1
|
Pattiyakumbura TT, Pathirathne SH, Muthugala MARV. Hantavirus infection in central Sri Lanka - an unusual clinical presentation: a case report. Access Microbiol 2024; 6:000554.v3. [PMID: 38737805 PMCID: PMC11083485 DOI: 10.1099/acmi.0.000554.v3] [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: 01/07/2023] [Accepted: 01/09/2024] [Indexed: 05/14/2024] Open
Abstract
Hantavirus infections are emerging zoonoses. In Asia, the hantavirus commonly manifests as haemorrhagic fever with renal syndrome (HFRS), apparent with fever, thrombocytopenia and acute kidney injury. There are a few cases with the atypical clinical course with cardiopulmonary symptoms in Asia including Sri Lanka. Here, we report a case of hantavirus infection with an atypical cardiopulmonary syndrome-like illness with serological evidence of the Puumala/Puumala-like virus.
Collapse
|
2
|
Uduwawala H, Manamperi A, Gunaratna GPS, Karunanayake L, Ceruti A, Abd El Wahed A, Fernando L, Premaratna R, Hapugoda M. Detection of pathogenic Leptospira with rapid extraction followed by recombinase polymerase amplification (RPA) and quantitative polymerase chain reaction (qPCR) assay-A comprehensive study from Sri Lanka. PLoS One 2024; 19:e0295287. [PMID: 38489285 PMCID: PMC10942058 DOI: 10.1371/journal.pone.0295287] [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: 08/03/2023] [Accepted: 11/16/2023] [Indexed: 03/17/2024] Open
Abstract
Leptospirosis is the most widespread zoonosis in the world. The disease is more prevalent in tropical regions where the majority of developing countries are located. Leptospirosis is considered a protean manifestation zoonosis with severity of the disease ranging from a mild febrile illness to a severe and life-threatening illness. Clinical symptoms of leptospirosis overlap with other tropical febrile illnesses. Early, rapid, and definitive diagnosis is important for effective patient management. Since Polymerase Chain Reaction (PCR)-based assays are not readily available in most clinical settings, there is a need for an affordable, simple, and rapid diagnostic test. Quantitative PCR (qPCR) and Recombinase Polymerase Amplification (RPA) were implemented at the Faculty of Medicine, University of Kelaniya, and a prospective study to evaluate RPA for diagnosis of acute phase of leptospirosis was conducted. Results indicate that RPA and qPCR were positive in 81% (98/121) of the total positive and acute clinical samples. Of the 81 positive MAT confirmed patients 60 (74%) and 53 (65%) were positive with qPCR and RPA respectively. Retrospective evaluation revealed a high diagnostic accuracy (sensitivity-70% and specificity-87%) of RPA compared to MAT as the reference gold standard. Results further suggest that there is no significant difference between the two assays, qPCR and RPA-SwiftX (P = 0.40). Laboratory procedures for the extraction and detection by qPCR in the laboratory have been optimized to obtain results within 6 hours. However, the RPA-SwiftX method under field conditions took 35 minutes. The RPA-SwiftX method could replace the qPCR which shows similar sensitivity and specificity. Therefore, RPA established under the current study presents a powerful tool for the early and rapid diagnosis of leptospirosis at point-of-care.
Collapse
Affiliation(s)
- Hansi Uduwawala
- Molecular Medicine Unit, Faculty of Medicine, University of Kelaniya, Ragama, Sri Lanka
| | - Aresha Manamperi
- Molecular Medicine Unit, Faculty of Medicine, University of Kelaniya, Ragama, Sri Lanka
| | - Gayana P. S. Gunaratna
- Department of Medical Microbiology, Faculty of Medicine, University of Kelaniya, Ragama, Sri Lanka
| | - Lilani Karunanayake
- National Reference Laboratory for Leptospirosis, Medical Research Institute, Colombo, Sri Lanka
| | - Arianna Ceruti
- Institute of Animal Hygiene and Veterinary Public Health, Leipzig University, Leipzig, Germany
| | - Ahmed Abd El Wahed
- Institute of Animal Hygiene and Veterinary Public Health, Leipzig University, Leipzig, Germany
| | - Lakkumar Fernando
- Centre for Clinical Management of Dengue & Dengue Haemorrhagic Fever, District General Hospital, Negombo, Sri Lanka
| | - Ranjan Premaratna
- Department of Medicine, Faculty of Medicine, University of Kelaniya, Ragama, Sri Lanka
| | - Menaka Hapugoda
- Molecular Medicine Unit, Faculty of Medicine, University of Kelaniya, Ragama, Sri Lanka
| |
Collapse
|
3
|
