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Morais DA, Nunes BC, Barnabé NNC, Anjos DM, Bezerra CS, Costa DF, Santos CSAB, Azevedo SS, Alves CJ. Spatial and seasonal distribution of Leptospira spp. seropositive horses in the Northeast region of Brazil. Prev Vet Med 2024; 231:106301. [PMID: 39121516 DOI: 10.1016/j.prevetmed.2024.106301] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2024] [Revised: 06/16/2024] [Accepted: 07/28/2024] [Indexed: 08/12/2024]
Abstract
Leptospirosis is an anthropozoonosis of economic and public health importance, caused by bacteria of the genus Leptospira. Horses are deemed important in its transmission chain due to their proximity to humans, and because the species is often asymptomatic, making these animals potential silent reservoirs. In this context, the objectives of this study were to determine the prevalence of seropositive horses for Leptospira spp., and to identify the presence of Leptospira spp. serogroups and antibody titers, the occurrence of areas with higher density of infection cases and demographic characteristics associated with seropositivity in the states of Paraíba (PB), Pernambuco (PE), Rio Grande do Norte (RN) and Ceará (CE), in the Northeast region of Brazil, during rainy (May and June) and dry (October and November) seasons from 2017 to 2019. Using the microscopic agglutination test (MAT), 1152 equine serum samples from 225 municipalities were analyzed. Anti-Leptospira antibodies were detected in 23.9 % (95 % CI= 21.4 - 26.3 %) of the samples in the three-year period, with a frequency of 30.4 % (95 % CI= 26.7 - 34.2 %) during the rainy period (with greater emphasis on the Ballum serogroup) and 17.4 % (95 % CI= 14.3 - 20.5 %) in the dry period (with greater emphasis on the Sejroe serogroup). Age of horses ≥ 6 years (6-10 years, 11-15 years and ≥ 16 years), rainy season, and animal belonging to Pernambuco state were factors with higher seropositivities. Regarding spatial distribution, a higher percentage of seropositive animals was observed in Pernambuco (P < 0.05), in interstate border areas, and large urban centers, with a spatial cluster detected in the dry season of 2018 with relative risk of 2.8 (P = 0.049) times higher in municipalities within the cluster. It is suggested that measures for controlling rodents and contact with wild animals in equine farming, both in rainy and dry periods, combined with care regarding the use of pastures shared with cattle and the adoption of immunoprophylaxis are important in preventing and controlling leptospirosis in horses in the Northeast region of Brazil.
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Affiliation(s)
- Davidianne A Morais
- Centro de Saúde Tecnologia Rural (CSTR), Universidade Federal de Campina Grande (UFCG), Av. Universitária, s/n, Santa Cecília, Patos, PB 58708-110, Brazil
| | - Bruno C Nunes
- Centro de Saúde Tecnologia Rural (CSTR), Universidade Federal de Campina Grande (UFCG), Av. Universitária, s/n, Santa Cecília, Patos, PB 58708-110, Brazil
| | - Nathanael N C Barnabé
- Centro de Saúde Tecnologia Rural (CSTR), Universidade Federal de Campina Grande (UFCG), Av. Universitária, s/n, Santa Cecília, Patos, PB 58708-110, Brazil
| | - Denize M Anjos
- Centro de Saúde Tecnologia Rural (CSTR), Universidade Federal de Campina Grande (UFCG), Av. Universitária, s/n, Santa Cecília, Patos, PB 58708-110, Brazil
| | - Camila S Bezerra
- Centro de Saúde Tecnologia Rural (CSTR), Universidade Federal de Campina Grande (UFCG), Av. Universitária, s/n, Santa Cecília, Patos, PB 58708-110, Brazil
| | - Diego F Costa
- Centro de Ciências Agrárias (CCA), Universidade Federal da Paraíba (UFPB), Rodovia BR 079, Km 02, Areia PB 58397-000, Brazil
| | - Carolina S A B Santos
- Centro de Saúde Tecnologia Rural (CSTR), Universidade Federal de Campina Grande (UFCG), Av. Universitária, s/n, Santa Cecília, Patos, PB 58708-110, Brazil
| | - Sérgio S Azevedo
- Centro de Saúde Tecnologia Rural (CSTR), Universidade Federal de Campina Grande (UFCG), Av. Universitária, s/n, Santa Cecília, Patos, PB 58708-110, Brazil.
| | - Clebert J Alves
- Centro de Saúde Tecnologia Rural (CSTR), Universidade Federal de Campina Grande (UFCG), Av. Universitária, s/n, Santa Cecília, Patos, PB 58708-110, Brazil
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Bloodworth S, Singleton D, Perkins E, Radford A, Pinchbeck G. Temporal trends and factors associated with vaccination uptake in dogs and cats from 2016 to 2022 in the United Kingdom. Vaccine 2024; 42:126185. [PMID: 39121699 DOI: 10.1016/j.vaccine.2024.126185] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2023] [Revised: 07/19/2024] [Accepted: 07/25/2024] [Indexed: 08/12/2024]
Abstract
BACKGROUND Vaccination of dogs and cats is considered a mainstay of preventive health, providing benefit to individual animals and the population. This study aimed to assess temporal trends in vaccination and factors associated with vaccination uptake in a large veterinary visiting population of UK cats and dogs. METHODS The electronic health records (EHRs) of 712,266 dogs and 306,888 cats (voluntarily contributed by 201 veterinary practices) were used to determine the proportion that had record of any type of veterinary vaccination either within one-year or within three-years of attending a participating veterinary practice. Socioeconomic and animal factors were also assessed for association with vaccination uptake using multivariable mixed effects logistic regression models. RESULTS The percentage of animals vaccinated within one-year of consultation declined across the years 2016 to 2022, from 76.58% (95% CI 74.82-78.33) to 69.04% (95% CI 68.02-70.07) in dogs, and 69.54% (95% CI 67.89-71.19) to 66.12% (95% CI 64.83-67.41) in cats. The proportion of animals that had a vaccination recorded within a three-year window of a consultation for dogs ranged from 81.36% (95% CI 79.74-82.99)to 84.42% (95% CI 83.31-85.54) in the period from 2016 to 2022; for cats, this measure increased from 73.90% (95% CI 72.24-75.56) in 2016 to 77.85% (95% CI 76.46-79.25) in 2022. Aging was associated with reduced odds of animals having a vaccination recorded within one-year and three-years. In both species the odds of vaccination reduced as the level of socioeconomic deprivation assigned to the animal's area of residence increased. CONCLUSION The results provide a baseline that can be used as a reference to continue to track vaccination uptake in the cat and dog population. Temporal trends suggest time between vaccinations has increased in recent years. Strategies to encourage owners to vaccinate their animals should consider targeting areas of high deprivation.
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Affiliation(s)
- Shona Bloodworth
- Department of Livestock and One Health, Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, Leahurst Campus, Neston, UK.
| | - David Singleton
- Department of Livestock and One Health, Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, Leahurst Campus, Neston, UK; Department of Clinical Infection, Microbiology & Immunology, Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, Liverpool, UK
| | - Elizabeth Perkins
- Institute of Population Health, University of Liverpool, Liverpool, UK
| | - Alan Radford
- Department of Infection Biology and Microbiomes, Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, Leahurst Campus, Neston, UK
| | - Gina Pinchbeck
- Department of Livestock and One Health, Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, Leahurst Campus, Neston, UK.
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Filipe J, Lauzi S, Marinoni V, Servida F, Dall'Ara P. Zoonoses and pet owners: A survey on risk perception in Northern Italy. Comp Immunol Microbiol Infect Dis 2024; 112:102224. [PMID: 39053041 DOI: 10.1016/j.cimid.2024.102224] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2024] [Revised: 07/05/2024] [Accepted: 07/22/2024] [Indexed: 07/27/2024]
Abstract
Veterinary and human medicine are focused on the issue of emerging and re-emerging diseases, which are especially represented by zoonosis that could be a threat for public health. Zoonotic risk may come from pets: some canine and/or feline viral, bacterial, parasitic, protozoal or mycotic diseases can be transmitted directly to humans. There are several strategies to prevent the transmission of such zoonosis, and among them vaccination plays an important role. Through a survey carried out in Northern Italy aimed to collect information regarding owners' knowledge and perception of the zoonotic risks associated with three zoonoses (rabies, leptospirosis, and dermatophytosis), it was demonstrated that dog owners tend to adhere more consistently to their pets' vaccination schedules and are more receptive to changes in vaccination scheduling compared to cat owners. This study also suggests that cat owners predominantly visit veterinarians for vaccination purposes, whereas dog owners seek veterinary services for a variety of reasons. The survey highlighted the ongoing need to enhance owners' understanding of zoonoses affecting their pets and also the protective role of vaccines. Veterinarians should undertake the responsibility of educating, reassuring, and informing pet owners about the significance of vaccines for their pets and for public health.
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Affiliation(s)
- Joel Filipe
- Department of Veterinary Medicine and Animal Sciences (DIVAS), University of Milan, Via dell'Università 6, Lodi, LO 26900, Italy.
| | - Stefania Lauzi
- Department of Veterinary Medicine and Animal Sciences (DIVAS), University of Milan, Via dell'Università 6, Lodi, LO 26900, Italy
| | - Veronica Marinoni
- Department of Veterinary Medicine and Animal Sciences (DIVAS), University of Milan, Via dell'Università 6, Lodi, LO 26900, Italy
| | | | - Paola Dall'Ara
- Department of Veterinary Medicine and Animal Sciences (DIVAS), University of Milan, Via dell'Università 6, Lodi, LO 26900, Italy
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Talukder H, Muñoz-Zanzi C, Salgado M, Berg S, Yang A. Identifying the Drivers Related to Animal Reservoirs, Environment, and Socio-Demography of Human Leptospirosis in Different Community Types of Southern Chile: An Application of Machine Learning Algorithm in One Health Perspective. Pathogens 2024; 13:687. [PMID: 39204287 PMCID: PMC11357164 DOI: 10.3390/pathogens13080687] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2024] [Revised: 08/06/2024] [Accepted: 08/08/2024] [Indexed: 09/03/2024] Open
Abstract
Leptospirosis is a zoonosis with global public health impact, particularly in poor socio-economic settings in tropical regions. Transmitted through urine-contaminated water or soil from rodents, dogs, and livestock, leptospirosis causes over a million clinical cases annually. Risk factors include outdoor activities, livestock production, and substandard housing that foster high densities of animal reservoirs. This One Health study in southern Chile examined Leptospira serological evidence of exposure in people from urban slums, semi-rural settings, and farm settings, using the Extreme Gradient Boosting algorithm to identify key influencing factors. In urban slums, age, shrub terrain, distance to Leptospira-positive households, and neighborhood housing density were contributing factors. Human exposure in semi-rural communities was linked to environmental factors (trees, shrubs, and lower vegetation terrain) and animal variables (Leptospira-positive dogs and rodents and proximity to Leptospira-positive households). On farms, dog counts, animal Leptospira prevalence, and proximity to Leptospira-contaminated water samples were significant drivers. The study underscores that disease dynamics vary across landscapes, with distinct drivers in each community setting. This case study demonstrates how the integration of machine learning with comprehensive cross-sectional epidemiological and geospatial data provides valuable insights into leptospirosis eco-epidemiology. These insights are crucial for informing targeted public health strategies and generating hypotheses for future research.
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Affiliation(s)
- Himel Talukder
- Department of Geography and Environmental Sustainability, University of Oklahoma, Norman, OK 73019, USA;
| | - Claudia Muñoz-Zanzi
- Division of Environmental Health Sciences, School of Public Health, University of Minnesota, Minneapolis, MN 55454, USA
| | - Miguel Salgado
- Preventive Veterinary Medicine Department, Faculty of Veterinary Sciences, Universidad Austral de Chile, Valdivia 5090000, Chile;
| | - Sergey Berg
- Department of Computer & Information Science, University of St. Thomas, St. Paul, MN 55105, USA;
| | - Anni Yang
- Department of Geography and Environmental Sustainability, University of Oklahoma, Norman, OK 73019, USA;
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Silva-Ramos CR, Matiz-González JM, Gil-Mora J, Martínez Díaz HC, Faccini-Martínez ÁA, Cuervo C, Melby PC, Aguilar PV, Cabada MM, Rodas JD, Hidalgo M. Molecular Characterization of Leptospira Species among Patients with Acute Undifferentiated Febrile Illness from the Municipality of Villeta, Colombia. Trop Med Infect Dis 2024; 9:168. [PMID: 39195606 PMCID: PMC11360529 DOI: 10.3390/tropicalmed9080168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2024] [Revised: 07/22/2024] [Accepted: 07/23/2024] [Indexed: 08/29/2024] Open
Abstract
Leptospira is a bacterial genus that includes several pathogenic species related to leptospirosis. In Colombia, leptospirosis is a mandatorily reported disease, widely distributed across the country. In the Villeta municipality, leptospirosis has been identified as an important cause of febrile illness; however, to date, no studies have been performed to identify the circulating species. A genus-specific qualitative qPCR was performed on DNA extracted from febrile patients' acute-phase whole-blood samples targeting a fragment of the rrs gene. Positive qPCR samples were further amplified for the adk, icdA, LipL32, LipL41, rrs, and secY genes through conventional PCR for sequencing. All high-quality obtained sequences were further assessed through concatenated phylogenetic analysis. A total of 25% (14/56) of febrile patients' acute blood samples were positive for Leptospira spp. High-quality sequences were obtained for only five genes, and analysis through concatenated phylogeny identified that all sequences clustered within the P1/pathogenic clade; some of them formed a robustly supported clade with Leptospira santarosai, and others were closely related with other Leptospira species but exhibited considerable genetic divergence. We describe the presence of pathogenic Leptospira species among febrile patients from the Villeta municipality and identify L. santarosai and other Leptospira species as causative agents of leptospirosis in the region.
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Affiliation(s)
- Carlos Ramiro Silva-Ramos
- Grupo de Enfermedades Infecciosas, Departamento de Microbiología, Facultad de Ciencias, Pontificia Universidad Javeriana, Bogotá 110231, Colombia; (J.M.M.-G.); (J.G.-M.); (H.-C.M.D.); (C.C.)
| | - J. Manuel Matiz-González
- Grupo de Enfermedades Infecciosas, Departamento de Microbiología, Facultad de Ciencias, Pontificia Universidad Javeriana, Bogotá 110231, Colombia; (J.M.M.-G.); (J.G.-M.); (H.-C.M.D.); (C.C.)
- Molecular Genetics and Antimicrobial Resistance Unit, Universidad El Bosque, Bogotá 110121, Colombia
| | - Juliana Gil-Mora
- Grupo de Enfermedades Infecciosas, Departamento de Microbiología, Facultad de Ciencias, Pontificia Universidad Javeriana, Bogotá 110231, Colombia; (J.M.M.-G.); (J.G.-M.); (H.-C.M.D.); (C.C.)
| | - Heidy-C. Martínez Díaz
- Grupo de Enfermedades Infecciosas, Departamento de Microbiología, Facultad de Ciencias, Pontificia Universidad Javeriana, Bogotá 110231, Colombia; (J.M.M.-G.); (J.G.-M.); (H.-C.M.D.); (C.C.)
| | - Álvaro A. Faccini-Martínez
- Servicio de Infectología, Hospital Militar Central, Bogotá 110110, Colombia;
- Facultad de Medicina, Universidad Militar Nueva Granada, Bogotá 110111, Colombia
- Servicios y Asesorías en Infectología—SAI, Bogotá 110110, Colombia
| | - Claudia Cuervo
- Grupo de Enfermedades Infecciosas, Departamento de Microbiología, Facultad de Ciencias, Pontificia Universidad Javeriana, Bogotá 110231, Colombia; (J.M.M.-G.); (J.G.-M.); (H.-C.M.D.); (C.C.)
| | - Peter C. Melby
- Division of Infectious Diseases, Department of Internal Medicine, University of Texas Medical Branch, Galveston, TX 77555, USA; (P.C.M.); (M.M.C.)
- Center for Tropical Diseases, University of Texas Medical Branch, Galveston, TX 77555, USA;
| | - Patricia V. Aguilar
- Center for Tropical Diseases, University of Texas Medical Branch, Galveston, TX 77555, USA;
- Department of Pathology, University of Texas Medical Branch, Galveston, TX 77555, USA
| | - Miguel M. Cabada
- Division of Infectious Diseases, Department of Internal Medicine, University of Texas Medical Branch, Galveston, TX 77555, USA; (P.C.M.); (M.M.C.)
- Center for Tropical Diseases, University of Texas Medical Branch, Galveston, TX 77555, USA;
| | - Juan David Rodas
- Grupo de Investigación en Ciencias Veterinarias Centauro, Universidad de Antioquia, Medellín 050010, Colombia;
| | - Marylin Hidalgo
- Grupo de Enfermedades Infecciosas, Departamento de Microbiología, Facultad de Ciencias, Pontificia Universidad Javeriana, Bogotá 110231, Colombia; (J.M.M.-G.); (J.G.-M.); (H.-C.M.D.); (C.C.)
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Zorilla R, Ching LL, Elisara T, Kramer K, Nerurkar VR. Re-Emerging, Under-Recognized Zoonotic, and Neglected Tropical Diseases in Hawai'i. Jpn J Infect Dis 2024; 77:187-200. [PMID: 38825457 DOI: 10.7883/yoken.jjid.2023.476] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2024]
Abstract
Hawai'i, the United States' most western geographic state in the Pacific, lies between the North and South American continents and the Indo-Pacific regions, including Japan. The tropical environmental conditions of the Hawaiian Islands provide favorable ecosystems for various infectious pathogens, their vectors, and reservoirs. This creates an environment conducive to the transmission of zoonotic diseases affecting both humans and animals. Hawai'i has experienced an increase in dengue, leptospirosis, and murine typhus outbreaks. Furthermore, toxoplasmosis and neuroangiostrongyliasis cases remain prevalent throughout the state, and the putative presence of autochthonous Zika cases identified in a retrospective study may be of national public health concern. Understanding the factors that affect the transmission and distribution of zoonoses is necessary to identify at-risk locations and populations. The One Health approach seeks to understand, report, and interpret these factors and requires collaboration between private and governmental institutions. One Health should focus on neglected tropical diseases (NTD) and prioritize development of interventions to control and prevent the transmission of diseases that spread between animals and humans. This review focuses on the epidemiological and clinical characteristics of under-recognized zoonotic and NTD affecting Hawai'i, including leptospirosis, murine typhus, neuroangiostrongyliasis, toxoplasmosis, dengue, and Zika.
