bovine genital leptospirosis (BGL) is an important reproductive disease that leads to embryonic death, gestational losses, stillbirths, or the birth of weak calves. The syndrome is characterized by uterine infection by leptospires, especially from the Sejroe serogroup, which is adapted to cattle. The infection in bulls is still poorly reported. The recommended diagnosis of BGL is the serologic screening of the herds, followed by an individual molecular analysis of genital samples. The control of BGL consists of applying three pillars: vaccination of the herd, treatment of the positive animals, and environmental management. In addition, the application of other procedures such as quarantine of newly purchased animals, and usage of antibiotics in semen diluents or embryo culture media also play a role in the control of the syndrome. Bovine leptospirosis is an important disease that affects the reproductive sphere. Due to its high relevance for the bovine production chain in a worldwide scenario, a better understanding of the disease is crucial to reduce its negative impacts. The main agents are strains from the Sejroe serogroup, such as Hardjo and Guaricura, which lead to renal and genital infection. The genital colonization causes a chronic, silent, and subclinical reproductive syndrome, called Bovine Genital Leptospirosis (BGL). Embryonic death, estrus repetition, subfertility, and abortions are the main signs of BGL condition in females. However, although leptospires have been identified in semen, the manifestation of BGL in bulls remains to be clarified. The recommended diagnosis of BGL includes a serologic screening of the herds using the microscopic agglutination test followed by PCR of genital samples (cervicovaginal mucus, uterine fragment, or semen), especially from animals with reproductive failures. After the identification of carriers, control is carried out considering three steps: antimicrobial treatment of the carriers, environmental and reproductive management, and herd vaccination. Systematic testing, quarantine of newly arrived animals, and usage of antimicrobials in semen diluents or embryo culture media are other sanitary approaches that are encouraged to improve the control of the syndrome. Herein we discuss protocols for an efficient diagnosis and preventive procedures of BGL, which are fundamental to reducing the negative impact of the disease on cattle reproduction and its consequent economic hazards. [ABSTRACT FROM AUTHOR]

Infection and invasion are the prerequisites for developing the disease symptoms in a host. While the probable mechanism of host invasion and pathogenesis is known in many pathogens, very little information is available on Leptospira invasion/pathogenesis. For causing systemic infection Leptospira must transmigrate across epithelial barriers, which is the most critical and challenging step. Extracellular and membrane-bound proteases play a crucial role in the invasion process. An extensive search for the proteins experimentally proven to be involved in the invasion process through cell junction cleavage in other pathogens has resulted in identifying 26 proteins. The similarity searches on the Leptospira genome for counterparts of these 26 pathogenesis-related proteins identified at least 12 probable coding sequences. The proteins were either extracellular or membrane-bound with a proteolytic domain to cleave the cell junction proteins. This review will emphasize our current understanding of the pathogenic aspects of host cell junction-pathogenic protein interactions involved in the invasion process. Further, potential candidate proteins with cell junction cleavage properties that may be exploited in the diagnostic/therapeutic aspects of leptospirosis will also be discussed. Key points: • The review focussed on the cell junction cleavage proteins in bacterial pathogenesis • Cell junction disruptors from Leptospira genome are identified using bioinformatics • The review provides insights into the therapeutic/diagnostic interventions possible [ABSTRACT FROM AUTHOR]

The purpose of this work is to present the numerical solutions of the nonlinear mathematical Leptospirosis disease (LD) model using the computational performances of the artificial neural networks (ANNs) along with the optimization procedures based on the global search genetic algorithm (GA) and local search active-set algorithm (ASA) scheme, i.e., ANNs-GA-ASA. LD is a zoonotic disease that is occurring in the whole world, obtained by rodents that become the reason of death in the people. The LD model based on the susceptible-infected-recovered, i.e., SIR, is used to solve the mechanisms of disease spread. The optimization of an error-based fitness function, which is constructed through the differential mathematical system using the hybrid computing proficiencies of the ANNs-GA-ASA for solving the LD model. The stochastic ANNs-GA-ASA procedures are applied to the LD model to authenticate the precision, exactness, reliability and competence of the ANNs-GA-ASA. The obtained results using the ANNs-GA-ASA of the LD model will be compared using the Runge–Kutta scheme, which authenticate the importance of the ANNs-GA-ASA. Furthermore, statistical analysis through different actions for the LD model approve the convergence and precision of the ANNs-GA-ASA. [ABSTRACT FROM AUTHOR]

Leptospirosis is a systemic zoonotic infection transmitted through the skin, mucous membranes, or ingestion of water contaminated with pathogenic spirochetes of the genus Leptospira in infected mammals and rodents. It appears with nonspecific symptoms of acute onset associated with abdominal pain, subconjunctival hemorrhage, and jaundice, which usually has complete resolution in the majority of patients. However, in a lower percentage, it can progress, causing severe systemic complications, with a high risk of mortality mainly due to acute kidney failure, liver dysfunction associated with jaundice, and hemorrhages, called Weil syndrome or icterohemorrhagic fever. We present a series of cases of patients with biliary obstruction as the primary manifestation of severe leptospirosis. [ABSTRACT FROM AUTHOR]

Introduction: This study aimed to evaluate town service personnel's knowledge, attitudes, and practices (KAP) regarding leptospirosis prevention and the influencing factors to its practice. Methods: A cross-sectional study was conducted in Kuching, Malaysia, involving town service workers using a self-administered validated questionnaire comprising sociodemographic and KAP information. The eligibility criteria included 18 years old and above and having worked for more than six months. The KAP was determined using descriptive analysis, and associations were identified using logistic regression analysis. Results: About 189 town service workers responded, giving a response rate of 87.5%, and a majority of them were Bumiputera Sarawak, with a mean age of 38.6 (±11.00) years old. The mean duration of employment was 9.3 (±6.99) years. About 88.9% had good knowledge of leptospirosis. Meanwhile, 85.2% and 79.9% had satisfactory attitudes and good practices. The knowledge on the aetiology of leptospirosis ranged from 25% to 94%. No significant association was found between the knowledge score and income with the practice score. The attitude score (AOR 1.161; 95% CI = 1.090, 1.238; p = 0.000) and working experience (AOR 1.174; 95% CI = 1.023, 1.346; p = 0.022) were found to be significantly associated with their practice score. Conclusion: Most town service workers have good knowledge and practice regarding leptospirosis prevention. Workers with good attitudes demonstrate good practising habits toward leptospirosis prevention. Awareness and activities related to disease prevention should be encouraged to ensure the continuity of a positive attitude. [ABSTRACT FROM AUTHOR]