Gamage CD, Nanayakkara S, Sarathkumara YD, Muthusinghe DS, Shimizu K, Arikawa J, Lokupathirage SMW, Nanayakkara N, Gunarathne L, Chandrajith R, Harada KH, Koizumi A, Yoshimatsu K. Hantavirus infection as a risk factor for chronic kidney disease of unknown aetiology (CKDu) and its prevalence in endemic areas of Sri Lanka since 2010 according to a retrospective serological analysis. J Med Microbiol 2022; 71. [PMID: 36748416 DOI: 10.1099/jmm.0.001630] [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: 12/23/2022] Open
Abstract
Background. Chronic kidney disease of unknown aetiology (CKDu) is a major public health problem in Sri Lanka, especially among agrarian communities. Although the cause of CKDu is still unknown, hantavirus infection has been proposed as a risk factor.Methods. This study was performed using serological samples collected from two CKDu-endemic areas, Anuradhapura (2010) and Badulla districts (2010 and 2016), and a non-endemic area, Matale (2016) district. The presence of anti-Thailand orthohantavirus IgG antibodies was investigated in serum samples. Hantavirus seroprevalence and demographic data were epidemiologically analysed.Results. Seroprevalence was higher in CKDu patients (40.6-60.0 %) and healthy individuals in CKDu-endemic areas (17.6-25.5 %) than in healthy individuals in non-endemic areas (3.0 %). Statistically significant odds ratios (ORs) for hantavirus infection in CKDu patients were detected in CKDu-endemic areas [ORs: 3.2 and 3.1; 95 % confidence interval (CI): 1.8-5.5 and 1.8-5.2 in Anuradhapura and Badulla districts in 2010; and OR: 4.4, 95 % CI: 2.3-8.5 in 2016 in Badulla district). Furthermore, the OR for hantavirus infection in Badulla district has increased in the last decade from 3.1 (95 % CI: 1.8-5.3) to 4.4 (95 % CI: 2.3-8.5).Conclusion. Hantavirus infection has been prevalent in two distant CKDu-endemic areas since 2010. The observed significant association of hantavirus seropositivity with CKDu indicates a possible role of hantavirus infection in CKDu pathogenesis.
Collapse
Affiliation(s)
- Chandika D Gamage
- Department of Microbiology, Faculty of Medicine, University of Peradeniya, 20400 Peradeniya, Sri Lanka
| | - Shanika Nanayakkara
- School of Dentistry, Faculty of Medicine and Health, The University of Sydney, Surry Hills, NSW 2010, Australia.,Department of Health and Environmental Sciences, Kyoto University Graduate School of Medicine, Kyoto 606-8501, Japan
| | - Yomani D Sarathkumara
- Department of Microbiology, Faculty of Medicine, University of Peradeniya, 20400 Peradeniya, Sri Lanka.,Australian Institute of Tropical Health and Medicine, James Cook University, Smithfield, QLD 4870, Australia
| | - Devinda S Muthusinghe
- Graduate School of Infectious Diseases, Hokkaido University, Sapporo 060-0815, Japan.,Institute for Genetic Medicine, Hokkaido University, Sapporo 060-0815, Japan
| | - Kenta Shimizu
- Department of Microbiology and Immunology, Faculty of Medicine, Hokkaido University, Sapporo 060-8638, Japan
| | - Jiro Arikawa
- Department of Microbiology and Immunology, Faculty of Medicine, Hokkaido University, Sapporo 060-8638, Japan
| | - Sithumini M W Lokupathirage
- Graduate School of Infectious Diseases, Hokkaido University, Sapporo 060-0815, Japan.,Institute for Genetic Medicine, Hokkaido University, Sapporo 060-0815, Japan
| | - Nishantha Nanayakkara
- Nephrology and Transplantation Unit, Teaching Hospital Kandy, 20000 Kandy, Sri Lanka
| | | | - Rohana Chandrajith
- Department of Geology, Faculty of Science, University of Peradeniya, 20400 Peradeniya, Sri Lanka
| | - Kouji H Harada
- Department of Health and Environmental Sciences, Kyoto University Graduate School of Medicine, Kyoto 606-8501, Japan
| | - Akio Koizumi
- Institute of Public Health and Welfare Research, Ukyo-ku, Kyoto 616-8141, Japan.,Department of Health and Environmental Sciences, Kyoto University Graduate School of Medicine, Kyoto 606-8501, Japan
| | - Kumiko Yoshimatsu
- Graduate School of Infectious Diseases, Hokkaido University, Sapporo 060-0815, Japan.,Institute for Genetic Medicine, Hokkaido University, Sapporo 060-0815, Japan
| |
Collapse
|
4
|
Muthugala R, Dheerasekara K, Manamperi A, Gunasena S, Galagoda G. Hantavirus Hemorrhagic Fever with Renal Syndrome (HFRS) – Suspected Cases in Sri Lanka; Clinical Picture and Epidemiology from 2013-2021. Jpn J Infect Dis 2022; 75:533-536. [DOI: 10.7883/yoken.jjid.2021.837] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
| | - Kalpa Dheerasekara
- Department of Medical Laboratory Science, Faculty of Allied Health Sciences, University of Peradeniya, Sri Lanka
| | - Aresha Manamperi