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Affiliation(s)
- Rodson Zorilla
- Department of Tropical Medicine, Medical Microbiology, and Pharmacology, John A Burns School of Medicine, University of Hawai'i at Mānoa, USA
- Pacific Center for Emerging Infectious Diseases, John A Burns School of Medicine, University of Hawai'i at Mānoa, USA
- Minority Health Research Training Program, John A Burns School of Medicine, University of Hawai'i at Mānoa, USA
| | - Lauren Lei Ching
- Department of Tropical Medicine, Medical Microbiology, and Pharmacology, John A Burns School of Medicine, University of Hawai'i at Mānoa, USA
- Pacific Center for Emerging Infectious Diseases, John A Burns School of Medicine, University of Hawai'i at Mānoa, USA
| | - Tiana Elisara
- Department of Tropical Medicine, Medical Microbiology, and Pharmacology, John A Burns School of Medicine, University of Hawai'i at Mānoa, USA
- Pacific Center for Emerging Infectious Diseases, John A Burns School of Medicine, University of Hawai'i at Mānoa, USA
- Minority Health Research Training Program, John A Burns School of Medicine, University of Hawai'i at Mānoa, USA
| | - Kenton Kramer
- Department of Tropical Medicine, Medical Microbiology, and Pharmacology, John A Burns School of Medicine, University of Hawai'i at Mānoa, USA
| | - Vivek Ramchandra Nerurkar
- Department of Tropical Medicine, Medical Microbiology, and Pharmacology, John A Burns School of Medicine, University of Hawai'i at Mānoa, USA
- Pacific Center for Emerging Infectious Diseases, John A Burns School of Medicine, University of Hawai'i at Mānoa, USA
- Minority Health Research Training Program, John A Burns School of Medicine, University of Hawai'i at Mānoa, USA
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Ashaiba A, Sapna K, Arun AB, Tellis RC, Prasad KS. Development and Evaluation of a Noninvasive Microfluidic-Based Paper Analytical Device for Leptospirosis Diagnosis. Anal Chem 2024; 96:11997-12005. [PMID: 38991147 DOI: 10.1021/acs.analchem.4c01934] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/13/2024]
Abstract
Leptospirosis is a re-emerging infectious disease that presents a diagnostic enigma for clinicians with frequent misdiagnosis due to lack of rapid and accurate diagnostic tests, as the current methods are encumbered by inherent limitations. The development of a diagnostic sensor with a sample-in-result-out capability is pivotal for prompt diagnosis. Herein, we developed a microfluidic paper-based analytical device (spin-μPAD) featuring a sample-in-result-out fashion for the detection of Leptospira specific urinary biomarker, sph2 sphingomyelinase, crucial for noninvasive point-of-care testing. Fabrication of paper devices involved precise photolithography techniques, ensuring a high degree of reproducibility and replicability. By optimizing the device's configuration and protein components, a remarkable sensitivity and specificity was achieved for detecting leptospiral sph2 in urine, even at low concentrations down to 1.5 fg/mL, with an assay time of 15 min. Further, the spin-μPAD was validated with 20 clinical samples, suspected of leptospirosis including other febrile illnesses, and compared with gold standard microscopic agglutination test, culture, Lepto IgM ELISA, darkfield microscopy, and Leptocheck WB spot test. In contrast to commercial diagnostic tools, the spin-μPAD was noninvasive, rapid, easy to use, specific, sensitive, and cost-effective. The results highlight the potential of this innovative spin-μPAD for an efficient and dependable approach to noninvasive leptospirosis diagnosis, addressing critical needs in the realms of public health and clinical settings.
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Affiliation(s)
- Asiamma Ashaiba
- Department of Microbiology, Yenepoya Medical College, Yenepoya (Deemed to be University), Deralakatte, Mangalore 575 018, India
- Nanomaterial Research Laboratory, Yenepoya Research Centre, Yenepoya (Deemed to be University), Deralakatte, Mangalore 575 018, India
| | - Kannan Sapna
- Nanomaterial Research Laboratory, Yenepoya Research Centre, Yenepoya (Deemed to be University), Deralakatte, Mangalore 575 018, India
| | | | - Rouchelle C Tellis
- Department of Microbiology, Yenepoya Medical College, Yenepoya (Deemed to be University), Deralakatte, Mangalore 575 018, India
| | - Kariate Sudhakara Prasad
- Nanomaterial Research Laboratory, Yenepoya Research Centre, Yenepoya (Deemed to be University), Deralakatte, Mangalore 575 018, India
- Centre for Nutrition Studies, Yenepoya (Deemed to be University), Mangalore 575 018, India
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Sultana M, Paul SK, Nasreen SA, Haque N, Hasan MK, Islam A, Nila SS, Jahan A, Sathi FA, Hossain T, Ferdaus SJ, Aung MS, Kobayashi N. Epidemiological Features of Leptospirosis and Identification of Leptospira wolffii as a Persistently Prevailing Species in North-Central Bangladesh. Infect Dis Rep 2024; 16:638-649. [PMID: 39195000 DOI: 10.3390/idr16040049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2024] [Revised: 07/18/2024] [Accepted: 07/20/2024] [Indexed: 08/29/2024] Open
Abstract
Leptospirosis is considered to be the most widespread, yet neglected, re-emerging zoonotic disease caused by infection with a pathogenic species of the genus Leptospira. Although this disease is prevalent in Bangladesh, the recent epidemiological status has not yet been well documented. In this study, we aimed to determine the prevalence of leptospirosis among febrile patients using different diagnostic methods and to characterize the epidemiological features and species of Leptospira in Mymensingh, north-central Bangladesh. Among the blood samples of 186 patients with suspected leptospirosis who met the inclusion criteria, including having a fever for more than 5 days (November 2021-June 2022), 88 samples (47%) were Leptospira-positive according to IgM LAT, IgM ELISA, or nested PCR (positivity rates: 38%, 37%, and 42%, respectively). Nested PCR showed a significantly higher positivity rate (54%) in patients with a short fever (5-10 day) than the other methods did, with lower rates among those with a longer fever. Leptospirosis cases were more common in males (68%), those 16-45 years of age (70%), residents of rural areas (81%), and farmers (41%). In addition to a fever, myalgia and jaundice were found in more than 70% of the patients, while variable symptoms were observed. The 16S rRNA sequencing analysis revealed that the Leptospira species in all the 22 samples tested were L. wolffii, belonging to the pathogenic subclade P2. This study showed the recent epidemiological features of leptospirosis in Bangladesh, indicating the presumptive predominance of L. wolffii since 2019.
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Affiliation(s)
- Monira Sultana
- Department of Microbiology, Nilphamari Medical College, Nilphamari 5300, Bangladesh
| | | | | | - Nazia Haque
- Department of Microbiology, Mymensingh Medical College, Mymensingh 2200, Bangladesh
| | - Md Kamrul Hasan
- Department of Ophthalmology, Sirajganj 250 Bed Bongamata Sheikh Fazilatunnesa Mujib General Hospital, Sirajganj 6700, Bangladesh
| | - Arup Islam
- Department of Microbiology, Mymensingh Medical College, Mymensingh 2200, Bangladesh
| | - Sultana Shabnam Nila
- Department of Microbiology, Mymensingh Medical College, Mymensingh 2200, Bangladesh
| | - Afsana Jahan
- Department of Microbiology, Pabna Medical College, Pabna 6602, Bangladesh
| | - Fardousi Akter Sathi
- Department of Microbiology, Mymensingh Medical College, Mymensingh 2200, Bangladesh
| | - Tasmia Hossain
- Department of Microbiology, Mymensingh Medical College, Mymensingh 2200, Bangladesh
| | - Syeda Jannatul Ferdaus
- Department of Oral Microbiology, Mymensingh Medical College, Mymensingh 2200, Bangladesh
| | - Meiji Soe Aung
- Department of Hygiene, School of Medicine, Sapporo Medical University, Sapporo 060-8556, Japan
| | - Nobumichi Kobayashi
- Department of Hygiene, School of Medicine, Sapporo Medical University, Sapporo 060-8556, Japan
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Lagarde-Guerrero R, Navarro-Arias MDJ, Duran-Pérez SA, Osuna-Ramírez I, Osuna-Martínez LU, Gonzáles-Durán E, Rendon-Maldonado JG. Frequency of Leptospira in the Blood of Patients with Fever of Unknown Origin in Sinaloa, Mexico. Vector Borne Zoonotic Dis 2024. [PMID: 39023575 DOI: 10.1089/vbz.2024.0001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/20/2024] Open
Abstract
Background: Leptospira is a genus of bacteria that causes the zoonotic disease known as leptospirosis, which mainly affects countries with tropical and subtropical climates. Its prevalence may be underestimated because the initial stage of the infection is characterized by presenting a febrile condition that is easily confused with other diseases, such as dengue. This work reports the frequency of leptospirosis in the blood of patients with febrile symptoms of unknown origin. Materials and Methods: A total of 218 peripheral blood samples were analyzed from volunteer participants from Culiacan Sinaloa in June 2019, one half corresponded to patients with undiagnosed febrile symptoms and the other half to asymptomatic volunteers. Data collected included the age and sex of the participants. Leptospira was detected by qPCR using a fragment of the lipL32 gene from the bacteria's genome as a target. Fisher's exact test was used as a statistical method to estimate the relationship between the infection and the data collected. Results: The study group comprised 134 female and 84 male patients ranging from ages 1 to 92 years, averaging 41 years. In this study, Leptospira infection was identified in the blood of 22/218 participating volunteers (10.09%), of which 20/109 (18.34%) presented febrile symptoms, whereas 2/109 (1.83%) were asymptomatic. The most affected participants were women with ages between 27 and 59 years. However, the analysis of the relationship between infection and the variables studied did not show statistical significance. Conclusions: Leptospirosis was detected in blood samples from patients with undiagnosed febrile illness and asymptomatic symptoms in Sinaloa. The lipL32 gene is useful as a target in identifying Leptospira in human blood in the acute phase of the disease.
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Affiliation(s)
- Rogelio Lagarde-Guerrero
- Posgrado en Ciencias Biomedicas, Facultad de Ciencias Quimico Biologicas, UAS. Av de las Americas y Blvd., Universitarios, Ciudad Universitaria., Culiacán, 80010 México
| | - María de Jesús Navarro-Arias
- Posgrado en Ciencias Biomedicas, Facultad de Ciencias Quimico Biologicas, UAS. Av de las Americas y Blvd., Universitarios, Ciudad Universitaria., Culiacán, 80010 México
| | - Sergio Alonso Duran-Pérez
- Posgrado en Ciencias Biomedicas, Facultad de Ciencias Quimico Biologicas, UAS. Av de las Americas y Blvd., Universitarios, Ciudad Universitaria., Culiacán, 80010 México
| | - Ignacio Osuna-Ramírez
- Posgrado en Ciencias Biomedicas, Facultad de Ciencias Quimico Biologicas, UAS. Av de las Americas y Blvd., Universitarios, Ciudad Universitaria., Culiacán, 80010 México
| | - Lorenzo Ulises Osuna-Martínez
- Posgrado en Ciencias Biomedicas, Facultad de Ciencias Quimico Biologicas, UAS. Av de las Americas y Blvd., Universitarios, Ciudad Universitaria., Culiacán, 80010 México
| | - Elizabeth Gonzáles-Durán
- Instituto Nacional de Diagnóstico y Referencia Epidemiológicos "Dr. Manuel Martínez Báez" (InDRE), Culiacan, México
| | - José Guadalupe Rendon-Maldonado
- Posgrado en Ciencias Biomedicas, Facultad de Ciencias Quimico Biologicas, UAS. Av de las Americas y Blvd., Universitarios, Ciudad Universitaria., Culiacán, 80010 México
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Li L, Li S, Ma H, Akhtar MF, Tan Y, Wang T, Liu W, Khan A, Khan MZ, Wang C. An Overview of Infectious and Non-Infectious Causes of Pregnancy Losses in Equine. Animals (Basel) 2024; 14:1961. [PMID: 38998073 PMCID: PMC11240482 DOI: 10.3390/ani14131961] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2024] [Revised: 06/25/2024] [Accepted: 06/28/2024] [Indexed: 07/14/2024] Open
Abstract
Equine breeding plays an essential role in the local economic development of many countries, and it has experienced rapid growth in China in recent years. However, the equine industry, particularly large-scale donkey farms, faces a significant challenge with pregnancy losses. Unfortunately, there is a lack of systematic research on abortion during equine breeding. Several causes, both infectious and non-infectious, of pregnancy losses have been documented in equines. The infectious causes are viruses, bacteria, parasites, and fungi. Non-infectious causes may include long transportation, ingestion of mycotoxins, hormonal disturbances, twinning, placentitis, umbilical length and torsion, etc. In current review, we discuss the transmission routes, diagnostic methods, and control measures for these infectious agents. Early detection of the cause and appropriate management are crucial in preventing pregnancy loss in equine practice. This review aims to provide a comprehensive understanding of the potential causes of abortion in equines, including infectious agents and non-infectious factors. It emphasizes the importance of continued research and effective control measures to address this significant challenge in the equine industry.
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Affiliation(s)
- Liangliang Li
- Liaocheng Research Institute of Donkey High-Efficiency Breeding and Ecological Feeding, Liaocheng University, Liaocheng 252059, China; (L.L.)
| | - Shuwen Li
- Liaocheng Research Institute of Donkey High-Efficiency Breeding and Ecological Feeding, Liaocheng University, Liaocheng 252059, China; (L.L.)
| | - Haoran Ma
- Liaocheng Research Institute of Donkey High-Efficiency Breeding and Ecological Feeding, Liaocheng University, Liaocheng 252059, China; (L.L.)
| | - Muhammad Faheem Akhtar
- Liaocheng Research Institute of Donkey High-Efficiency Breeding and Ecological Feeding, Liaocheng University, Liaocheng 252059, China; (L.L.)
| | - Ying Tan
- Liaocheng Research Institute of Donkey High-Efficiency Breeding and Ecological Feeding, Liaocheng University, Liaocheng 252059, China; (L.L.)
| | - Tongtong Wang
- Liaocheng Research Institute of Donkey High-Efficiency Breeding and Ecological Feeding, Liaocheng University, Liaocheng 252059, China; (L.L.)
| | - Wenhua Liu
- College of Veterinary Medicine, Qingdao Agricultural University, Qingdao 266109, China
| | - Adnan Khan
- Genome Analysis Laboratory of the Ministry of Agriculture, Agricultural Genomics Institute at Shenzhen, Chinese Academy of Agricultural Sciences, Shenzhen 511464, China
| | - Muhammad Zahoor Khan
- Liaocheng Research Institute of Donkey High-Efficiency Breeding and Ecological Feeding, Liaocheng University, Liaocheng 252059, China; (L.L.)
| | - Changfa Wang
- Liaocheng Research Institute of Donkey High-Efficiency Breeding and Ecological Feeding, Liaocheng University, Liaocheng 252059, China; (L.L.)
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11
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Choi KS, Hwang S, Kim MC, Cho HC, Park YJ, Ji MJ, Han SW, Chae JS. Molecular surveillance of zoonotic pathogens from wild rodents in the Republic of Korea. PLoS Negl Trop Dis 2024; 18:e0012306. [PMID: 38976750 PMCID: PMC11257403 DOI: 10.1371/journal.pntd.0012306] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2023] [Revised: 07/18/2024] [Accepted: 06/21/2024] [Indexed: 07/10/2024] Open
Abstract
BACKGROUND Rodents are recognized as major reservoirs of numerous zoonotic pathogens and are involved in the transmission and maintenance of infectious diseases. Furthermore, despite their importance, diseases transmitted by rodents have been neglected. To date, there have been limited epidemiological studies on rodents, and information regarding their involvement in infectious diseases in the Republic of Korea (ROK) is still scarce. METHODOLOGY/PRINCIPAL FINDINGS We investigated rodent-borne pathogens using nested PCR/RT-PCR from 156 rodents including 151 Apodemus agrarius and 5 Rattus norvegicus from 27 regions in eight provinces across the ROK between March 2019 and November 2020. Spleen, kidney, and blood samples were used to detect Anaplasma phagocytophilum, Bartonella spp., Borrelia burgdorferi sensu lato group, Coxiella burnetii, Leptospira interrogans, and severe fever with thrombocytopenia syndrome virus (SFTSV). Of the 156 rodents, 73 (46.8%) were infected with Bartonella spp., 25 (16.0%) with C. burnetii, 24 (15.4%) with L. interrogans, 21 (13.5%) with A. phagocytophilum, 9 (5.8%) with SFTSV, and 5 (3.2%) with Borrelia afzelii. Co-infections with two and three pathogens were detected in 33 (21.1%) and 11 rodents (7.1%), respectively. A. phagocytophilum was detected in all regions, showing a widespread occurrence in the ROK. The infection rates of Bartonella spp. were 83.3% for B. grahamii and 16.7% for B. taylorii. CONCLUSIONS/SIGNIFICANCE To the best of our knowledge, this is the first report of C. burnetii and SFTSV infections in rodents in the ROK. This study also provides the first description of various rodent-borne pathogens through an extensive epidemiological survey in the ROK. These results suggest that rodents harbor various pathogens that pose a potential threat to public health in the ROK. Our findings provide useful information on the occurrence and distribution of zoonotic pathogens disseminated among rodents and emphasize the urgent need for rapid diagnosis, prevention, and control strategies for these zoonotic diseases.
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Affiliation(s)
- Kyoung-Seong Choi
- Department of Animal Science and Biotechnology, College of Ecology and Environmental Science, Kyungpook National University, Sangju, Republic of Korea
| | - Sunwoo Hwang
- Department of Animal Science and Biotechnology, College of Ecology and Environmental Science, Kyungpook National University, Sangju, Republic of Korea
| | - Myung Cheol Kim
- Department of Ecological Science, College of Ecology and Environmental Science, Kyungpook National University, Sangju, Republic of Korea
| | - Hyung-Chul Cho
- Department of Animal Science and Biotechnology, College of Ecology and Environmental Science, Kyungpook National University, Sangju, Republic of Korea
| | - Yu-Jin Park
- Department of Animal Science and Biotechnology, College of Ecology and Environmental Science, Kyungpook National University, Sangju, Republic of Korea
| | - Min-Jeong Ji
- Department of Animal Science and Biotechnology, College of Ecology and Environmental Science, Kyungpook National University, Sangju, Republic of Korea
| | - Sun-Woo Han
- Laboratory of Veterinary Internal Medicine, BK21 FOUR Future Veterinary Medicine Leading Education and Research Centre, Research Institute for Veterinary Science and College of Veterinary Medicine, Seoul National University, Seoul, Republic of Korea
| | - Joon-Seok Chae
- Laboratory of Veterinary Internal Medicine, BK21 FOUR Future Veterinary Medicine Leading Education and Research Centre, Research Institute for Veterinary Science and College of Veterinary Medicine, Seoul National University, Seoul, Republic of Korea
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Krishnan BK, Balasubramanian G, Kumar PP. Leptospirosis in India: insights on circulating serovars, research lacunae and proposed strategies to control through one health approach. ONE HEALTH OUTLOOK 2024; 6:11. [PMID: 38849946 PMCID: PMC11161969 DOI: 10.1186/s42522-024-00098-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/04/2023] [Accepted: 02/23/2024] [Indexed: 06/09/2024]
Abstract
Leptospirosis is one of the most neglected zoonotic infections of public health concern worldwide and a remerging infection in tropical countries such as India. The infection least explored disease and the epidemiological and other critical data are scarce for the disease rate reported and to control the infection. Leptospirosis as sapronosis is as underrated as the infection itself, and this article aims to explore the significance of this aspect of the disease. The research review aimed at the epidemiological understanding of the infection to control the negative impact of the disease. A mixed review and analysis were carried out to understand the knowledge published on the critical and understudied areas like epidemiology, transmission, diagnosis, treatment, and control of infection. A systematic analysis was carried out to extract information about the reported circulating strains, and research lacunae in India with the published data available in PubMed. The article elaborately discusses crucial inference areas of infection transmission and addresses lacunae in critically unacclaimed areas of infection to control the spread of infection using one health approach (OHA), and strategies to control leptospiral infection are proposed. The article also reviewed how and why Leptospirosis can be best studied and controlled by "One health approach" in India.
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Affiliation(s)
- Baby Karpagam Krishnan
- Department of Health Research (D.H.R.), ICMR-National Institute of Epidemiology (ICMR-NIE), Indian Council of Medical Research, Ministry of Health & Family Welfare, Government of India, R-127, 2Nd Main Road, T.N.H.B. Layout, Ayapakkam, Chennai, Tamil Nadu, 600 077, India.
| | - Ganesh Balasubramanian
- Department of Health Research (D.H.R.), ICMR-National Institute of Epidemiology (ICMR-NIE), Indian Council of Medical Research, Ministry of Health & Family Welfare, Government of India, R-127, 2Nd Main Road, T.N.H.B. Layout, Ayapakkam, Chennai, Tamil Nadu, 600 077, India
| | - Pesingi Pavan Kumar
- Department of Veterinary Public Health and Epidemiology, Faculty of Veterinary and Animal Sciences, Rajiv Gandhi South Campus, Banaras Hindu University, Mirzapur, UP, 231001, India
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da Costa Barnabé NN, Soares RR, Barros DKS, Araújo Júnior JP, Malossi CD, Rodrigues Silva MLC, Brasil AWDL, da Costa DF, Higino SSDS, Santos CDSAB, de Azevedo SS, Alves CJ. The Role of Transplacental Infection in Leptospira spp. Epidemiology in Cattle in Caatinga Biome, Brazil. Microorganisms 2024; 12:1044. [PMID: 38930426 PMCID: PMC11205532 DOI: 10.3390/microorganisms12061044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2024] [Revised: 04/29/2024] [Accepted: 05/01/2024] [Indexed: 06/28/2024] Open
Abstract
Leptospirosis is an infectious disease that affects domestic animals, wild animals, and humans. It represents a public health problem and has an important economic impact on livestock. This study aims to investigate the importance of genital and transplacental infection in the epidemiology of leptospirosis in cows maintained in Caatinga biome conditions, Northeastern Brazil, as well as reporting organs colonized by Leptospira spp. in embryos and fetuses. Blood, urinary tract (urine, bladder, and kidney), and reproductive tract (vaginal fluid, uterus, uterine tube, ovary, and placenta) samples were collected from 15 slaughtered pregnant cows. Two embryos and 13 fetuses were sampled. Central nervous system and choroid ovoid samples were collected from embryos. Blood, central nervous system, lung, peritoneal liquid, abomasal content, liver, spleen, urine, bladder, kidney, and reproductive system samples were collected from fetuses. Diagnostic methods included the microscopic agglutination test (MAT) using a collection of 24 serovars belonging to 17 different pathogenic serogroups of five species as antigens, as well as polymerase chain reaction (PCR). Anti-Leptospira spp. antibodies were found in 9 cows (60%), while 13 cows (86.67%) had at least one organ or urine with leptospiral DNA. No fetus was seroreactive. Among the embryos and fetuses, 13 (86.67%) presented leptospiral DNA, proving a high frequency of transplacental infection (100%). For cows, the most frequent biological materials regarding Leptospira spp. DNA detection were placenta (13 out of 15 samples; 86.7%), uterus (10 out of 15 samples; 66.7%), and vaginal fluid (5 out of 15 samples; 33.3%), while, for fetuses/embryos, the most frequent PCR-positive samples were choroid ovoid (1/2; 50%), spleen (6/13; 46.2%), kidney (5/13; 38.5%), and central nervous system (5/15; 33.3%). Sequenced samples based on the LipL32 gene presented 99% similarity with L. borgpetersenii. The results indicate that transplacental infection is an efficient way of spreading Leptospira spp. in cows maintained in Caatinga biome conditions. Therefore, prevention and control strategies must include actions that interrupt transmission through this alternative route.
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Affiliation(s)
- Nathanael Natércio da Costa Barnabé
- Centro de Saúde Tecnologia Rural (CSTR), Universidade Federal de Campina Grande (UFCG), Av. Universitária, s/n, Santa Cecília, Patos 58708110, PB, Brazil; (N.N.d.C.B.); (R.R.S.); (D.K.S.B.); (M.L.C.R.S.); (S.S.d.S.H.); (C.d.S.A.B.S.); (C.J.A.)
| | - Rafael Rodrigues Soares
- Centro de Saúde Tecnologia Rural (CSTR), Universidade Federal de Campina Grande (UFCG), Av. Universitária, s/n, Santa Cecília, Patos 58708110, PB, Brazil; (N.N.d.C.B.); (R.R.S.); (D.K.S.B.); (M.L.C.R.S.); (S.S.d.S.H.); (C.d.S.A.B.S.); (C.J.A.)
| | - Deivyson Kelvis Silva Barros
- Centro de Saúde Tecnologia Rural (CSTR), Universidade Federal de Campina Grande (UFCG), Av. Universitária, s/n, Santa Cecília, Patos 58708110, PB, Brazil; (N.N.d.C.B.); (R.R.S.); (D.K.S.B.); (M.L.C.R.S.); (S.S.d.S.H.); (C.d.S.A.B.S.); (C.J.A.)
| | - João Pessoa Araújo Júnior
- Instituto de Biociências, Departamento de Microbiologia e Imunologia, Universidade Estadual Paulista (Unesp), Av. Prof. Mário Rubens Guimarães Montenegro, s/n, Botucatu 18618687, SP, Brazil; (J.P.A.J.); (C.D.M.)
| | - Camila Dantas Malossi
- Instituto de Biociências, Departamento de Microbiologia e Imunologia, Universidade Estadual Paulista (Unesp), Av. Prof. Mário Rubens Guimarães Montenegro, s/n, Botucatu 18618687, SP, Brazil; (J.P.A.J.); (C.D.M.)
| | - Maria Luana Cristiny Rodrigues Silva
- Centro de Saúde Tecnologia Rural (CSTR), Universidade Federal de Campina Grande (UFCG), Av. Universitária, s/n, Santa Cecília, Patos 58708110, PB, Brazil; (N.N.d.C.B.); (R.R.S.); (D.K.S.B.); (M.L.C.R.S.); (S.S.d.S.H.); (C.d.S.A.B.S.); (C.J.A.)
| | - Arthur Willian de Lima Brasil
- Centro de Ciências Agrárias (CCA), Universidade Federal da Paraíba (UFPB), Rodovia BR 079, Km 02, Areia 58397000, PB, Brazil; (A.W.d.L.B.); (D.F.d.C.)
| | - Diego Figueiredo da Costa
- Centro de Ciências Agrárias (CCA), Universidade Federal da Paraíba (UFPB), Rodovia BR 079, Km 02, Areia 58397000, PB, Brazil; (A.W.d.L.B.); (D.F.d.C.)
| | - Severino Silvano dos Santos Higino
- Centro de Saúde Tecnologia Rural (CSTR), Universidade Federal de Campina Grande (UFCG), Av. Universitária, s/n, Santa Cecília, Patos 58708110, PB, Brazil; (N.N.d.C.B.); (R.R.S.); (D.K.S.B.); (M.L.C.R.S.); (S.S.d.S.H.); (C.d.S.A.B.S.); (C.J.A.)
| | - Carolina de Sousa Américo Batista Santos
- Centro de Saúde Tecnologia Rural (CSTR), Universidade Federal de Campina Grande (UFCG), Av. Universitária, s/n, Santa Cecília, Patos 58708110, PB, Brazil; (N.N.d.C.B.); (R.R.S.); (D.K.S.B.); (M.L.C.R.S.); (S.S.d.S.H.); (C.d.S.A.B.S.); (C.J.A.)
| | - Sérgio Santos de Azevedo
- Centro de Saúde Tecnologia Rural (CSTR), Universidade Federal de Campina Grande (UFCG), Av. Universitária, s/n, Santa Cecília, Patos 58708110, PB, Brazil; (N.N.d.C.B.); (R.R.S.); (D.K.S.B.); (M.L.C.R.S.); (S.S.d.S.H.); (C.d.S.A.B.S.); (C.J.A.)
| | - Clebert José Alves
- Centro de Saúde Tecnologia Rural (CSTR), Universidade Federal de Campina Grande (UFCG), Av. Universitária, s/n, Santa Cecília, Patos 58708110, PB, Brazil; (N.N.d.C.B.); (R.R.S.); (D.K.S.B.); (M.L.C.R.S.); (S.S.d.S.H.); (C.d.S.A.B.S.); (C.J.A.)
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Lv T, Xie X, Diao L, Jiang S, Ding Y, Yuan X, Gong L, Chen X, Zhang W, Cao Y. Leptospira-specific immunoglobulin Y (IgY) is protective in infected hamsters. Vaccine 2024; 42:3220-3229. [PMID: 38641497 DOI: 10.1016/j.vaccine.2024.04.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2024] [Revised: 04/03/2024] [Accepted: 04/04/2024] [Indexed: 04/21/2024]
Abstract
Leptospirosis, a globally significant zoonotic disease caused by pathogenic Leptospira, continues to threaten the health and public safety of both humans and animals. Current clinical treatment of leptospirosis mainly relies on antibiotics but their efficacy in severe cases is controversial. Passive immunization has a protective effect in the treatment of infectious diseases. In addition, chicken egg yolk antibody (IgY) has gained increasing attention as a safe passive immunization agent. This study aimed to investigate whether hens produce specific IgY after immunization with inactivated Leptospira and the protective effect of specific IgY against leptospirosis. First, it was demonstrated that specific IgY could be extracted from the eggs of hens vaccinated with inactivated Leptospira and that specific IgY can specifically recognize and bind homotypic Leptospira with a high titre, as shown by MAT and ELISA. Next, we tested the therapeutic effects of IgY in early and late leptospirosis using a hamster model. The results showed that early specific IgY treatment increased the survival rate of hamsters to 100%, alleviated pathological damage to the liver, kidney, and lung, reduced leptospiral burden, and restored haematological indices as well as functional indicators of the liver and kidney. The therapeutic effect of early specific IgY was comparable to that of doxycycline. Late IgY treatment also enhanced the survival rate of hamsters and improved the symptoms of leptospirosis similar to early IgY treatment. However, the therapeutic effect of late IgY treatment was better when combined with doxycycline. Furthermore, no Leptospira colonization was observed in the kidneys, livers, or lungs of the surviving hamsters treated with specific IgY. Mechanistically, IgY was found to inhibit the growth and adhesion to cells of Leptospira. In conclusion, passive immunotherapy with specific IgY can be considered an effective treatment for leptospirosis, and may replace antibiotics regarding its therapeutic effects.
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Affiliation(s)
- Tianbao Lv
- Department of Clinical Veterinary Medicine, College of Veterinary Medicine, Jilin University, Changchun 130062, China
| | - Xufeng Xie
- Department of Clinical Veterinary Medicine, College of Veterinary Medicine, Jilin University, Changchun 130062, China
| | - Luteng Diao
- Department of Clinical Veterinary Medicine, College of Veterinary Medicine, Jilin University, Changchun 130062, China
| | - Shuang Jiang
- Department of Clinical Veterinary Medicine, College of Veterinary Medicine, Jilin University, Changchun 130062, China
| | - Yue Ding
- Department of Clinical Veterinary Medicine, College of Veterinary Medicine, Jilin University, Changchun 130062, China
| | - Xin Yuan
- Department of Clinical Veterinary Medicine, College of Veterinary Medicine, Jilin University, Changchun 130062, China
| | - Lingling Gong
- Department of Clinical Veterinary Medicine, College of Veterinary Medicine, Jilin University, Changchun 130062, China
| | - Xi Chen
- Department of Clinical Veterinary Medicine, College of Veterinary Medicine, Jilin University, Changchun 130062, China
| | - Wenlong Zhang
- Department of Clinical Veterinary Medicine, College of Veterinary Medicine, Jilin University, Changchun 130062, China; State Key Laboratory for Diagnosis and Treatment of Severe Zoonotic Infectious Diseases, Key Laboratory for Zoonosis Research of the Ministry of Education, Institute of Zoonosis, and College of Veterinary Medicine, Jilin University, Changchun 130062, China.
| | - Yongguo Cao
- Department of Clinical Veterinary Medicine, College of Veterinary Medicine, Jilin University, Changchun 130062, China; State Key Laboratory for Diagnosis and Treatment of Severe Zoonotic Infectious Diseases, Key Laboratory for Zoonosis Research of the Ministry of Education, Institute of Zoonosis, and College of Veterinary Medicine, Jilin University, Changchun 130062, China.
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Nualnoi T, Lomlim L, Naorungroj S. Accuracy of rapid lateral flow immunoassays for human leptospirosis diagnosis: A systematic review and meta-analysis. PLoS Negl Trop Dis 2024; 18:e0012174. [PMID: 38748731 PMCID: PMC11132494 DOI: 10.1371/journal.pntd.0012174] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2024] [Revised: 05/28/2024] [Accepted: 04/29/2024] [Indexed: 05/29/2024] Open
Abstract
BACKGROUND In the last two decades, several rapid lateral flow immunoassays (LFIs) for the diagnosis of human leptospirosis were developed and commercialized. However, the accuracy and reliability of these LFIs are not well understood. In this study, we aimed to evaluate the accuracy of leptospirosis LFIs as well as the factors affecting the test efficiency using systematic review and meta-analysis. METHODS AND RESULTS Original articles reporting the accuracy of human leptospirosis LFIs against microagglutination tests (MAT) or immunofluorescent assays (IFA) were searched from PubMed, Embase, and Scopus, and selected as per pre-set inclusion and exclusion criteria. A total of 49 data entries extracted from 24 eligible records published between 2003 and 2023 were included for meta-analysis. A meta-analysis was performed using STATA. The quality of the included studies was assessed according to the revised QUADAS-2. Only nine studies (32.1%) were considered to have a low risk of bias and no concern for applicability. Pooled sensitivity and specificity were calculated to be 68% (95% confidence interval, CI: 57-78) and 93% (95% CI: 90-95), respectively. However, the ranges of sensitivity (3.6 - 100%) and specificity (53.5 - 100%) of individual entries are dramatically broad, possibly due to the heterogeneity found in both study designs and LFIs themselves. Subgroup analysis demonstrated that IgM detection has better sensitivity than detection of IgG alone. Moreover, the test performance seems to be unaffected by samples from different phases of infection. CONCLUSIONS The pooled specificity of LFIs observed is somewhat acceptable, but the pooled sensitivity is low. These results, however, must be interpreted with caution because of substantial heterogeneity. Further evaluations of the LFIs with well-standardized design and reference test will be needed for a greater understanding of the test performance. Additionally, IgM detection type should be employed when leptospirosis LFIs are developed in the future.
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Affiliation(s)
- Teerapat Nualnoi
- Department of Pharmaceutical Technology, Faculty of Pharmaceutical Sciences, Prince of Songkla University, Hat Yai, Songkhla, Thailand
- Drug Delivery System Excellence Center (DDSEC), Faculty of Pharmaceutical Sciences, Prince of Songkla University, Hat Yai, Songkhla, Thailand
| | - Luelak Lomlim
- Department of Pharmaceutical Chemistry, Faculty of Pharmaceutical Sciences, Prince of Songkla University, Hat Yai, Songkhla, Thailand
- Phytomedicine and Pharmaceutical Biotechnology Excellence Center (PPBEC), Faculty of Pharmaceutical Sciences, Prince of Songkla University, Hat Yai, Songkhla, Thailand
| | - Supawadee Naorungroj
- Department of Conservative Dentistry, Faculty of Dentistry, Prince of Songkla University, Hat Yai, Songkhla, Thailand
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Bridgemohan R, Deitch MJ, Harmon E, Whiles MR, Wilson PC, Bean E, Bridgemohan P, Bisesi JH, Nicholas J, Redhead A, Bachoon DS. Spatiotemporal assessment of pathogenic Leptospira in subtropical coastal watersheds. JOURNAL OF WATER AND HEALTH 2024; 22:923-938. [PMID: 38822470 DOI: 10.2166/wh.2024.038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/23/2024] [Accepted: 03/20/2024] [Indexed: 06/03/2024]
Abstract
The World Health Organization classifies leptospirosis as a significant public health concern, predominantly affecting impoverished and unsanitary regions. By using the Pensacola Bay System as a case study, this study examines the underappreciated susceptibility of developed subtropical coastal ecosystems such as the Pensacola Bay System to neglected zoonotic pathogens such as Leptospira. We analyzed 132 water samples collected over 12 months from 44 distinct locations with high levels of Escherichia coli (>410 most probable number/100 mL). Fecal indicator bacteria (FIB) concentrations were assessed using IDEXX Colilert-18 and Enterolert-18, and an analysis of water physiochemical characteristics and rainfall intensity was conducted. The LipL32 gene was used as a quantitative polymerase chain reaction (qPCR) indicator to identify the distribution of Leptospira interrogans. The results revealed 12 instances of the presence of L. interrogans at sites with high FIB over various land cover and aquatic ecosystem types. Independent of specific rainfall events, a seasonal relationship between precipitation and elevated rates of fecal bacteria and leptospirosis was found. These findings highlight qPCR's utility in identifying pathogens in aquatic environments and the widespread conditions where it can be found in natural and developed areas.
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Affiliation(s)
- Ronell Bridgemohan
- Soil, Water, and Ecosystem Sciences Department, University of Florida IFAS West Florida Research and Education Center, Milton, FL, USA E-mail:
| | - Matthew J Deitch
- Soil, Water, and Ecosystem Sciences Department, University of Florida IFAS West Florida Research and Education Center, Milton, FL, USA
| | - Emily Harmon
- Soil, Water, and Ecosystem Sciences Department, University of Florida IFAS West Florida Research and Education Center, Milton, FL, USA
| | - Matt R Whiles
- Soil, Water, and Ecosystem Sciences Department 2181 McCarty Hall, University of Florida, P.O. Box 110290, Gainesville, FL 32611, USA
| | - P Christopher Wilson
- Soil, Water, and Ecosystem Sciences Department 2181 McCarty Hall, University of Florida, P.O. Box 110290, Gainesville, FL 32611, USA
| | - Eban Bean
- Department of Agricultural and Biological Engineering, University of Florida Main Office, Room 120 Frazier Rogers Hall1741 Museum Road, Building. 474, Gainesville, FL 32611, USA
| | - Puran Bridgemohan
- Tropical Research and Education Center, IFAS Research, University of Florida, Homestead, FL 33031, USA
| | - Joseph H Bisesi
- Department of Environmental and Global Health and Center for Environmental and Human Toxicology, College of Public Health and Health Professions, University of Florida, Gainesville, FL, USA
| | - Jodel Nicholas
- Department of Biological and Environmental Sciences, Georgia College and State University, Campus Box 81, Milledgeville, GA 31061, USA
| | - Aaden Redhead
- Department of Biological and Environmental Sciences, Georgia College and State University, Campus Box 81, Milledgeville, GA 31061, USA
| | - Dave S Bachoon
- Department of Biological and Environmental Sciences, Georgia College and State University, Campus Box 81, Milledgeville, GA 31061, USA
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Petakh P, Behzadi P, Oksenych V, Kamyshnyi O. Current treatment options for leptospirosis: a mini-review. Front Microbiol 2024; 15:1403765. [PMID: 38725681 PMCID: PMC11081000 DOI: 10.3389/fmicb.2024.1403765] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2024] [Accepted: 04/15/2024] [Indexed: 05/12/2024] Open
Abstract
Leptospirosis, one of the most common global zoonotic infections, significantly impacts global human health, infecting more than a million people and causing approximately 60,000 deaths annually. This mini-review explores effective treatment strategies for leptospirosis, considering its epidemiology, clinical manifestations, and current therapeutic approaches. Emphasis is placed on antibiotic therapy, including recommendations for mild and severe cases, as well as the role of probiotics in modulating the gut microbiota. Furthermore, novel treatment options, such as bacteriophages and newly synthesized/natural compounds, are discussed, and the findings are expected to provide insights into promising approaches for combating leptospirosis.