- Molecular Medicine Unit, Faculty of Medicine, University of Kelaniya, Sri Lanka
| | | | | |
Collapse
|
5
|
Warnasekara J, Srimantha S, Kappagoda C, Jayasundara D, Senevirathna I, Matthias M, Agampodi S, Vinetz JM. Diagnostic method-based underestimation of leptospirosis in clinical and research settings; an experience from a large prospective study in a high endemic setting. PLoS Negl Trop Dis 2022; 16:e0010331. [PMID: 35377883 PMCID: PMC9009773 DOI: 10.1371/journal.pntd.0010331] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2021] [Revised: 04/14/2022] [Accepted: 03/15/2022] [Indexed: 11/18/2022] Open
Abstract
Background Leptospirosis has globally significant human mortality and morbidity, yet estimating the clinical and public health burden of leptospirosis is challenging because timely diagnosis remains limited. The goal of the present study was to evaluate leptospirosis undercounting by current standard methods in both clinical and epidemiological study settings. Methodology/Principal findings A prospective hospital-based study was conducted in multiple hospitals in Sri Lanka from 2016 to 2019. Culture, whole blood, and urine samples were collected from clinically suspected leptospirosis cases and patients with undifferentiated fever. Analysis of biological samples from 1,734 subjects confirmed 591 (34.1%) cases as leptospirosis and 297 (17.1%) were classified as “probable” leptospirosis cases. Whole blood quantitative PCR (qPCR) did identify the most cases (322/540(60%)) but missed 40%. Cases missed by each method include; urine qPCR, 70% (153/220); acute sample microscopic agglutination test (MAT), 80% (409/510); paired serum sample MAT, 58% (98/170); and surveillance clinical case definition, 53% (265/496). qPCR of negative culture samples after six months of observation was of diagnostic value retrospectively with but missed 58% of positives (109/353). Conclusion Leptospirosis disease burden estimates should consider the limitations of standard diagnostic tests. qPCR of multiple sample types should be used as a leading standard test for diagnosing acute leptospirosis. Diagnostics of leptospirosis have not been optimised yet and is considered as a significant limiting factor for estimating the disease burden. This prospective hospital-based study, including 1734 clinically suspected leptospirosis cases and undifferentiated febrile patients, revealed that a minimum of 40% of cases would be missed by using any of the following tests individually. (Whole blood qPCR, single or paired-sample MAT, Urine qPCR, culture, culture qPCR, surveillance case definition). Therefore, we conclude that whole blood qPCR should be the standard test for diagnosing leptospirosis for clinical purposes until day 10 of the reported disease. MAT should be limited to places where the serological diagnosis has an epidemiological interest. qPCR testing of microscopically-negative cultures should be done before discarding to increase the yield in research settings.
Collapse
Affiliation(s)
- Janith Warnasekara
- Department of Community Medicine, Faculty of Medicine and Allied Sciences, Rajarata University of Sri Lanka, Saliyapura, Sri Lanka
| | - Shalka Srimantha
- Department of Community Medicine, Faculty of Medicine and Allied Sciences, Rajarata University of Sri Lanka, Saliyapura, Sri Lanka
| | - Chamila Kappagoda
- Department of Community Medicine, Faculty of Medicine and Allied Sciences, Rajarata University of Sri Lanka, Saliyapura, Sri Lanka
| | - Dinesha Jayasundara
- Department of Community Medicine, Faculty of Medicine and Allied Sciences, Rajarata University of Sri Lanka, Saliyapura, Sri Lanka
- Department of Microbiology, Faculty of Medicine and Allied Sciences, Rajarata University of Sri Lanka, Saliyapura, Sri Lanka
| | - Indika Senevirathna
- Department of Community Medicine, Faculty of Medicine and Allied Sciences, Rajarata University of Sri Lanka, Saliyapura, Sri Lanka
- Department of Biochemistry, Faculty of Medicine and Allied Sciences, Rajarata University of Sri Lanka, Saliyapura, Sri Lanka
| | - Michael Matthias
- Section of Infectious Diseases, Department of Internal Medicine, School of Medicine, Yale University, New Haven, Connecticut, United States of America
| | - Suneth Agampodi
- Department of Community Medicine, Faculty of Medicine and Allied Sciences, Rajarata University of Sri Lanka, Saliyapura, Sri Lanka
- Section of Infectious Diseases, Department of Internal Medicine, School of Medicine, Yale University, New Haven, Connecticut, United States of America
- * E-mail: ,
| | - Joseph M. Vinetz