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Affiliation(s)
- Pavlo Petakh
- Department of Biochemistry and Pharmacology, Uzhhorod National University, Uzhhorod, Ukraine
- Department of Microbiology, Virology, and Immunology, I. Horbachevsky Ternopil National Medical University, Ternopil, Ukraine
| | - Payam Behzadi
- Department of Microbiology, Shahr-e-Qods Branch, Islamic Azad University, Tehran, Iran
| | - Valentyn Oksenych
- Broegelmann Research Laboratory, Department of Clinical Science, University of Bergen, Bergen, Norway
| | - Oleksandr Kamyshnyi
- Department of Microbiology, Virology, and Immunology, I. Horbachevsky Ternopil National Medical University, Ternopil, Ukraine
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Allyn J, Miailhe AF, Delmas B, Marti L, Allou N, Jabot J, Reignier J. Severe leptospirosis in tropical and non-tropical areas: A comparison of two french, multicentre, retrospective cohorts. PLoS Negl Trop Dis 2024; 18:e0012084. [PMID: 38598602 PMCID: PMC11034666 DOI: 10.1371/journal.pntd.0012084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2024] [Revised: 04/22/2024] [Accepted: 03/19/2024] [Indexed: 04/12/2024] Open
Abstract
BACKGROUND Leptospirosis is an anthropozoonosis that occurs worldwide but is more common in tropical regions. Severe forms may require intensive care unit (ICU) admission. Whether the clinical patterns and outcomes differ between tropical and non-tropical regions with similar healthcare systems is unclear. Our objective here was to address this issue by comparing two cohorts of ICU patients with leptospirosis managed in mainland France and in the overseas French department of Réunion, respectively. METHODOLOGY/PRINCIPAL FINDINGS We compared two retrospective cohorts of patients admitted to intensive care for severe leptospirosis, one from Reunion Island in the Indian Ocean (tropical climate) and the other from metropolitan France (temperate climate). Chi-square and Student's t tests were used for comparisons. After grouping the two cohorts, we also performed multiple correspondence analysis and hierarchical clustering to search for distinct clinical phenotypes. The Réunion and Metropolitan France cohorts comprised 128 and 160 patients respectively. Compared with the Réunion cohort, the metropolitan cohort had a higher mean age (42.5±14.1 vs. 51.4±16.5 years, p<0.001). Severity scores, length of stay and mortality did not differ between the two cohorts. Three phenotypes were identified: hepato-renal leptospirosis (54.5%) characterized by significant hepatic, renal and coagulation failure, with a mortality of 8.3%; moderately severe leptospirosis (38.5%) with less severe organ failure and the lowest mortality rate (1.8%); and very severe leptospirosis (7%) manifested by neurological, respiratory and cardiovascular failure, with a mortality of 30%. CONCLUSIONS/SIGNIFICANCE The outcomes of severe leptospirosis requiring ICU admission did not differ between tropical and temperate regions with similar healthcare access, practices, and resources, despite some differences in patient characteristics. The identification of three different clinical phenotypes may assist in the early diagnosis and management of severe leptospirosis.
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Affiliation(s)
- Jérôme Allyn
- Réanimation Polyvalente, Centre hospitalier universitaire Félix Guyon, La Réunion, Bellepierre Saint-Denis cedex, France
- Département d’Informatique Clinique, Centre hospitalier universitaire Félix Guyon, La Réunion, Bellepierre Saint-Denis cedex, France
| | | | - Benjamin Delmas
- Réanimation Polyvalente, Centre hospitalier universitaire Félix Guyon, La Réunion, Bellepierre Saint-Denis cedex, France
| | - Lucas Marti
- Réanimation Polyvalente, Centre hospitalier universitaire Félix Guyon, La Réunion, Bellepierre Saint-Denis cedex, France
| | - Nicolas Allou
- Réanimation Polyvalente, Centre hospitalier universitaire Félix Guyon, La Réunion, Bellepierre Saint-Denis cedex, France
- Département d’Informatique Clinique, Centre hospitalier universitaire Félix Guyon, La Réunion, Bellepierre Saint-Denis cedex, France
| | - Julien Jabot
- Réanimation Polyvalente, Centre hospitalier universitaire Félix Guyon, La Réunion, Bellepierre Saint-Denis cedex, France
| | - Jean Reignier
- Nantes Université, CHU Nantes, Médecine Intensive Réanimation, Movement—Interactions—Performance, MIP, UR 4334, Nantes, France
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Win TZ, Perinpanathan T, Mukadi P, Smith C, Edwards T, Han SM, Maung HT, Brett-Major DM, Lee N. Antibiotic prophylaxis for leptospirosis. Cochrane Database Syst Rev 2024; 3:CD014959. [PMID: 38483067 PMCID: PMC10938880 DOI: 10.1002/14651858.cd014959.pub2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/17/2024]
Abstract
BACKGROUND Leptospirosis is a global zoonotic and waterborne disease caused by pathogenic Leptospira species. Antibiotics are used as a strategy for prevention of leptospirosis, in particular in travellers and high-risk groups. However, the clinical benefits are unknown, especially when considering possible treatment-associated adverse effects. This review assesses the use of antibiotic prophylaxis in leptospirosis and is an update of a previously published review in the Cochrane Library (2009, Issue 3). OBJECTIVES To evaluate the benefits and harms of antibiotic prophylaxis for human leptospirosis. SEARCH METHODS We identified randomised clinical trials through electronic searches of the Cochrane Hepato-Biliary Group Controlled Trials Register, CENTRAL, MEDLINE, Embase, LILACS, Science Citation Index Expanded, and other resources. We searched online clinical trial registries to identify unpublished or ongoing trials. We checked reference lists of the retrieved studies for further trials. The last date of search was 17 April 2023. SELECTION CRITERIA We included randomised clinical trials of any trial design, assessing antibiotics for prevention of leptospirosis, and with no restrictions on age, sex, occupation, or comorbidity of trial participants. We looked for trials assessing antibiotics irrespective of route of administration, dosage, and schedule versus placebo or no intervention. We also included trials assessing antibiotics versus other antibiotics using these criteria, or the same antibiotic but with another dose or schedule. DATA COLLECTION AND ANALYSIS We followed Cochrane methodology. The primary outcomes were all-cause mortality, laboratory-confirmed leptospirosis regardless of the presence of an identified clinical syndrome (inclusive of asymptomatic cases), clinical diagnosis of leptospirosis regardless of the presence of laboratory confirmation, clinical diagnosis of leptospirosis confirmed by laboratory diagnosis (exclusive of asymptomatic cases), and serious adverse events. The secondary outcomes were quality of life and the proportion of people with non-serious adverse events. We assessed the risk of bias of the included trials using the RoB 2 tool and the certainty of evidence using GRADE. We presented dichotomous outcomes as risk ratios (RR) and continuous outcomes as mean difference (MD), with their 95% confidence intervals (CI). We used a random-effects model for our main analyses and the fixed-effect model for sensitivity analyses. Our primary outcome analyses included trial data at the longest follow-up. MAIN RESULTS We identified five randomised clinical trials comprising 2593 participants that compared antibiotics (doxycycline, azithromycin, or penicillin) with placebo, or one antibiotic compared with another. Four trials assessed doxycycline with different durations, one trial assessed azithromycin, and one trial assessed penicillin. One trial had three intervention groups: doxycycline, azithromycin, and placebo. Three trials assessed pre-exposure prophylaxis, one trial assessed postexposure prophylaxis, and one did not report this clearly. Four trials recruited residents in endemic areas, and one trial recruited soldiers who experienced limited time exposure. The participants' ages in the included trials were 10 to 80 years. Follow-up ranged from one to three months. Antibiotics versus placebo Doxycycline compared with placebo may result in little to no difference in all-cause mortality (RR 0.15, 95% CI 0.01 to 2.83; 1 trial, 782 participants; low-certainty evidence). Prophylactic antibiotics may have little to no effect on laboratory-confirmed leptospirosis, but the evidence is very uncertain (RR 0.56, 95% CI 0.25 to 1.26; 5 trials, 2593 participants; very low-certainty evidence). Antibiotics may result in little to no difference in the clinical diagnosis of leptospirosis regardless of laboratory confirmation (RR 0.76, 95% CI 0.53 to 1.08; 4 trials, 1653 participants; low-certainty evidence) and the clinical diagnosis of leptospirosis with laboratory confirmation (RR 0.57, 95% CI 0.26 to 1.26; 4 trials, 1653 participants; low-certainty evidence). Antibiotics compared with placebo may increase non-serious adverse events, but the evidence is very uncertain (RR 10.13, 95% CI 2.40 to 42.71; 3 trials, 1909 participants; very low-certainty evidence). One antibiotic versus another antibiotic One trial assessed doxycycline versus azithromycin but did not report mortality. Compared to azithromycin, doxycycline may have little to no effect on laboratory-confirmed leptospirosis regardless of the presence of an identified clinical syndrome (RR 1.49, 95% CI 0.51 to 4.32; 1 trial, 137 participants), on the clinical diagnosis of leptospirosis regardless of the presence of laboratory confirmation (RR 4.18, 95% CI 0.94 to 18.66; 1 trial, 137 participants), on the clinical diagnosis of leptospirosis confirmed by laboratory diagnosis (RR 4.18, 95% CI 0.94 to 18.66; 1 trial, 137 participants), and on non-serious adverse events (RR 1.12, 95% CI 0.36 to 3.48; 1 trial, 137 participants), but the evidence is very uncertain. The certainty of evidence for all the outcomes was very low. None of the five included trials reported serious adverse events or assessed quality of life. One study is awaiting classification. Funding Four of the five trials included statements disclosing their funding/supporting sources, and the remaining trial did not include this. Three of the four trials that disclosed their supporting sources received the supply of trial drugs directly from the same pharmaceutical company, and the remaining trial received financial support from a governmental source. AUTHORS' CONCLUSIONS We do not know if antibiotics versus placebo or another antibiotic has little or have no effect on all-cause mortality or leptospirosis infection because the certainty of evidence is low or very low. We do not know if antibiotics versus placebo may increase the overall risk of non-serious adverse events because of very low-certainty evidence. We lack definitive rigorous data from randomised trials to support the use of antibiotics for the prophylaxis of leptospirosis infection. We lack trials reporting data on clinically relevant outcomes.
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Affiliation(s)
- Tin Zar Win
- School of Tropical Medicine and Global Health, Nagasaki University, Nagasaki, Japan
| | - Tanaraj Perinpanathan
- School of Tropical Medicine and Global Health, Nagasaki University, Nagasaki, Japan
- Department of Clinical Research, Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, London, UK
| | - Patrick Mukadi
- Department of Clinical Medicine, Institute of Tropical Medicine, Nagasaki University, Nagasaki, Japan
- Program for Nurturing Global Leaders in Tropical and Emerging Communicable Diseases, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Japan
- Institut National de Recherche Biomedicale (INRB), Kinshasa, DRC
| | - Chris Smith
- School of Tropical Medicine and Global Health, Nagasaki University, Nagasaki, Japan
- Department of Clinical Research, Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, London, UK
| | - Tansy Edwards
- Department of Infectious Disease Epidemiology, Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, UK
| | - Su Myat Han
- School of Tropical Medicine and Global Health, Nagasaki University, Nagasaki, Japan
- Department of Infectious Disease Epidemiology, Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, UK
| | - Hsu Thinzar Maung
- School of Tropical Medicine and Global Health, Nagasaki University, Nagasaki, Japan
| | - David M Brett-Major
- Department of Preventive Medicine and Biometrics, Uniformed Services University, Bethesda, MD, USA
| | - Nathaniel Lee
- School of Tropical Medicine and Global Health, Nagasaki University, Nagasaki, Japan
- Department of Infectious Disease Epidemiology, Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, UK
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20
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Win TZ, Han SM, Edwards T, Maung HT, Brett-Major DM, Smith C, Lee N. Antibiotics for treatment of leptospirosis. Cochrane Database Syst Rev 2024; 3:CD014960. [PMID: 38483092 PMCID: PMC10938876 DOI: 10.1002/14651858.cd014960.pub2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/17/2024]
Abstract
BACKGROUND Leptospirosis is a disease transmitted from animals to humans through water, soil, or food contaminated with the urine of infected animals, caused by pathogenic Leptospira species. Antibiotics are commonly prescribed for the management of leptospirosis. Despite the widespread use of antibiotic treatment for leptospirosis, there seems to be insufficient evidence to determine its effectiveness or to recommend antibiotic use as a standard practice. This updated systematic review evaluated the available evidence regarding the use of antibiotics in treating leptospirosis, building upon a previously published Cochrane review. OBJECTIVES To evaluate the benefits and harms of antibiotics versus placebo, no intervention, or another antibiotic for the treatment of people with leptospirosis. SEARCH METHODS We identified randomised clinical trials following standard Cochrane procedures. The date of the last search was 27 March 2023. SELECTION CRITERIA We searched for randomised clinical trials of various designs that examined the use of antibiotics for treating leptospirosis. We did not impose any restrictions based on the age, sex, occupation, or comorbidities of the participants involved in the trials. Our search encompassed trials that evaluated antibiotics, regardless of the method of administration, dosage, and schedule, and compared them with placebo or no intervention, or compared different antibiotics. We included trials regardless of the outcomes reported. DATA COLLECTION AND ANALYSIS During the preparation of this review, we adhered to the Cochrane methodology and used Review Manager. The primary outcomes were all-cause mortality and serious adverse events (nosocomial infection). Our secondary outcomes were quality of life, proportion of people with adverse events considered non-serious, and days of hospitalisation. To assess the risk of bias of the included trials, we used the RoB 2 tool, and for evaluating the certainty of evidence we used GRADEpro GDT software. We presented dichotomous outcomes as risk ratios (RR) and continuous outcomes as mean differences (MD), both accompanied by their corresponding 95% confidence intervals (CI). We used the random-effects model for all our main analyses and the fixed-effect model for sensitivity analyses. For our primary outcome analyses, we included trial data from the longest follow-up period. MAIN RESULTS We identified nine randomised clinical trials comprising 1019 participants. Seven trials compared two intervention groups and two trials compared three intervention groups. Amongst the trials comparing antibiotics versus placebos, four trials assessed penicillin and one trial assessed doxycycline. In the trials comparing different antibiotics, one trial evaluated doxycycline versus azithromycin, one trial assessed penicillin versus doxycycline versus cefotaxime, and one trial evaluated ceftriaxone versus penicillin. One trial assessed penicillin with chloramphenicol and no intervention. Apart from two trials that recruited military personnel stationed in endemic areas or military personnel returning from training courses in endemic areas, the remaining trials recruited people from the general population presenting to the hospital with fever in an endemic area. The participants' ages in the included trials was 13 to 92 years. The treatment duration was seven days for penicillin, doxycycline, and cephalosporins; five days for chloramphenicol; and three days for azithromycin. The follow-up durations varied across trials, with three trials not specifying their follow-up periods. Three trials were excluded from quantitative synthesis; one reported zero events for a prespecified outcome, and two did not provide data for any prespecified outcomes. Antibiotics versus placebo or no intervention The evidence is very uncertain about the effect of penicillin versus placebo on all-cause mortality (RR 1.57, 95% CI 0.65 to 3.79; I2 = 8%; 3 trials, 367 participants; very low-certainty evidence). The evidence is very uncertain about the effect of penicillin or chloramphenicol versus placebo on adverse events considered non-serious (RR 1.05, 95% CI 0.35 to 3.17; I2 = 0%; 2 trials, 162 participants; very low-certainty evidence). None of the included trials assessed serious adverse events. Antibiotics versus another antibiotic The evidence is very uncertain about the effect of penicillin versus cephalosporin on all-cause mortality (RR 1.38, 95% CI 0.47 to 4.04; I2 = 0%; 2 trials, 348 participants; very low-certainty evidence), or versus doxycycline (RR 0.93, 95% CI 0.13 to 6.46; 1 trial, 168 participants; very low-certainty evidence). The evidence is very uncertain about the effect of cefotaxime versus doxycycline on all-cause mortality (RR 0.18, 95% CI 0.01 to 3.78; 1 trial, 169 participants; very low-certainty evidence). The evidence is very uncertain about the effect of penicillin versus doxycycline on serious adverse events (nosocomial infection) (RR 0.62, 95% CI 0.11 to 3.62; 1 trial, 168 participants; very low-certainty evidence) or versus cefotaxime (RR 1.01, 95% CI 0.15 to 7.02; 1 trial, 175 participants; very low-certainty evidence). The evidence is very uncertain about the effect of doxycycline versus cefotaxime on serious adverse events (nosocomial infection) (RR 1.01, 95% CI 0.15 to 7.02; 1 trial, 175 participants; very low-certainty evidence). The evidence is very uncertain about the effect of penicillin versus cefotaxime (RR 3.03, 95% CI 0.13 to 73.47; 1 trial, 175 participants; very low-certainty evidence), versus doxycycline (RR 2.80, 95% CI 0.12 to 67.66; 1 trial, 175 participants; very low-certainty evidence), or versus chloramphenicol on adverse events considered non-serious (RR 0.74, 95% CI 0.15 to 3.67; 1 trial, 52 participants; very low-certainty evidence). Funding Six of the nine trials included statements disclosing their funding/supporting sources and three trials did not mention funding source. Four of the six trials mentioning sources received funds from public or governmental sources or from international charitable sources, and the remaining two, in addition to public or governmental sources, received support in the form of trial drug supply directly from pharmaceutical companies. AUTHORS' CONCLUSIONS As the certainty of evidence is very low, we do not know if antibiotics provide little to no effect on all-cause mortality, serious adverse events, or adverse events considered non-serious. There is a lack of definitive rigorous data from randomised trials to support the use of antibiotics for treating leptospirosis infection, and the absence of trials reporting data on clinically relevant outcomes further adds to this limitation.
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Affiliation(s)
- Tin Zar Win
- School of Tropical Medicine and Global Health, Nagasaki University, Nagasaki, Japan
| | - Su Myat Han
- School of Tropical Medicine and Global Health, Nagasaki University, Nagasaki, Japan
- Department of Infectious Disease Epidemiology, Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, UK
| | - Tansy Edwards
- Department of Infectious Disease Epidemiology, Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, UK
| | - Hsu Thinzar Maung
- School of Tropical Medicine and Global Health, Nagasaki University, Nagasaki, Japan
| | - David M Brett-Major
- Department of Preventive Medicine and Biometrics, Uniformed Services University, Bethesda, Maryland, USA
| | - Chris Smith
- School of Tropical Medicine and Global Health, Nagasaki University, Nagasaki, Japan
- Department of Clinical Research, Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, London, UK
| | - Nathaniel Lee
- Department of Infectious Disease Epidemiology, Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, UK
- School of Tropical Medicine and Global Health, Nagasaki University, Nagasaki, Japan
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Yang QF, Shu CM, Ji QY. Diagnosis of pulmonary hemorrhagic leptospirosis complicated by invasive pulmonary aspergillosis complemented by metagenomic next-generation sequencing: a case report. Front Med (Lausanne) 2024; 11:1365096. [PMID: 38500954 PMCID: PMC10944945 DOI: 10.3389/fmed.2024.1365096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2024] [Accepted: 02/22/2024] [Indexed: 03/20/2024] Open
Abstract
Background Leptospirosis is a bacterial zoonosis with variable clinical manifestations. Pulmonary diffuse hemorrhagic leptospirosis often occurs rapidly and, when not promptly diagnosed and treated, it can be life-threatening. Aspergillus flavus is an opportunistic fungus that is commonly seen in immunosuppressed patients. Invasive pulmonary aspergillosis also progresses rapidly. This case study describes a patient with severe pneumonia caused by pulmonary hemorrhagic leptospirosis combined with invasive pulmonary aspergillosis. We have found almost no clinical reports to date on these two diseases occurring in the same patient. Case presentation A 73-year-old male arrived at our hospital complaining of fever, general malaise, and hemoptysis that had lasted 4 days. The patient was initially diagnosed with severe pneumonia in the emergency department, but he did not respond well to empiric antibiotics. Subsequently, the patient's condition worsened and was transferred to the ICU ward after emergency tracheal intubation and invasive ventilator. In the ICU, antibacterial drugs were adjusted to treat bacteria and fungi extensively. Although the inflammatory indices decreased, the patient still had recurrent fever, and a series of etiological tests were negative. Finally, metagenomic next-generation sequencing (mNGS) of bronchial alveolar lavage fluid detected Leptospira interrogans and Aspergillus flavus. After targeted treatment with penicillin G and voriconazole, the patient's condition improved rapidly, and he was eventually transferred out of the ICU and recovered. Conclusion Early recognition and diagnosis of leptospirosis is difficult, especially when a patient is co-infected with other pathogens. The use of mNGS to detect pathogens in bronchial alveolar lavage fluid is conducive to early diagnosis and treatment of the disease, and may significantly improve the prognosis in severe cases.
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Selim A, Marzok M, Gattan HS, Abdelhady A, Salem M, Hereba AM. Seroprevalence and associated risk factors for bovine leptospirosis in Egypt. Sci Rep 2024; 14:4645. [PMID: 38409338 PMCID: PMC10897380 DOI: 10.1038/s41598-024-54882-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2023] [Accepted: 02/17/2024] [Indexed: 02/28/2024] Open
Abstract
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.
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Affiliation(s)
- Abdelfattah Selim
- Department of Animal Medicine (Infectious Diseases), Faculty of Veterinary Medicine, Benha University, Toukh, 13736, Egypt.
| | - Mohamed Marzok
- Department of Clinical Sciences, College of Veterinary Medicine, King Faisal University, 31982, Al-Ahsa, Saudi Arabia.
- Department of Surgery, Faculty of Veterinary Medicine, Kafr El Sheikh University, Kafr El Sheikh, Egypt.
| | - Hattan S Gattan
- Department of Medical Laboratory Sciences, Faculty of Applied Medical Sciences, King Abdulaziz University, Jeddah, Saudi Arabia
- Special Infectious Agents Unit, King Fahad Medical Research Center, King AbdulAziz University, Jeddah, Saudi Arabia
| | - Abdelhamed Abdelhady
- Department of Parasitology and Animal Diseases, National Research Center, Giza, Egypt
| | - Mohamed Salem
- Department of Clinical Sciences, College of Veterinary Medicine, King Faisal University, 31982, Al-Ahsa, Saudi Arabia
- Department of Medicine and Infectious Diseases, Faculty of Veterinary Medicine, Cairo University, 12613, Cairo, Egypt
| | - Abdelrahman M Hereba
- Department of Biomedical Physics, Medical Research Institute, Alexandria University, Alexandria, Egypt
- Department of Microbiology, College of Veterinary Medicine, King Faisal University, 31982, Al-Ahsa, Saudi Arabia
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Andityas M, Nuraini DM, Sota P, Loong SK, Sripa B, Sukon P, Tangkawattana P, Tangkawattana S. Feline leptospirosis prevalence worldwide: A systematic review and meta-analysis of diagnostic approaches. Vet World 2024; 17:255-272. [PMID: 38595668 PMCID: PMC11000471 DOI: 10.14202/vetworld.2024.255-272] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Accepted: 01/05/2024] [Indexed: 04/11/2024] Open
Abstract
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.
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Affiliation(s)
- Morsid Andityas
- Veterinary Science Program, Faculty of Veterinary Medicine, Khon Kaen University, Khon Kaen, 40002, Thailand
- Veterinary Technology Study Program, Department of Bioresources Technology and Veterinary, Vocational College, Universitas Gadjah Mada, 55281, Indonesia
| | - Dian Meididewi Nuraini
- Veterinary Science Program, Faculty of Veterinary Medicine, Khon Kaen University, Khon Kaen, 40002, Thailand
- Department of Animal Science, Faculty of Animal Science, Sebelas Maret University, Surakarta, 57126, Indonesia
| | - Pornphutthachat Sota
- Tropical Disease Research Center, WHO Collaborating Center for Research and Control of Opisthorchiasis (Southeast Asian Liver Fluke Disease), Khon Kaen University, Khon Kaen, 40002, Thailand
| | - Shih Keng Loong
- Tropical Infectious Diseases Research and Education Centre, Higher Institution Centre of Excellence, Universiti Malaya, Kuala Lumpur, 50603, Malaysia
| | - Banchob Sripa
- Tropical Disease Research Center, WHO Collaborating Center for Research and Control of Opisthorchiasis (Southeast Asian Liver Fluke Disease), Khon Kaen University, Khon Kaen, 40002, Thailand
- Department of Tropical Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, 40002, Thailand
| | - Peerapol Sukon
- Department of Veterinary Anatomy, Faculty of Veterinary Medicine, Khon Kaen University, Khon Kaen, 40002, Thailand
| | - Prasarn Tangkawattana
- Department of Veterinary Anatomy, Faculty of Veterinary Medicine, Khon Kaen University, Khon Kaen, 40002, Thailand
| | - Sirikachorn Tangkawattana
- Tropical Disease Research Center, WHO Collaborating Center for Research and Control of Opisthorchiasis (Southeast Asian Liver Fluke Disease), Khon Kaen University, Khon Kaen, 40002, Thailand
- Department of Veterinary Pathobiology, Faculty of Veterinary Medicine, Khon Kaen University, Khon Kaen, 40002, Thailand
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de Azevedo SS. Epidemiology of Leptospira sp. Infection: Current Status, Insights and Future Prospects. Microorganisms 2023; 12:22. [PMID: 38257849 PMCID: PMC10821098 DOI: 10.3390/microorganisms12010022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2023] [Accepted: 12/19/2023] [Indexed: 01/24/2024] Open
Abstract
In recent decades, the scientific community has been faced with an increased risk of emerging or re-emerging zoonotic diseases, such as leptospirosis, mainly originating from anthropic actions [...].
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Affiliation(s)
- Sérgio Santos de Azevedo
- Academic Unit of Veterinary Medicine, Center for Rural Health and Technology, Federal University of Campina Grande, Patos 58708-110, Brazil
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25
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Mahamat AB, Groud K, Djibrine SI, Soro SD, Fourel I, Rached A, Chatron N, Benoit E, Lattard V. Exposure and resistance to anticoagulant rodenticides in invasive and endemic Chadian urban rodent species to develop a rational management strategy. PEST MANAGEMENT SCIENCE 2023. [PMID: 38031300 DOI: 10.1002/ps.7911] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/03/2023] [Revised: 11/24/2023] [Accepted: 11/27/2023] [Indexed: 12/01/2023]
Abstract
Rodent management involves the use of anticoagulant rodenticides (ARs). This use has resulted in the selection of numerous resistance alleles in the Vkorc1 gene, encoding the target enzyme of ARs. In Africa, although rodents are a major problem as a consequence of their transport and transmission of zoonotic pathogens, and damage to crops, the use of ARs and the spread of resistance alleles are poorly documented. We attempted to address both issues in Chad which is one of the largest countries in Africa. Owing to its location at the crossroads of central and northern Africa, Chad is representative of many African countries. METHODS Using a sampling of nearly 300 rodents composed of invasive and endemic rodents collected in six of Chad's largest cities, exposure to ARs was analyzed by their quantification in the liver; the spread of AR resistance alleles was analyzed by Vkorc1 sequencing. RESULTS We demonstrate the use of both ARs generations in Chadian cities and report the total sequencing of the Vkorc1 for 44 Mastomys natalensis with detection of two different haplotypes, the sequencing of the Vkorc1 for two other endemic rodent species, M. kollmannspergeri and Arvicanthis niloticus, and finally the detection of three new missense mutations - V29E, V69E and D127V - in R. rattus, potentially associated with resistance to ARs. DISCUSSION These results should argue for the implementation of a reasoned management of rodent populations in Africa to avoid the spread of ARs resistance alleles. © 2023 The Authors. Pest Management Science published by John Wiley & Sons Ltd on behalf of Society of Chemical Industry.
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Affiliation(s)
- Ali Barka Mahamat
- USC 1233 RS2GP, VetAgro Sup, INRAe, University of Lyon, Lyon, France
- Department of Biomedical and Pharmaceutical Sciences, National Higher Institute of Science and Technology, Abeche, Chad
| | - Karine Groud
- USC 1233 RS2GP, VetAgro Sup, INRAe, University of Lyon, Lyon, France
| | - Soudy Imar Djibrine
- Department of Biomedical and Pharmaceutical Sciences, National Higher Institute of Science and Technology, Abeche, Chad
- Food Quality Control Center, N'Djamena, Chad
| | | | - Isabelle Fourel
- USC 1233 RS2GP, VetAgro Sup, INRAe, University of Lyon, Lyon, France
| | - Antoine Rached
- USC 1233 RS2GP, VetAgro Sup, INRAe, University of Lyon, Lyon, France
| | - Nolan Chatron
- USC 1233 RS2GP, VetAgro Sup, INRAe, University of Lyon, Lyon, France
| | - Etienne Benoit
- USC 1233 RS2GP, VetAgro Sup, INRAe, University of Lyon, Lyon, France
| | - Virginie Lattard
- USC 1233 RS2GP, VetAgro Sup, INRAe, University of Lyon, Lyon, France
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Arboleda M, Mejía-Torres M, Posada M, Restrepo N, Ríos-Tapias P, Rivera-Pedroza LA, Calle D, Sánchez-Jiménez MM, Marín K, Agudelo-Flórez P. Molecular Diagnosis as an Alternative for Public Health Surveillance of Leptospirosis in Colombia. Microorganisms 2023; 11:2759. [PMID: 38004770 PMCID: PMC10673046 DOI: 10.3390/microorganisms11112759] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Revised: 10/24/2023] [Accepted: 10/30/2023] [Indexed: 11/26/2023] Open
Abstract
Leptospirosis represents a public health problem in Colombia. However, the underreporting of the disease is an unfortunate reality, with a clear trend towards a decrease in cases since 2019, when the guidelines for its confirmatory diagnosis changed with the requirement of two paired samples. The purpose of this review is to highlight the importance of leptospirosis. While the access to rapid diagnosis is available at practically all levels of care for dengue and malaria, leptospirosis-a doubly neglected disease-deserves recognition as a serious public health problem in Colombia. In this manner, it is proposed that molecular tests are a viable diagnostic alternative that can improve the targeted treatment of the patient and the timeliness of data and case reporting to SIVIGILA, and reduce the underreporting of the disease. Taking advantage of the strengthened technological infrastructure derived from the SARS-CoV-2 pandemic for molecular diagnosis in Colombia, with a network of 227 laboratories distributed throughout the national territory, with an installed capacity for PCR testing, it is proposed that molecular diagnosis can be used as an alternative for early diagnosis. This would allow case confirmation through the public health network in Colombia, and, together with the microagglutination (MAT) technique, the epidemiological surveillance of this disease in this country would be strengthened.
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Affiliation(s)
- Margarita Arboleda
- Tropical Medicine Group, Colombian Institute of Tropical Medicine, Sabaneta 055450, Colombia; (M.M.-T.); (M.P.); (N.R.); (P.R.-T.); (L.A.R.-P.); (D.C.); (M.M.S.-J.); (K.M.)
| | - Mariana Mejía-Torres
- Tropical Medicine Group, Colombian Institute of Tropical Medicine, Sabaneta 055450, Colombia; (M.M.-T.); (M.P.); (N.R.); (P.R.-T.); (L.A.R.-P.); (D.C.); (M.M.S.-J.); (K.M.)
| | - Maritza Posada
- Tropical Medicine Group, Colombian Institute of Tropical Medicine, Sabaneta 055450, Colombia; (M.M.-T.); (M.P.); (N.R.); (P.R.-T.); (L.A.R.-P.); (D.C.); (M.M.S.-J.); (K.M.)
| | - Nicaela Restrepo
- Tropical Medicine Group, Colombian Institute of Tropical Medicine, Sabaneta 055450, Colombia; (M.M.-T.); (M.P.); (N.R.); (P.R.-T.); (L.A.R.-P.); (D.C.); (M.M.S.-J.); (K.M.)
| | - Paola Ríos-Tapias
- Tropical Medicine Group, Colombian Institute of Tropical Medicine, Sabaneta 055450, Colombia; (M.M.-T.); (M.P.); (N.R.); (P.R.-T.); (L.A.R.-P.); (D.C.); (M.M.S.-J.); (K.M.)
| | - Luis Alberto Rivera-Pedroza
- Tropical Medicine Group, Colombian Institute of Tropical Medicine, Sabaneta 055450, Colombia; (M.M.-T.); (M.P.); (N.R.); (P.R.-T.); (L.A.R.-P.); (D.C.); (M.M.S.-J.); (K.M.)
| | - David Calle
- Tropical Medicine Group, Colombian Institute of Tropical Medicine, Sabaneta 055450, Colombia; (M.M.-T.); (M.P.); (N.R.); (P.R.-T.); (L.A.R.-P.); (D.C.); (M.M.S.-J.); (K.M.)
| | - Miryan M. Sánchez-Jiménez
- Tropical Medicine Group, Colombian Institute of Tropical Medicine, Sabaneta 055450, Colombia; (M.M.-T.); (M.P.); (N.R.); (P.R.-T.); (L.A.R.-P.); (D.C.); (M.M.S.-J.); (K.M.)
| | - Katerine Marín
- Tropical Medicine Group, Colombian Institute of Tropical Medicine, Sabaneta 055450, Colombia; (M.M.-T.); (M.P.); (N.R.); (P.R.-T.); (L.A.R.-P.); (D.C.); (M.M.S.-J.); (K.M.)
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Techawiwattanaboon T, Phanchamnan E, Iadsee N, Makjaroen J, Pisitkun T, Patarakul K. Proteomic profile of naturally released extracellular vesicles secreted from Leptospira interrogans serovar Pomona in response to temperature and osmotic stresses. Sci Rep 2023; 13:18601. [PMID: 37903905 PMCID: PMC10616267 DOI: 10.1038/s41598-023-45863-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Accepted: 10/25/2023] [Indexed: 11/01/2023] Open
Abstract
Bacterial extracellular vesicles (EVs) are generally formed by pinching off outer membrane leaflets while simultaneously releasing multiple active molecules into the external environment. In this study, we aimed to identify the protein cargo of leptospiral EVs released from intact leptospires grown under three different conditions: EMJH medium at 30 °C, temperature shifted to 37 °C, and physiologic osmolarity (EMJH medium with 120 mM NaCl). The naturally released EVs observed under transmission electron microscopy were spherical in shape with an approximate diameter of 80-100 nm. Quantitative proteomics and bioinformatic analysis indicated that the EVs were formed primarily from the outer membrane and the cytoplasm. The main functional COG categories of proteins carried in leptospiral EVs might be involved in cell growth, survival and adaptation, and pathogenicity. Relative to their abundance in EVs grown in EMJH medium at 30 °C, 39 and 69 proteins exhibited significant changes in response to the temperature shift and the osmotic change, respectively. During exposure to both stresses, Leptospira secreted several multifunctional proteins via EVs, while preserving certain virulence proteins within whole cells. Therefore, leptospiral EVs may serve as a decoy structure for host responses, whereas some virulence factors necessary for direct interaction with the host environment are reserved in leptospiral cells. This knowledge will be useful for understanding the pathogenesis of leptospirosis and developing as one of vaccine platforms against leptospirosis in the future.
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Affiliation(s)
- Teerasit Techawiwattanaboon
- Department of Microbiology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
- Chula Vaccine Research Center (Chula VRC), Center of Excellence in Vaccine Research and Development, Chulalongkorn University, Bangkok, Thailand
| | - Eakalak Phanchamnan
- Chula Vaccine Research Center (Chula VRC), Center of Excellence in Vaccine Research and Development, Chulalongkorn University, Bangkok, Thailand
- Medical Microbiology, Interdisciplinary Program, Graduate School, Chulalongkorn University, Bangkok, Thailand
| | - Nutta Iadsee
- Chula Vaccine Research Center (Chula VRC), Center of Excellence in Vaccine Research and Development, Chulalongkorn University, Bangkok, Thailand
- Medical Microbiology, Interdisciplinary Program, Graduate School, Chulalongkorn University, Bangkok, Thailand
| | - Jiradej Makjaroen
- Center of Excellence in Systems Biology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
- Department of Transfusion Medicine and Clinical Microbiology, Faculty of Allied Health Sciences, Chulalongkorn University, Bangkok, Thailand
| | - Trairak Pisitkun
- Center of Excellence in Systems Biology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Kanitha Patarakul
- Department of Microbiology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.
- Chula Vaccine Research Center (Chula VRC), Center of Excellence in Vaccine Research and Development, Chulalongkorn University, Bangkok, Thailand.
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Jajosky RP, Wu SC, Jajosky PG, Stowell SR. Plasmodium knowlesi ( Pk) Malaria: A Review & Proposal of Therapeutically Rational Exchange (T-REX) of Pk-Resistant Red Blood Cells. Trop Med Infect Dis 2023; 8:478. [PMID: 37888606 PMCID: PMC10610852 DOI: 10.3390/tropicalmed8100478] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Revised: 10/09/2023] [Accepted: 10/12/2023] [Indexed: 10/28/2023] Open
Abstract
Plasmodium knowlesi (Pk) causes zoonotic malaria and is known as the "fifth human malaria parasite". Pk malaria is an emerging threat because infections are increasing and can be fatal. While most infections are in Southeast Asia (SEA), especially Malaysia, travelers frequently visit this region and can present with Pk malaria around the world. So, clinicians need to know (1) patients who present with fever after recent travel to SEA might be infected with Pk and (2) Pk is often misdiagnosed as P. malariae (which typically causes less severe malaria). Here we review the history, pathophysiology, clinical features, diagnosis, and treatment of Pk malaria. Severe disease is most common in adults. Signs and symptoms can include fever, abdominal pain, jaundice, acute kidney injury, acute respiratory distress syndrome, hyponatremia, hyperparasitemia, and thrombocytopenia. Dengue is one of the diseases to be considered in the differential. Regarding pathophysiologic mechanisms, when Pk parasites invade mature red blood cells (RBCs, i.e., normocytes) and reticulocytes, changes in the red blood cell (RBC) surface can result in life-threatening cytoadherence, sequestration, and reduced RBC deformability. Since molecular mechanisms involving the erythrocytic stage are responsible for onset of severe disease and lethal outcomes, it is biologically plausible that manual exchange transfusion (ET) or automated RBC exchange (RBCX) could be highly beneficial by replacing "sticky" parasitized RBCs with uninfected, deformable, healthy donor RBCs. Here we suggest use of special Pk-resistant donor RBCs to optimize adjunctive manual ET/RBCX for malaria. "Therapeutically-rational exchange transfusion" (T-REX) is proposed in which Pk-resistant RBCs are transfused (instead of disease-promoting RBCs). Because expression of the Duffy antigen on the surface of human RBCs is essential for parasite invasion, T-REX of Duffy-negative RBCs-also known as Fy(a-b-) RBCs-could replace the majority of the patient's circulating normocytes with Pk invasion-resistant RBCs (in a single procedure lasting about 2 h). When sequestered or non-sequestered iRBCs rupture-in a 24 h Pk asexual life cycle-the released merozoites cannot invade Fy(a-b-) RBCs. When Fy(a-b-) RBC units are scarce (e.g., in Malaysia), clinicians can consider the risks and benefits of transfusing plausibly Pk-resistant RBCs, such as glucose-6-phosphate dehydrogenase deficient (G6PDd) RBCs and Southeast Asian ovalocytes (SAO). Patients typically require a very short recovery time (<1 h) after the procedure. Fy(a-b-) RBCs should have a normal lifespan, while SAO and G6PDd RBCs may have mildly reduced half-lives. Because SAO and G6PDd RBCs come from screened blood donors who are healthy and not anemic, these RBCs have a low-risk for hemolysis and do not need to be removed after the patient recovers from malaria. T-REX could be especially useful if (1) antimalarial medications are not readily available, (2) patients are likely to progress to severe disease, or (3) drug-resistant strains emerge. In conclusion, T-REX is a proposed optimization of manual ET/RBCX that has not yet been utilized but can be considered by physicians to treat Pk malaria patients.
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Affiliation(s)
- Ryan Philip Jajosky
- Joint Program in Transfusion Medicine, Brigham and Women’s Hospital, Harvard Medical School, 630E New Research Building, 77 Avenue Louis Pasteur, Boston, MA 02115, USA; (S.-C.W.)
- Biconcavity Inc., Lilburn, GA 30047, USA
| | - Shang-Chuen Wu
- Joint Program in Transfusion Medicine, Brigham and Women’s Hospital, Harvard Medical School, 630E New Research Building, 77 Avenue Louis Pasteur, Boston, MA 02115, USA; (S.-C.W.)
| | | | - Sean R. Stowell
- Joint Program in Transfusion Medicine, Brigham and Women’s Hospital, Harvard Medical School, 630E New Research Building, 77 Avenue Louis Pasteur, Boston, MA 02115, USA; (S.-C.W.)
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Ashaiba A, Arun A, Prasad KS, Tellis RC. A clinical pilot study for the detection of sphingomyelinase in leptospirosis patient's urine at tertiary care hospital. Heliyon 2023; 9:e21138. [PMID: 37916114 PMCID: PMC10616390 DOI: 10.1016/j.heliyon.2023.e21138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Revised: 10/13/2023] [Accepted: 10/17/2023] [Indexed: 11/03/2023] Open
Abstract
Purpose Leptospirosis is a perplexing mystification for many clinicians. Clinically often underdiagnosed due to lack of a rapid, sensitive, and specific diagnostic test. Currently available diagnostic tests have their own limitations; therefore, monitoring biomarkers that contribute an essential role in pathogenesis is crucial. Herein, a pilot study was conducted to detect the presence of sphingomyelinase in urine of leptospirosis patients. Methods Blood and urine samples were collected from 140 patients having febrile illness. Samples were analyzed through culturing, dark-field microscopy, detecting anti-leptospiral antibodies by MAT, IgM ELISA, Leptocheck-WB and screening for sphingomyelinase using a sphingomyelinase assay kit. Results Out of 140 febrile illness patients, 22.14 % were tested leptospirosis, 33.57 % were dengue, 25 % scrub typhus, 18.57 % malaria and 0.71 % co-infection (dengue-leptospirosis). MAT seropositivity of 19.28 % (27/140) was confirmed with the highest agglutinant determined against serovar Icterohaemorrhagiae RGA followed by Autumnalis, Australis, and Pyrogens. IgM ELISA and Leptocheck-WB positivity was 16.42 % and 13.57 % respectively. Whereas culture and dark-field microscopy showed a sensitivity of 4.28 % and 2.1 %, respectively. Out of 31 confirmed cases of leptospirosis, sphingomyelinase was detected in the urine of 25 (80.64 %) patients, MAT positivity was seen in 87.09 % and culture positivity was seen in 12.90 % of cases. Conclusion Detection of sphingomyelinase in the urine of a leptospirosis patient and its absence in other febrile illnesses like dengue, malaria and scrub typhus establish evidence of secretion of sphingomyelinase in urine during leptospiral infection. Hence, sphingomyelinase could be used as a potential diagnostic biomarker to detect leptospirosis in a non-invasive way.
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Affiliation(s)
- A. Ashaiba
- Department of Microbiology, Yenepoya Medical College, Yenepoya (Deemed to be University), Deralakatte, Mangalore, 575 018, India
- Yenepoya Research Centre, Yenepoya (Deemed to be University), Deralakatte, Mangalore, 575 018, India
| | - A.B. Arun
- Yenepoya Research Centre, Yenepoya (Deemed to be University), Deralakatte, Mangalore, 575 018, India
- Yenepoya Institute of Arts, Science, Commerce and Management (YIASCM), Yenepoya (deemed to be) University, Mangalore, 575 002, India
| | - K. Sudhakara Prasad
- Yenepoya Research Centre, Yenepoya (Deemed to be University), Deralakatte, Mangalore, 575 018, India
- Nanomaterial Research Laboratory, Yenepoya Research Centre Yenepoya (Deemed to be University), Deralakatte, Mangalore, 575 018, India
| | - Rouchelle C. Tellis
- Department of Microbiology, Yenepoya Medical College, Yenepoya (Deemed to be University), Deralakatte, Mangalore, 575 018, India
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Díaz EA, Arroyo G, Sáenz C, Mena L, Barragán V. Leptospirosis in horses: Sentinels for a neglected zoonosis? A systematic review. Vet World 2023; 16:2110-2119. [PMID: 38023277 PMCID: PMC10668546 DOI: 10.14202/vetworld.2023.2110-2119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Accepted: 09/14/2023] [Indexed: 12/01/2023] Open
Abstract
Background and Aim Leptospirosis is considered a neglected tropical zoonosis in low-income countries due to surveillance system limitations and non-specificity of symptoms. Humans become infected through direct contact with carrier animals or indirectly through Leptospira-contaminated environments. Conventionally, equines have been considered an uncommon source of leptospirosis, but recent publications in Latin America suggest that their role in the maintenance and dispersion of the bacteria could be more relevant than expected, as horses are susceptible to a wide variety of zoonotic Leptospira spp. from domestic and wild animals with which they share the environment. A systematic review of the published literature was conducted to compile the available information on Leptospira spp. in Ecuador, with a special focus on equine leptospirosis, to better understand the epidemiology of the bacterium and identify possible knowledge gaps. Materials and Methods A systematic review of the published literature was conducted in PubMed, SciELO and Web of Science databases to compile the available information on Leptospira spp. in Ecuador, with a special focus on equine leptospirosis, to better understand the epidemiology of the bacterium. We used a combination of the terms (Leptospira OR Leptospirosis) AND Ecuador, without restrictions on language or publication date. Results Our literature review reveals that published scientific information is very scarce. Eighteen full-text original scientific articles related to Leptospira or leptospirosis cases in Ecuador were included in the systematic review. Most of the studies reported data obtained from one of the four regions (Coast), and specifically from only one of the 24 Provinces of Ecuador (Manabí), which evidence a large information bias at the geographical level. Furthermore, only the studies focused on humans included clinical signs of leptospirosis and there is only one study that analyzes the presence of Leptospira spp. in water or soil as a risk factor for pathogen transmission. Finally, only one study investigated Leptospira in horses. Conclusion Since sentinel species can provide useful data on infectious diseases when epidemiologic al information is lacking, and horses could be considered excellent sentinel species to reveal circulating serovars, we propose developing a nationwide surveillance system using horses. This cost-effective epidemiological survey method provides a baseline for implementing specific prevention and control programs in Ecuador and neighboring developing countries.
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Affiliation(s)
- Eduardo A. Díaz
- Escuela de Medicina Veterinaria, Colegio de Ciencias de la Salud, Universidad San Francisco de Quito, Diego Robles, Quito, 170157, Ecuador
| | - Gabriela Arroyo
- Escuela de Medicina Veterinaria, Colegio de Ciencias de la Salud, Universidad San Francisco de Quito, Diego Robles, Quito, 170157, Ecuador
| | - Carolina Sáenz
- Hospital de Fauna Silvestre Tueri, Instituto iBIOTROP, Universidad San Francisco de Quito, Diego Robles, Quito, 170157, Ecuador
| | - Luis Mena
- Carrera de Medicina Veterinaria, Facultad de Ciencias Pecuarias, Escuela Superior Politécnica de Chimborazo ESPOCH, Riobamba, 060155, Ecuador
| | - Verónica Barragán
- Colegio de Ciencias Biológicas y Ambientales, Instituto de Microbiología, Universidad San Francisco de Quito, Diego Robles, Quito, 170157, Ecuador
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Arteaga-Troncoso G, Luna-Alvarez M, Hernández-Andrade L, Jiménez-Estrada JM, Sánchez-Cordero V, Botello F, Montes de Oca-Jiménez R, López-Hurtado M, Guerra-Infante FM. Modelling the Unidentified Abortion Burden from Four Infectious Pathogenic Microorganisms ( Leptospira interrogans, Brucella abortus, Brucella ovis, and Chlamydia abortus) in Ewes Based on Artificial Neural Networks Approach: The Epidemiological Basis for a Control Policy. Animals (Basel) 2023; 13:2955. [PMID: 37760355 PMCID: PMC10525082 DOI: 10.3390/ani13182955] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Revised: 08/23/2023] [Accepted: 09/07/2023] [Indexed: 09/29/2023] Open
Abstract
Unidentified abortion, of which leptospirosis, brucellosis, and ovine enzootic abortion are important factors, is the main cause of disease spread between animals and humans in all agricultural systems in most developing countries. Although there are well-defined risk factors for these diseases, these characteristics do not represent the prevalence of the disease in different regions. This study predicts the unidentified abortion burden from multi-microorganisms in ewes based on an artificial neural networks approach and the GLM. METHODS A two-stage cluster survey design was conducted to estimate the seroprevalence of abortifacient microorganisms and to identify putative factors of infectious abortion. RESULTS The overall seroprevalence of Brucella was 70.7%, while Leptospira spp. was 55.2%, C. abortus was 21.9%, and B. ovis was 7.4%. Serological detection with four abortion-causing microorganisms was determined only in 0.87% of sheep sampled. The best GLM is integrated via serological detection of serovar Hardjo and Brucella ovis in animals of the slopes with elevation between 2600 and 2800 meters above sea level from the municipality of Xalatlaco. Other covariates included in the GLM, such as the sheep pen built with materials of metal grids and untreated wood, dirt and concrete floors, bed of straw, and the well water supply were also remained independently associated with infectious abortion. Approximately 80% of those respondents did not wear gloves or masks to prevent the transmission of the abortifacient zoonotic microorganisms. CONCLUSIONS Sensitizing stakeholders on good agricultural practices could improve public health surveillance. Further studies on the effect of animal-human transmission in such a setting is worthwhile to further support the One Health initiative.
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Affiliation(s)
- Gabriel Arteaga-Troncoso
- Department of Cellular Biology and Development, Instituto Nacional de Perinatología, Ciudad de Mexico 11000, Mexico;
- Military School of Health Officers, University of the Mexican Army and Air Force, SEDENA, Ciudad de Mexico 11650, Mexico
| | - Miguel Luna-Alvarez
- Laboratory of Leptospirosis, National Centre for Disciplinary Research in Animal Health, and Food Safety (CENID-SAI, INIFAP), Ciudad de Mexico 05110, Mexico;
| | - Laura Hernández-Andrade
- Laboratory of Bacteriology, National Centre for Disciplinary Research in Animal Health, and Food Safety (CENID-SAI, INIFAP), Ciudad de Mexico 05110, Mexico;
| | | | - Víctor Sánchez-Cordero
- Department of Zoology and National Pavilion of Biodiversity, Institute of Biology, National Autonomous University of Mexico, Ciudad de Mexico 04510, Mexico; (V.S.-C.); (F.B.)
| | - Francisco Botello
- Department of Zoology and National Pavilion of Biodiversity, Institute of Biology, National Autonomous University of Mexico, Ciudad de Mexico 04510, Mexico; (V.S.-C.); (F.B.)
| | | | - Marcela López-Hurtado
- Department of Infectology and Immunology, Instituto Nacional de Perinatología, Ciudad de Mexico 11000, Mexico;
| | - Fernando M. Guerra-Infante
- Department of Infectology and Immunology, Instituto Nacional de Perinatología, Ciudad de Mexico 11000, Mexico;
- Department of Veterinary Microbiology, Escuela Superior de Ciencias Biológicas, IPN, Ciudad de Mexico 11340, Mexico
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Bradley EA, Lockaby G. Leptospirosis and the Environment: A Review and Future Directions. Pathogens 2023; 12:1167. [PMID: 37764975 PMCID: PMC10538202 DOI: 10.3390/pathogens12091167] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Revised: 08/31/2023] [Accepted: 09/13/2023] [Indexed: 09/29/2023] Open
Abstract
Leptospirosis is a zoonotic disease of global importance with significant morbidity and mortality. However, the disease is frequently overlooked and underdiagnosed, leading to uncertainty of the true scale and severity of the disease. A neglected tropical disease, leptospirosis disproportionately impacts disadvantaged socioeconomic communities most vulnerable to outbreaks of zoonotic disease, due to contact with infectious animals and contaminated soils and waters. With growing evidence that Leptospira survives, persists, and reproduces in the environment, this paper reviews the current understanding of the pathogen in the environment and highlights the unknowns that are most important for future study. Through a systematic Boolean review of the literature, our study finds that detailed field-based study of Leptospira prevalence, survival, and transmission in natural waters and soils is lacking from the current literature. This review identified a strong need for assessment of physical characteristics and biogeochemical processes that support long-term viability of Leptospira in the environment followed by epidemiological assessment of the transmission and movement of the same strains of Leptospira in the present wildlife and livestock as the first steps in improving our understanding of the environmental stage of the leptospirosis transmission cycle.
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Affiliation(s)
- Elizabeth A. Bradley
- College of Forestry, Wildlife, and Environment, Auburn University, Auburn, AL 36849, USA
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Sohn-Hausner N, Kmetiuk LB, da Silva EC, Langoni H, Biondo AW. One Health Approach to Leptospirosis: Dogs as Environmental Sentinels for Identification and Monitoring of Human Risk Areas in Southern Brazil. Trop Med Infect Dis 2023; 8:435. [PMID: 37755896 PMCID: PMC10534403 DOI: 10.3390/tropicalmed8090435] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Revised: 08/26/2023] [Accepted: 08/29/2023] [Indexed: 09/28/2023] Open
Abstract
Leptospirosis has been a neglected, widespread and reemerging zoonotic disease of global importance. The One Health holistic approach combining human, animal and environmental health has been important for control and prevention of zoonotic disease. An urban municipality in Southern Brazil with a high prevalence of leptospirosis was selected by convenience, with asymptomatic human and canine individuals serologically tested using MAT against 30 Leptospira spp. serovars. Epidemiological questionnaires were assessed along with the historical national database, with associated risk factors to dog and human seropositivity analyzed using multiple logistic regression. The spatial distribution of retrospective human leptospirosis cases was analyzed using a Kernel map and overlapped dog seropositivity and historical flooding areas, demonstrating that domestic and asymptomatic dogs may be important environmental sentinels for leptospirosis in such urban areas, even in the absence of human seropositivity and low canine seropositivity. Associated risk factors for leptospirosis in dogs and humans according to multiple regression included healthy dogs (p = 0.02, odds ratio-OR = 0.17, confidence interval of 95%CI 0.03-0.71) with indoor access (p = 0.059, OR = 5.12, 95%CI 1.10-37.7) and human males (p = 0.042, OR = 2.44, 95%CI 1.08-6.11) with presenting calf pain (p = 0.005, OR = 3.14, 95%CI 1.46-7. 14), jaundice (p < 0.001, OR = 4.61, 95%CI 2.11-10.10) and renal failure (p = 0.008, OR = 4.49, 95%CI 1.49-13.76). The greater the rain precipitation (above 3 mm of average annual precipitation), the higher the number of leptospirosis cases in humans. In conclusion, dog active serosurvey and rain precipitation should be systematically reported and plotted altogether as a basis for the early detection and monitoring of human risk areas. Such findings may serve as a basis for public health policies in Brazil and other endemic countries worldwide.
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Affiliation(s)
- Natacha Sohn-Hausner
- Department of Cell and Molecular Biology, Federal University of Paraná, Curitiba 80035-050, PR, Brazil
| | - Louise Bach Kmetiuk
- Department of Cell and Molecular Biology, Federal University of Paraná, Curitiba 80035-050, PR, Brazil
| | - Evelyn Cristine da Silva
- Department of Veterinary Hygiene and Public Health, Sao Paulo State University, Botucatu 18618-681, SP, Brazil
| | - Helio Langoni
- Department of Veterinary Hygiene and Public Health, Sao Paulo State University, Botucatu 18618-681, SP, Brazil
| | - Alexander Welker Biondo
- Department of Cell and Molecular Biology, Federal University of Paraná, Curitiba 80035-050, PR, Brazil
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Bansal SB, Ramasubramanian V, Prasad N, Saraf N, Soman R, Makharia G, Varughese S, Sahay M, Deswal V, Jeloka T, Gang S, Sharma A, Rupali P, Shah DS, Jha V, Kotton CN. South Asian Transplant Infectious Disease Guidelines for Solid Organ Transplant Candidates, Recipients, and Donors. Transplantation 2023; 107:1910-1934. [PMID: 36749281 DOI: 10.1097/tp.0000000000004521] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
These guidelines discuss the epidemiology, screening, diagnosis, posttransplant prophylaxis, monitoring, and management of endemic infections in solid organ transplant (SOT) candidates, recipients, and donors in South Asia. The guidelines also provide recommendations for SOT recipients traveling to this region. These guidelines are based on literature review and expert opinion by transplant physicians, surgeons, and infectious diseases specialists, mostly from South Asian countries (India, Pakistan, Bangladesh, Nepal, and Sri Lanka) as well as transplant experts from other countries. These guidelines cover relevant endemic bacterial infections (tuberculosis, leptospirosis, melioidosis, typhoid, scrub typhus), viral infections (hepatitis A, B, C, D, and E; rabies; and the arboviruses including dengue, chikungunya, Zika, Japanese encephalitis), endemic fungal infections (mucormycosis, histoplasmosis, talaromycosis, sporotrichosis), and endemic parasitic infections (malaria, leishmaniasis, toxoplasmosis, cryptosporidiosis, strongyloidiasis, and filariasis) as well as travelers' diarrhea and vaccination for SOT candidates and recipients including travelers visiting this region. These guidelines are intended to be an overview of each topic; more detailed reviews are being published as a special supplement in the Indian Journal of Transplantation .
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Affiliation(s)
- Shyam Bihari Bansal
- Department of Nephrology and Kidney Transplantation, Medanta Institute of Kidney and Urology Medanta-Medicity, Gurgaon, India
| | | | - Narayan Prasad
- Department of Nephrology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India
| | - Neeraj Saraf
- Department of Hepatology, Medanta, Medicity, Gurgaon, India
| | - Rajeev Soman
- Department of Infectious Diseases, Jupiter Hospital, Pune, India
| | - Govind Makharia
- Department of Gastroenterology and Human Nutrition, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, India
| | - Santosh Varughese
- Department of Nephrology, Christian Medical College, Vellore, Tamil Nadu, India
| | - Manisha Sahay
- Department of Nephrology, Osmania Medical College, and Hospital, Hyderabad, India
| | - Vikas Deswal
- Department of Infectious Diseases, Medanta, Medicity, Gurgaon, India
| | - Tarun Jeloka
- Department of Infectious Diseases, Jupiter Hospital, Pune, India
| | - Sishir Gang
- Department of Nephrology, Muljibhai Patel Urological Hospital, Nadiad, Gujrat, India
| | - Ashish Sharma
- Department of Renal Transplant Surgery, PGIMER, Chandigarh, India
| | - Priscilla Rupali
- Department of Infectious Diseases, Christian Medical College, Vellore, Tamil Nadu, India
| | - Dibya Singh Shah
- Department of Nephrology and Transplant Medicine, Institute of Medicine, Tribhuvan University of Teaching hospital, Kathmandu, Nepal
| | | | - Camille Nelson Kotton
- Transplant and Immunocompromised Host Infectious Diseases Division, Massachusetts General Hospital, Harvard Medical School, Boston, MA
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Rathi H, Patel A, Beblawy R, Hassoun A. A Rare Complication of Leptospirosis: Weil's Disease Diagnosed in the United States. Cureus 2023; 15:e43620. [PMID: 37719584 PMCID: PMC10504683 DOI: 10.7759/cureus.43620] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/17/2023] [Indexed: 09/19/2023] Open
Abstract
Leptospirosis is mostly found in tropical regions such as Latin America and Southeast Asia. Here we present a case of leptospirosis in the United States in a 43-year-old African American male who had complications such as sepsis, acute renal failure, hyperbilirubinemia, and transaminitis. Through this case report, we want to highlight the rare occurrence of this infection in the United States. It should be considered high in the list of differential diagnoses for patients traveling to underdeveloped countries and participating in adventure sports. Early recognition and treatment of leptospirosis are essential in decreasing life-threatening complications.
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Affiliation(s)
- Hinal Rathi
- Internal Medicine, University of Alabama at Birmingham, Huntsville, USA
| | - Aesha Patel
- Internal Medicine, University of Alabama at Birmingham, Huntsville, USA
| | - Rafik Beblawy
- Internal Medicine, University of Alabama at Birmingham, Huntsville, USA
| | - Ali Hassoun
- Infectious Disease, Huntsville Hospital, Huntsville, USA
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36
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Chou LF, Yang HY, Hung CC, Tian YC, Hsu SH, Yang CW. Leptospirosis kidney disease: Evolution from acute to chronic kidney disease. Biomed J 2023; 46:100595. [PMID: 37142093 PMCID: PMC10345244 DOI: 10.1016/j.bj.2023.100595] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Revised: 04/17/2023] [Accepted: 04/26/2023] [Indexed: 05/06/2023] Open
Abstract
Leptospirosis is a neglected bacterial disease caused by leptospiral infection that carries a substantial mortality risk in severe cases. Research has shown that acute, chronic, and asymptomatic leptospiral infections are closely linked to acute and chronic kidney disease (CKD) and renal fibrosis. Leptospires affect renal function by infiltrating kidney cells via the renal tubules and interstitium and surviving in the kidney by circumventing the immune system. The most well-known pathogenic molecular mechanism of renal tubular damage caused by leptospiral infection is the direct binding of the bacterial outer membrane protein LipL32 to toll-like receptor-2 expressed in renal tubular epithelial cells (TECs) to induce intracellular inflammatory signaling pathways. These pathways include the production of tumor necrosis factor (TNF)-α and nuclear factor kappa activation, resulting in acute and chronic leptospirosis-related kidney injury. Few studies have investigated the relationship between acute and chronic renal diseases and leptospirosis and further evidence is necessary. In this review, we intend to discuss the roles of acute kidney injury (AKI) to/on CKD in leptospirosis. This study reviews the molecular pathways underlying the pathogenesis of leptospirosis kidney disease, which will assist in concentrating on potential future research directions.
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Affiliation(s)
- Li-Fang Chou
- Kidney Research Center, Chang Gung Memorial Hospital at Linkou, Linkou, Taiwan; Graduate Institute of Biomedical Sciences, Department of Microbiology and Immunology, Department of Biochemistry, Chang Gung University, Taoyuan, Taiwan
| | - Huang-Yu Yang
- Kidney Research Center, Chang Gung Memorial Hospital at Linkou, Linkou, Taiwan; Department of Nephrology, Chang Gung Memorial Hospital at Linkou, Linkou, Taiwan; College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Cheng-Chieh Hung
- Kidney Research Center, Chang Gung Memorial Hospital at Linkou, Linkou, Taiwan; Department of Nephrology, Chang Gung Memorial Hospital at Linkou, Linkou, Taiwan; College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Ya-Chung Tian
- Kidney Research Center, Chang Gung Memorial Hospital at Linkou, Linkou, Taiwan; Department of Nephrology, Chang Gung Memorial Hospital at Linkou, Linkou, Taiwan; College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Shen-Hsing Hsu
- Kidney Research Center, Chang Gung Memorial Hospital at Linkou, Linkou, Taiwan
| | - Chih-Wei Yang
- Kidney Research Center, Chang Gung Memorial Hospital at Linkou, Linkou, Taiwan; Department of Nephrology, Chang Gung Memorial Hospital at Linkou, Linkou, Taiwan; College of Medicine, Chang Gung University, Taoyuan, Taiwan.
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37
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Rathinam SR, Kohila GJ, Gowri PC, Balagiri KS. Leptospiral uveitis- "Transition 'from epidemic to endemic form" difficulties in laboratory confirmations. Indian J Ophthalmol 2023; 71:3031-3038. [PMID: 37530277 PMCID: PMC10538821 DOI: 10.4103/ijo.ijo_61_23] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2023] [Revised: 05/02/2023] [Accepted: 05/29/2023] [Indexed: 08/03/2023] Open
Abstract
Purpose Leptospirosis is a waterborne zoonotic disease that primarily causes systemic illness, followed by uveitis. After heavy flooding in Madurai district, an epidemic outbreak of systemic and ocular leptospirosis occurred in 1994. Our data shows a transition to endemicity after each epidemic. Aim The aim of this study is to report the clinical signs, epidemic outbreaks, and persistent endemicity of leptospiral uveitis, as well as the diagnostic dilemmas associated with it. Methods A retrospective analysis of clinical signs was conducted using medical records of leptospiral uveitis patients over a period of 27 years (1994-2020) in a tertiary care eye hospital. The clinical workup of uveitis included a detailed clinical history, systemic, and ophthalmic examination. Microagglutination tests (MATs) was done at the Centers for Disease Control and Prevention (CDC) in Atlanta and later in our regional laboratory. Serum samples were collected from human systemic leptospirosis cases and a small group of animals in and around Madurai. Results The first epidemic outbreak resulted in 200 seropositive patients. Subsequent epidemic outbreaks occurred in 1997, 1998, 2001, 2005, and 2012, with Madurai experiencing multiple outbreaks. However, the disease remained endemic, with 25-50 patients being observed per year in between the peaks. Ocular examination revealed acute non-granulomatous uveitis (94.9%), pan uveitis (59.8%), vitreous inflammatory reaction (55.4%), retinal vasculitis (29.5%), disc hyperemia (20.9%), and hypopyon. (16.2%). New serovars emerged every year, resulting in decreased sensitivity of the MAT. Over time, the MAT started to miss diagnoses. Conclusion The persistent endemicity of leptospiral uveitis emphasizes the need for accessible diagnostic tests. The low performance of the MAT can be attributable to the use of an older panel. The incorporation of new isolates in the MAT by a national laboratory will improve the accuracy of diagnosis.
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Affiliation(s)
- SR. Rathinam
- Aravind Eye Hospital and PG. Institute of Ophthalmology, Aravind Medical Research Foundation, Madurai, Tamil Nadu, India
| | - G. Jeya Kohila
- Aravind Eye Hospital and PG. Institute of Ophthalmology, Aravind Medical Research Foundation, Madurai, Tamil Nadu, India
| | | | - KS. Balagiri
- Biostatistics, Aravind Medical Research Foundation, Madurai, Tamil Nadu, India
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Dai J, Yao C, Ling H, Li B, Chen R, Shi F. A rare case of severe leptospirosis infection presenting as septic shock in a non-endemic area: a case report and literature review. BMC Infect Dis 2023; 23:503. [PMID: 37525113 PMCID: PMC10391985 DOI: 10.1186/s12879-023-08367-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2023] [Accepted: 06/02/2023] [Indexed: 08/02/2023] Open
Abstract
BACKGROUND Leptospirosis is a zoonosis caused by spirochete "genus" leptospira. The clinical presentations of leptospirosis range from an influenza-like presentation of fever and myalgia, to severe forms. Leptospirosis can potentially lead to a misdiagnosis or delay in diagnosis when clinical similarities exist. CASE PRESENTATION A 63-year-old man presented with fever, shock and thrombocytopenia followed by diffuse pulmonary hemorrhage. Peripheral blood Metagenomic Next-generation Sequencing (mNGS) reported Leptospira interrogans. The patient was treated with piperacillin-tazobactam (TZP) plus doxycycline and improved dramatically after 7 days. CONCLUSION We conclude that leptospirosis can potentially lead to a misdiagnosis or delay in diagnosis. Correctly evaluation of thrombocytopenia in acute febrile illnesses facilitates the differential diagnosis of leptospirosis. mNGS can accurately detect Leptospira DNA during the early stage of the infection.
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Affiliation(s)
- Junjie Dai
- The Second Clinical Medical College, Jinan University, Shenzhen, 518020, Guangdong, China
- Department of Infectious diseases, The Second Clinical Medical College, The First Affiliated Hospital, Shenzhen People's Hospital, Jinan University, Southern University of Science and Technology), Shenzhen, 518020, Guangdong, China
| | - Can Yao
- Department of Infectious diseases, The Second Clinical Medical College, The First Affiliated Hospital, Shenzhen People's Hospital, Jinan University, Southern University of Science and Technology), Shenzhen, 518020, Guangdong, China
| | - Huaxiang Ling
- The Second Clinical Medical College, Jinan University, Shenzhen, 518020, Guangdong, China
| | - Binbin Li
- Department of Infectious diseases, The Second Clinical Medical College, The First Affiliated Hospital, Shenzhen People's Hospital, Jinan University, Southern University of Science and Technology), Shenzhen, 518020, Guangdong, China
| | - Rongchang Chen
- Key Laboratory of Shenzhen Respiratory Diseases, Institute of Shenzhen Respiratory Diseases, The Second Clinical Medical College, The First Affiliated Hospital, Shenzhen People's Hospital, Jinan University, Southern University of Science and Technology), Shenzhen, 518020, Guangdong, China.
| | - Fei Shi
- Department of Infectious diseases, The Second Clinical Medical College, The First Affiliated Hospital, Shenzhen People's Hospital, Jinan University, Southern University of Science and Technology), Shenzhen, 518020, Guangdong, China.
- Key Laboratory of Shenzhen Respiratory Diseases, Institute of Shenzhen Respiratory Diseases, The Second Clinical Medical College, The First Affiliated Hospital, Shenzhen People's Hospital, Jinan University, Southern University of Science and Technology), Shenzhen, 518020, Guangdong, China.
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Sohn-Hausner N, Kmetiuk LB, Biondo AW. One Health Approach to Leptospirosis: Human-Dog Seroprevalence Associated to Socioeconomic and Environmental Risk Factors in Brazil over a 20-Year Period (2001-2020). Trop Med Infect Dis 2023; 8:356. [PMID: 37505652 PMCID: PMC10383893 DOI: 10.3390/tropicalmed8070356] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2023] [Revised: 06/22/2023] [Accepted: 06/26/2023] [Indexed: 07/29/2023] Open
Abstract
Despite being considered a neglected, re-emerging and the most widespread zoonotic disease worldwide, human-dog leptospirosis has not been subjected to One Health approach, and neither were its socioeconomic and environmental risk factors, as well as concomitant spatial analysis over time. Accordingly, notified human leptospirosis cases, incidence rate and urban hotspot areas, in addition to a systematic review of dog leptospirosis cases, were performed nationwide from 2001 to 2020 in Brazil. Data on Gross Domestic Product (GDP), flooding and study areas were also assessed and tabulated. Human-dog leptospirosis cases were simultaneously mapped with overlapping flooding areas, along with the main circulant serovars. Comparative outcome has shown that dogs may be exposed similarly to humans, becoming important sentinels and/or reservoirs for human leptospirosis in larger geographic areas. Moreover, the study herein can help in the decision and implementation of public policies in Brazil and may serve as a model for other tropical countries worldwide.
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Affiliation(s)
- Natacha Sohn-Hausner
- Department of Cell and Molecular Biology, Federal University of Paraná, Curitiba 80035-050, PR, Brazil
| | - Louise Bach Kmetiuk
- Department of Cell and Molecular Biology, Federal University of Paraná, Curitiba 80035-050, PR, Brazil
| | - Alexander Welker Biondo
- Department of Cell and Molecular Biology, Federal University of Paraná, Curitiba 80035-050, PR, Brazil
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40
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Teles AJ, Bohm BC, Silva SCM, Bruhn FRP. Socio-geographical factors and vulnerability to leptospirosis in South Brazil. BMC Public Health 2023; 23:1311. [PMID: 37420253 PMCID: PMC10329394 DOI: 10.1186/s12889-023-16094-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Accepted: 06/09/2023] [Indexed: 07/09/2023] Open
Abstract
BACKGROUND Leptospirosis, caused by the Leptospira bacteria, is an acute infectious disease that is mainly transmitted by exposure to contaminated soil or water, thereby presenting a wide range of subsequent clinical conditions. This study aimed to assess the distribution of cases and deaths from leptospirosis and its association with social vulnerability in the state of Rio Grande do Sul, Brazil, between 2010 and 2019. METHODS The lethality rates and incidence of leptospirosis and their association with gender, age, education, and skin color were analyzed using chi-square tests. The spatial relationship between the environmental determinants, social vulnerability, and the incidence rate of leptospirosis in the different municipalities of Rio Grande do Sul was analyzed through spatial regression analysis. RESULTS During the study period, a total of 4,760 cases of leptospirosis, along with 238 deaths, were confirmed. The mean incidence rate was 4.06 cases/100,000 inhabitants, while the mean fatality rate was 5%. Although the entire population was susceptible, white-colored individuals, males, people of the working-age group, along with less-educated individuals, were more affected by the disease. Lethality was higher in people with dark skin, and the prime risk factor associated with death was the direct contact of the patients with rodents, sewage, and garbage. The social vulnerability was positively associated with the incidence of leptospirosis in the Rio Grande do Sul, especially in municipalities located in the center of the state. CONCLUSIONS It is evident that the incidence of the disease is significantly related to the vulnerability of the population. The use of the health vulnerability index showed great relevance in the evaluation of leptospirosis cases and can be used further as a tool to help municipalities identify disease-prone areas for intervention and resource allocation.
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Affiliation(s)
| | - Bianca Conrad Bohm
- Postgraduate Program in Veterinary, Federal University of Pelotas, Capão Do Leão, Rio Grande Do Sul, Brazil
| | - Suellen Caroline M Silva
- Postgraduate Program in Veterinary, Federal University of Pelotas, Capão Do Leão, Rio Grande Do Sul, Brazil.
| | - Fábio Raphael P Bruhn
- Department of Preventive Veterinary Medicine, Federal University of Pelotas, Capão Do Leão, Rio Grande Do Sul, Brazil
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Govindan S, Fernando E, Kurien AA. Interesting Histology in Tropical Acute Kidney Injury. Kidney Int Rep 2023; 8:1272-1274. [PMID: 37284674 PMCID: PMC10239777 DOI: 10.1016/j.ekir.2023.02.1095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2023] [Accepted: 02/14/2023] [Indexed: 06/08/2023] Open
Affiliation(s)
| | - Edwin Fernando
- Government Stanley Medical College, Chennai, Tamil Nadu, India
| | - Anila Abraham Kurien
- Renopathology, Center for Renal and Urological Pathology, Chennai, Tamil Nadu, India
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Zeng Z, Chen H, Xu J, Zhang H, Xu C, Fan L, Chen S, Chen K, Yang Z, Wei Y. Characteristics of leptospirosis cases, prevention and control managements 1955-2020, Guangzhou, China. One Health 2023; 16:100541. [PMID: 37363250 PMCID: PMC10288099 DOI: 10.1016/j.onehlt.2023.100541] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Revised: 03/25/2023] [Accepted: 04/11/2023] [Indexed: 06/28/2023] Open
Abstract
Background Leptospirosis, which is an easily overlooked zoonotic disease, was once widespread in Guangzhou, China. However, due to the implementation of control measures, the number of cases is decreasing. Based on the characteristics of leptospirosis cases in Guangzhou, China, between 1955 and 2020, we describe the changes and achievements in prevention and control management strategies over that period. Methods The development of the leptospirosis control system in Guangzhou occurred over three periods: Period I: 1955-1978; Period II: 1979-2000; and Period III: 2001-2020. Data about leptospirosis cases were obtained from the Guangzhou Center for Disease Control and Prevention (CDC) and national health departments. The demographic characteristics of leptospirosis patients were analyzed using descriptive statistics. Results During Period I, only the Guangzhou CDC and medical institutions at every level participated in the leptospirosis control system. During Period II, additional types of organizations, including local CDCs, countryside committees, community committees, and the Patriotic Health Movement Commission, were involved in the control system. Additionally, strong links were established between different organizations. After entering Period III, an increasing number of departments joined the cooperation, and the management of human patients was expanded to include the management of host animals, and thus, the prevalence of leptospirosis was monitored and controlled in various ways. The leptospirosis control system in Guangzhou has been further improved. From 1955 to 2020, a total of 2501 leptospirosis cases were recorded in Guangzhou, and the number of cases decreased significantly over time, from 1608 (Period I) to 744 (Period II) and then to 149 (Period III). Conclusion The improvements of the leptospirosis control system in Guangzhou that occurred over decades were associated with a marked decrease in the number of leptospirosis cases. Guangzhou's experience can provide guidance for other countries or cities around the world facing similar challenges.
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Affiliation(s)
- Ziyi Zeng
- Guangzhou Center for Disease Control and Prevention, Guangzhou, China
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, Guangzhou, China
| | - Haiyan Chen
- Guangzhou Center for Disease Control and Prevention, Guangzhou, China
- Institute of Public Health, Guangzhou Medical University, Guangzhou, China
| | - Jianmin Xu
- Guangzhou Center for Disease Control and Prevention, Guangzhou, China
- Institute of Public Health, Guangzhou Medical University, Guangzhou, China
| | - Hao Zhang
- Guangzhou Center for Disease Control and Prevention, Guangzhou, China
- Institute of Public Health, Guangzhou Medical University, Guangzhou, China
| | - Conghui Xu
- Guangzhou Center for Disease Control and Prevention, Guangzhou, China
- Institute of Public Health, Guangzhou Medical University, Guangzhou, China
| | - Lirui Fan
- Guangzhou Center for Disease Control and Prevention, Guangzhou, China
- Institute of Public Health, Guangzhou Medical University, Guangzhou, China
| | - Shouyi Chen
- Guangzhou Center for Disease Control and Prevention, Guangzhou, China
- Institute of Public Health, Guangzhou Medical University, Guangzhou, China
| | - Kuncai Chen
- Guangzhou Center for Disease Control and Prevention, Guangzhou, China
- Institute of Public Health, Guangzhou Medical University, Guangzhou, China
| | - Zhicong Yang
- Guangzhou Center for Disease Control and Prevention, Guangzhou, China
- Institute of Public Health, Guangzhou Medical University, Guangzhou, China
| | - Yuehong Wei
- Guangzhou Center for Disease Control and Prevention, Guangzhou, China
- Institute of Public Health, Guangzhou Medical University, Guangzhou, China
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Ab Kadir MA, Abdul Manaf R, Mokhtar SA, Ismail LI. Spatio-Temporal Analysis of Leptospirosis Hotspot Areas and Its Association With Hydroclimatic Factors in Selangor, Malaysia: Protocol for an Ecological Cross-sectional Study. JMIR Res Protoc 2023; 12:e43712. [PMID: 37184897 DOI: 10.2196/43712] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2022] [Revised: 04/27/2023] [Accepted: 04/30/2023] [Indexed: 05/16/2023] Open
Abstract
BACKGROUND Leptospirosis is considered a neglected zoonotic disease in temperate regions but an endemic disease in countries with tropical climates such as South America, Southern Asia, and Southeast Asia. There has been an increase in leptospirosis incidence in Malaysia from 1.45 to 25.94 cases per 100,000 population between 2005 and 2014. With increasing incidence in Selangor, Malaysia, and frequent climate change dynamics, a study on the disease hotspot areas and their association with the hydroclimatic factors would further enhance disease surveillance and public health interventions. OBJECTIVE This study aims to examine the association between the spatio-temporal distribution of leptospirosis hotspot areas from 2011 to 2019 with the hydroclimatic factors in Selangor using the geographical information system and remote sensing techniques to develop a leptospirosis hotspot predictive model. METHODS This will be an ecological cross-sectional study with geographical information system and remote sensing mapping and analysis concerning leptospirosis using secondary data. Leptospirosis cases in Selangor from January 2011 to December 2019 shall be obtained from the Selangor State Health Department. Laboratory-confirmed cases with data on the possible source of infection would be identified and georeferenced according to their longitude and latitudes. Topographic data consisting of subdistrict boundaries and the distribution of rivers in Selangor will be obtained from the Department of Survey and Mapping. The ArcGIS Pro software will be used to evaluate the clustering of the cases and mapped using the Getis-Ord Gi* tool. The satellite images for rainfall and land surface temperature will be acquired from the Giovanni National Aeronautics and Space Administration EarthData website and processed to obtain the average monthly values in millimeters and degrees Celsius. Meanwhile, the average monthly river hydrometric levels will be obtained from the Department of Drainage and Irrigation. Data are then inputted as thematic layers and in the ArcGIS software for further analysis. The artificial neural network analysis in artificial intelligence Phyton software will then be used to obtain the leptospirosis hotspot predictive model. RESULTS This research was funded as of November 2022. Data collection, processing, and analysis commenced in December 2022, and the results of the study are expected to be published by the end of 2024. The leptospirosis distribution and clusters may be significantly associated with the hydroclimatic factors of rainfall, land surface temperature, and the river hydrometric level. CONCLUSIONS This study will explore the associations of leptospirosis hotspot areas with the hydroclimatic factors in Selangor and subsequently the development of a leptospirosis predictive model. The constructed predictive model could potentially be used to design and enhance public health initiatives for disease prevention. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) PRR1-10.2196/43712.
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Affiliation(s)
- Muhammad Akram Ab Kadir
- Department of Community Health, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Selangor, Malaysia
| | - Rosliza Abdul Manaf
- Department of Community Health, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Selangor, Malaysia
| | - Siti Aisah Mokhtar
- Department of Community Health, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Selangor, Malaysia
| | - Luthffi Idzhar Ismail
- Department of Electrical & Electronic Engineering, Faculty of Engineering, Universiti Putra Malaysia, Selangor, Malaysia
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Freitas AR, Delai RR, Kmetiuk LB, Gaspar RC, da Silva EC, Martini R, Biondo LM, Giuffrida R, de Barros Filho IR, Santarém VA, Langoni H, Pimpão CT, Biondo AW. Spatial Owner-Dog Seroprevalence of Leptospira spp. Antibodies in Oceanic Islands and Costal Mainland of Southern Brazil. Trop Med Infect Dis 2023; 8:tropicalmed8040229. [PMID: 37104354 PMCID: PMC10141485 DOI: 10.3390/tropicalmed8040229] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Revised: 04/12/2023] [Accepted: 04/14/2023] [Indexed: 04/28/2023] Open
Abstract
Leptospirosis has been described as a disease neglected worldwide. Affecting humans and animals, the disease is often related to poor environmental conditions such as lack of sanitation and presence of synanthropic rodents. Despite being considered as a One Health issue, no study has focused on comparing owner-dog seroprevalence between islands and seashore mainland. Accordingly, the present study assessed anti-Leptospira spp. antibodies by applying microscopic agglutination test (MAT) methods to Leptospira and assessing associated risk factors via univariate and multivariate logistic regression analysis of owners and their dogs in islands and seashore mainland of southern Brazil. No anti-Leptospira spp. Seropositivity was found in 330 owner serum samples, while dogs presented an overall seroprevalence of 5.9%. All seropositive dogs reacted to serogroups of Leptospira interrogans, including 66.7% of Pyrogenes, 44.4% Canicola, 22.2% Icterohaemorrhagiae, 16.7% Australis; six reacted to more than one serogroup. No association was found among seropositivity and epidemiological variables, except that neighborhood dogs were less likely to be seropositive. Although no seropositivity was observed in owners, seropositivity in dogs had the potential to indicate such species as being sentinels for environmental exposure and potential human risk of infection.
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Affiliation(s)
- Aaronson Ramathan Freitas
- Department of Veterinary Medicine, Federal University of Paraná State, Curitiba 80035-050, PR, Brazil
| | - Ruana Renostro Delai
- Department of Animal Science, School of Life Sciences, Pontifical Catholic University of Paraná, Curitiba 80230-130, PR, Brazil
| | - Louise Bach Kmetiuk
- Department of Veterinary Medicine, Federal University of Paraná State, Curitiba 80035-050, PR, Brazil
| | - Raquel Cuba Gaspar
- Department of Animal Production and Preventive Veterinary Medicine, School of Veterinary Medicine and Animals Science, São Paulo State University, Botucatu 18618-681, SP, Brazil
| | - Evelyn Cristine da Silva
- Institute of Biotechnology, São Paulo State University (UNESP), Tecomarias Avenue, Botucatu 18607-440, SP, Brazil
| | - Rafaella Martini
- Department of Physiology, Federal University of Paraná State, Curitiba 81530-000, PR, Brazil
| | | | - Rogério Giuffrida
- Laboratory of Veterinary Parasitology, Veterinary Teaching Hospital, University of Western São Paulo, São Paulo 19001-970, SP, Brazil
| | | | - Vamilton Alvares Santarém
- Laboratory of Veterinary Parasitology, Veterinary Teaching Hospital, University of Western São Paulo, São Paulo 19001-970, SP, Brazil
| | - Helio Langoni
- Department of Animal Production and Preventive Veterinary Medicine, School of Veterinary Medicine and Animals Science, São Paulo State University, Botucatu 18618-681, SP, Brazil
| | - Cláudia Turra Pimpão
- Department of Animal Science, School of Life Sciences, Pontifical Catholic University of Paraná, Curitiba 80230-130, PR, Brazil
| | - Alexander Welker Biondo
- Department of Veterinary Medicine, Federal University of Paraná State, Curitiba 80035-050, PR, Brazil
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Calvopiña M, Romero-Alvarez D, Vasconez E, Valverde-Muñoz G, Trueba G, Garcia-Bereguiain MA, Orlando SA. Leptospirosis in Ecuador: Current Status and Future Prospects. Trop Med Infect Dis 2023; 8:tropicalmed8040202. [PMID: 37104328 PMCID: PMC10141158 DOI: 10.3390/tropicalmed8040202] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2023] [Revised: 03/09/2023] [Accepted: 03/14/2023] [Indexed: 04/28/2023] Open
Abstract
The location of Ecuador-an equatorial nation-favors the multiplication and dispersal of the Leptospira genus both on the Pacific Coast and in the Amazon tropical ecoregions. Nevertheless, leptospirosis epidemiology has not been fully addressed, even though the disease has been recognized as a significant public health problem in the country. The purpose of this literature review is to update knowledge on the epidemiology and geographical distribution of Leptospira spp. and leptospirosis in Ecuador to target future research and develop a national control strategy. A retrospective literature search using five international, regional, and national databases on Leptospira and leptospirosis including humans, animals, and environmental isolations of the bacteria and the disease incidence in Ecuador published between 1919 and 2022 (103 years) with no restriction on language or publication date was performed. We found and analyzed 47 publications including 22 of humans, 19 of animals, and two of the environments; three of these covered more than one of these topics, and one covered all three (i.e., One Health). Most (60%) of the studies were conducted in the Coastal ecoregion. Twenty-four (51%) were published in international journals, and 27 (57%) were in Spanish. A total of 7342 human and 6314 other animal cases were studied. Leptospirosis was a frequent cause of acute undifferentiated febrile illness in the Coast and Amazon and was associated with rainfall. All three major clusters of Leptospira-pathogenic, intermediate, and saprophytic-were identified from both healthy and febrile humans, the environment, and animals; moreover, nine species and 29 serovars were recorded over the three Ecuadorian ecoregions. Leptospira infections were diagnosed in livestock, companion, and wild animals from the Amazon and the Coast regions along with sea lions from the Galápagos Islands. Microscopic-agglutination test was the diagnostic tool most widely used. Three reviews covering national data on outpatients and inpatients determined the varied annual incidence and mortality rate, with males being more commonly affected. No human cases have been reported in the Galápagos Islands. Genomic sequences of three pathogenic Leptospira were reported. No studies on clinical ground, antibiotic resistance, or treatment were reported, nor were control programs or clinical-practice guidelines found. The published literature demonstrated that leptospirosis was and still is an endemic disease with active transmission in the four geoclimatic regions of Ecuador including the Galápagos Islands. Animal infections, distributed in mainland and insular Ecuador, pose a significant health risk for humans. Nationwide epidemiological surveys-encouraging more research on the fauna and environment with appropriate sampling design on risk factors for human and animal leptospirosis, Leptospira genotyping, increased laboratory capability, and readily available official data-are required to improve our understanding of transmission patterns and to develop effective national intervention strategies with the intention of applying One Health approaches.
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Affiliation(s)
- Manuel Calvopiña
- One Health Research Group, Facultad de Medicina, Universidad de Las Américas (UDLA), Quito 170124, Ecuador
| | - Daniel Romero-Alvarez
- One Health Research Group, Facultad de Medicina, Universidad de Las Américas (UDLA), Quito 170124, Ecuador
- Biodiversity Institute and Department of Ecology and Evolutionary Biology, University of Kansas, Lawrence, KS 66045, USA
| | - Eduardo Vasconez
- One Health Research Group, Facultad de Medicina, Universidad de Las Américas (UDLA), Quito 170124, Ecuador
| | - Gabriela Valverde-Muñoz
- Proyecto de Fortalecimiento de la Atención Integral de Personas con Discapacidad, Ministerio de Salud Pública, Quito 170702, Ecuador
| | - Gabriel Trueba
- Institute of Microbiology, Universidad San Francisco de Quito, Quito 170901, Ecuador
| | - Miguel Angel Garcia-Bereguiain
- One Health Research Group, Facultad de Medicina, Universidad de Las Américas (UDLA), Quito 170124, Ecuador
- Universidad Latinoamerica de Costa Rica, San Jose 11501, Costa Rica
| | - Solon Alberto Orlando
- Instituto Nacional de Investigación en Salud Pública INSPI, Quito 3961, Ecuador
- Universidad Espíritu Santo, Guayaquil 092301, Ecuador
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Galdino GS, de Sandes-Freitas TV, de Andrade LGM, Adamian CMC, Meneses GC, da Silva Junior GB, de Francesco Daher E. Development and validation of a simple machine learning tool to predict mortality in leptospirosis. Sci Rep 2023; 13:4506. [PMID: 36934135 PMCID: PMC10024714 DOI: 10.1038/s41598-023-31707-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Accepted: 03/16/2023] [Indexed: 03/20/2023] Open
Abstract
Predicting risk factors for death in leptospirosis is challenging, and identifying high-risk patients is crucial as it might expedite the start of life-saving supportive care. Admission data of 295 leptospirosis patients were enrolled, and a machine-learning approach was used to fit models in a derivation cohort. The comparison of accuracy metrics was performed with two previous models-SPIRO score and quick SOFA score. A Lasso regression analysis was the selected model, demonstrating the best accuracy to predict mortality in leptospirosis [area under the curve (AUC-ROC) = 0.776]. A score-based prediction was carried out with the coefficients of this model and named LeptoScore. Then, to simplify the predictive tool, a new score was built by attributing points to the predictors with importance values higher than 1. The simplified score, named QuickLepto, has five variables (age > 40 years; lethargy; pulmonary symptom; mean arterial pressure < 80 mmHg and hematocrit < 30%) and good predictive accuracy (AUC-ROC = 0.788). LeptoScore and QuickLepto had better accuracy to predict mortality in patients with leptospirosis when compared to SPIRO score (AUC-ROC = 0.500) and quick SOFA score (AUC-ROC = 0.782). The main result is a new scoring system, the QuickLepto, that is a simple and useful tool to predict death in leptospirosis patients at hospital admission.
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Affiliation(s)
- Gabriela Studart Galdino
- Medical Sciences Postgraduate Program, Federal University of Ceará, Rua Silva Jatahy 1000 ap 600, Fortaleza, Ceará, 60165-070, Brazil.
- Hospital Universitário Walter Cantídio, Federal University of Ceará, Fortaleza, Ceará, Brazil.
| | - Tainá Veras de Sandes-Freitas
- Medical Sciences Postgraduate Program, Federal University of Ceará, Rua Silva Jatahy 1000 ap 600, Fortaleza, Ceará, 60165-070, Brazil
- Hospital Universitário Walter Cantídio, Federal University of Ceará, Fortaleza, Ceará, Brazil
- Hospital Geral de Fortaleza, Fortaleza, Ceara, Brazil
| | | | | | - Gdayllon Cavalcante Meneses
- Medical Sciences Postgraduate Program, Federal University of Ceará, Rua Silva Jatahy 1000 ap 600, Fortaleza, Ceará, 60165-070, Brazil
| | - Geraldo Bezerra da Silva Junior
- Medical Sciences Postgraduate Program, Federal University of Ceará, Rua Silva Jatahy 1000 ap 600, Fortaleza, Ceará, 60165-070, Brazil
- Hospital Universitário Walter Cantídio, Federal University of Ceará, Fortaleza, Ceará, Brazil
- School of Medicine, Medical Sciences and Public Health Postgraduate Programs, University of Fortaleza, Fortaleza, Ceará, Brazil
| | - Elizabeth de Francesco Daher
- Medical Sciences Postgraduate Program, Federal University of Ceará, Rua Silva Jatahy 1000 ap 600, Fortaleza, Ceará, 60165-070, Brazil
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Cataldo C, Bellenghi M, Masella R, Busani L. One Health challenges and actions: Integration of gender considerations to reduce risks at the human-animal-environmental interface. One Health 2023; 16:100530. [PMID: 37089529 PMCID: PMC10114509 DOI: 10.1016/j.onehlt.2023.100530] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Revised: 03/23/2023] [Accepted: 03/26/2023] [Indexed: 04/03/2023] Open
Abstract
The human-animal-environment interface is where the emergence of new infectious diseases can occur as a result of many complex reasons, including its alteration due to intensive farming and agriculture, increased human encroachment into wildlife habitats, international travel networks, and urbanization. The One Health approach to zoonoses is a holistic approach that considers environmental sustainability, animal health, and human health together. Gender-specific social and domestic roles can modulate (increase or decrease) an individual's risk of exposure to various hazards, including infectious diseases and zoonoses. The two scenarios presented here, one on avian influenza and the other on leptospirosis, clearly highlight the influence of gender, demonstrating that women's roles at the human-animal-environment interface are not the same as men's. Integrating the gender aspect into cross-sectoral interventions defined according to the One Health perspective could help reduce the risks of exposure to infections for humans and animals and the possible consequent economic losses. We suggest supplementing the One Health perspective with a gender analysis to study the influence of social norms, activities and risk behavior on exposure to infections, chemical pollution and the consequences of climate change.
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Urban flooding and risk of leptospirosis; Pakistan on the verge of a new disaster: A call for action. Int J Hyg Environ Health 2023; 248:114081. [PMID: 36463767 DOI: 10.1016/j.ijheh.2022.114081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2022] [Revised: 11/15/2022] [Accepted: 11/24/2022] [Indexed: 12/03/2022]
Abstract
Leptospirosis is an overlooked zoonotic and waterborne disease that is emerging as a global public threat due to morbidity and mortality observed in both animals and humans. The outbreaks are typically related to floods and hurricanes following monsoon rains, during which Leptospiras are washed off in contaminated soil and often settle in water bodies. Wildlife trapping for scientific purposes, industrial animal employment, water-intensive crop farming, sewage work, and open-water swimming are one of the major risk factors contributing to the rapid spread of disease. Occasionally, outbreaks are linked to higher-than-average precipitation and exposure to contaminated floodwaters that may have contributed to a sudden spike in leptospirosis cases in New Caledonia, Fiji, Vanuatu, and Tanzania. This amplifies the risk of leptospirosis in Pakistan and other nations with urban floods. Therefore, it is of paramount importance to address this health emergency considering the recent surge in leptospirosis cases.
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Biochemical characterization, substrate and stereoselectivity of an outer surface putative α/β hydrolase from the pathogenic Leptospira. Int J Biol Macromol 2023; 229:803-813. [PMID: 36587638 DOI: 10.1016/j.ijbiomac.2022.12.283] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Revised: 12/13/2022] [Accepted: 12/25/2022] [Indexed: 12/30/2022]
Abstract
The genome of pathogenic leptospira encodes a plethora of outer surface and secretory proteins. The outer surface or secreted α/β hydrolases in a few pathogenic organisms are crucial virulent factors. They hydrolyze host immune factors and pathogen's immune-activating ligands, which help pathogens to evade the host's innate immunity. In this study, we report biochemical characterizations, substrate and stereoselectivity of one of the leptospiral outer surface putative α/β hydrolases, IQB77_09235 (LABH). Purified LABH displayed better kinetic parameters towards small water-soluble esters such as p-nitrophenyl acetate and p-nitrophenyl butyrate. The LABH exhibited moderate thermostability and displayed a pH optimum of 8.5. Remarkably, a phylogenetic study suggested that LABH does not cluster with other characterized bacterial esterases or lipases. Protein structural modeling revealed that some structural features are closely associated with Staphylococcus hycus lipase (SAH), a triacylglycerol hydrolase. The hydrolytic activity of the protein was found to be inhibited by a lipase inhibitor, orlistat. Biocatalytic application of the protein in the kinetic resolution of racemic 1-phenylethyl acetate reveals excellent enantioselectivity (E > 500) in the production of (R)-1-phenylethanol, a valuable chiral synthon in several industries. To our knowledge, this is the first detailed characterization of outer surface α/β hydrolases from leptospiral spp.
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Mazzotta E, Bellinati L, Bertasio C, Boniotti MB, Lucchese L, Ceglie L, Martignago F, Leopardi S, Natale A. Synanthropic and Wild Animals as Sentinels of Zoonotic Agents: A Study of Leptospira Genotypes Circulating in Northeastern Italy. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:3783. [PMID: 36900793 PMCID: PMC10000914 DOI: 10.3390/ijerph20053783] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/29/2022] [Revised: 02/08/2023] [Accepted: 02/18/2023] [Indexed: 06/18/2023]
Abstract
Leptospirosis is an infectious disease widely reported in veterinary practice and a worldwide zoonosis. In Northeastern Italy, different serogroups and genotypes of Leptospira have been described in ill dogs, the most commonly detected being Icterohaemorragiae (ICT) ST 17, Australis (AUS) ST 24 and ST 198, Pomona (POM) ST 117 and ST 289, and Sejroe (SEJ) ST 155. However, there is little information available on the environmental exposure to Leptospira of wild and synanthropic animals. The aim of this study was to identify the circulating genotypes in potential reservoirs to fill this gap of knowledge. Between 2015 and 2022, 681 animal carcasses collected by the Public Veterinary Service were analyzed for Leptospira with a real-time PCR-based screening test, while positive samples were genotyped by multi-locus sequence typing analysis. To carry out our study, we tested 330 hedgehogs, 105 red foxes, 108 Norway rats, 79 mice, 22 coypus, 10 bank voles, 13 grey wolves, 5 common shrews and 9 greater mouse-eared bats. Five sequence types (STs) common in dogs were also found in wild animals: ST 24, ST 198, ST 17 and ST 155 in hedgehogs, ST 17 and ST 24 in foxes, ST 17 in rats, ST 17 and ST 155 in mice, and ST 117 in a wolf. In addition, to the best of the authors' knowledge, this is the first Italian report of SEJ ST 197 in a bank vole. Furthermore, this study described a previous survey conducted in 2009 on coypus (30 animals from the province of Trento and 41 from the province of Padua), referring to a serological positivity (L. Bratislava) without any molecular detection of Leptospira. This study on Leptospira in synanthropic and wild animals highlighted the importance of increasing our epidemiological knowledge of leptospirosis and its zoonotic risks.
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Affiliation(s)
- Elisa Mazzotta
- Istituto Zooprofilattico Sperimentale delle Venezie, 35020 Legnaro, Italy
| | - Laura Bellinati
- Istituto Zooprofilattico Sperimentale delle Venezie, 35020 Legnaro, Italy
| | - Cristina Bertasio
- National Reference Centre for Animal Leptospirosis, Istituto Zooprofilattico Sperimentale della Lombardia ed Emilia Romagna “Bruno Ubertini”, 25121 Brescia, Italy
| | - Maria Beatrice Boniotti
- National Reference Centre for Animal Leptospirosis, Istituto Zooprofilattico Sperimentale della Lombardia ed Emilia Romagna “Bruno Ubertini”, 25121 Brescia, Italy
| | - Laura Lucchese
- Istituto Zooprofilattico Sperimentale delle Venezie, 35020 Legnaro, Italy
| | - Letizia Ceglie
- Istituto Zooprofilattico Sperimentale delle Venezie, 35020 Legnaro, Italy
| | | | - Stefania Leopardi
- Istituto Zooprofilattico Sperimentale delle Venezie, 35020 Legnaro, Italy
| | - Alda Natale
- Istituto Zooprofilattico Sperimentale delle Venezie, 35020 Legnaro, Italy
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