- Section of Infectious Diseases, Department of Internal Medicine, School of Medicine, Yale University, New Haven, Connecticut, United States of America
| |
Collapse
|
6
|
Muthugala R, Dheerasekara K, Harischandra N, Wickramasinghe D, Abeykoon M, Dasanayake D, Manamperi A, Gunasena S, Galagoda G. Hantavirus infection with pulmonary symptoms in north central part of Sri Lanka. JOURNAL OF CLINICAL VIROLOGY PLUS 2021. [DOI: 10.1016/j.jcvp.2021.100052] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
|
7
|
Identification of Novel Rodent-Borne Orthohantaviruses in an Endemic Area of Chronic Kidney Disease of Unknown Etiology (CKDu) in Sri Lanka. Viruses 2021; 13:v13101984. [PMID: 34696414 PMCID: PMC8539126 DOI: 10.3390/v13101984] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2021] [Revised: 09/20/2021] [Accepted: 09/28/2021] [Indexed: 01/25/2023] Open
Abstract
We reported the genetic evidence of circulating hantaviruses from small mammals captured in a chronic kidney disease of unknown etiology (CKDu) hotspot area of Sri Lanka. The high seroprevalence of anti-hantavirus antibodies against Thailand orthohantavirus (THAIV) has been reported among CKDu patients and rodents in Sri Lankan CKDu hotspots. We captured 116 small mammals from CKDu endemic regions in the Polonnaruwa District of Sri Lanka. Seven animals (five out of 11 Mus booduga and two out of 99 Rattus rattus) were PCR-positive for the hantavirus. A rat-borne sequence was grouped with a THAIV-like Anjozorobe virus. In contrast, Mus-borne sequences belonged to the THAIV lineage, suggesting a novel orthohantavirus species according to the phylogenetic analyses and whole-genome comparisons. Our genetic evidence indicates the presence of two THAIV-related viruses circulating in this CKDu endemic area, suggesting a basis for further investigations to identify the infectious virus in patients with CKDu and the CKDu induction mechanism of these viruses.
Collapse
|
8
|
Žele-Vengušt D, Lindtner-Knific R, Mlakar-Hrženjak N, Jerina K, Vengušt G. Exposure of Free-Ranging Wild Animals to Zoonotic Leptospira interrogans Sensu Stricto in Slovenia. Animals (Basel) 2021; 11:ani11092722. [PMID: 34573688 PMCID: PMC8468819 DOI: 10.3390/ani11092722] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2021] [Revised: 09/10/2021] [Accepted: 09/14/2021] [Indexed: 12/24/2022] Open
Abstract
Simple Summary Wildlife can serve as a reservoir for highly contagious and deadly diseases, many of which are infectious to domestic animals and/or humans. Wildlife pathogen and disease surveillance is, thus, an essential tool that can provide valuable information on population health status and protect human health. Blood samples from 244 wild animals and 5 from carcasses were tested for specific antibodies against Leptospira serovars in Slovenia between 2019 and 2020 using the microscopic agglutination test. The results confirm that various wildlife species were exposed to Leptospira interrogans and may be used as a sentinel for leptospirosis, which is considered a significant health threat to other wildlife species and to humans. Abstract A total of 249 serum samples from 13 wild animal species namely fallow deer (Dama dama, n = 1), roe deer (Capreolus capreolus, n = 80), red deer (Cervus elaphus, n = 22), chamois (Rupicapra rupicapra, n = 21), mouflon (Ovis musimon, n = 4), brown hare (Lepus europaeus, n = 2), nutria (Myocastor coypus, n = 1), red fox (Vulpes vulpes, n = 97), stone marten (Martes foina, n = 12), European badger (Meles meles, n = 2), golden jackal (Canis aureus, n = 2) Eurasian lynx (Lynx lynx, n = 2) and grey wolf (Canis lupus, n = 3) were analysed for the presence of antibodies against Leptospira interrogans sensu stricto. Serum samples were examined via the microscopic agglutination test for the presence of specific antibodies against Leptospira serovars Icterohaemorrhagiae, Bratislava, Pomona, Grippotyphosa, Hardjo, Sejroe, Australis, Autumnalis, Canicola, Saxkoebing and Tarassovi. Antibodies to at least one of the pathogenic serovars were detected in 77 (30.9%; CI = 25–37%) sera. The proportion of positive samples varied intraspecifically and was the biggest in large carnivores (lynx, wolf and jackal; 86%), followed by mezzo predators: stone marten (67%) and red fox (34%), and large herbivores: red deer (32%), roe deer (25%), alpine chamois (10%) and mouflon (0%). Out of the 77 positive samples, 42 samples (53.8%) had positive titres against a single serovar, while 35 (45.4%) samples had positive titres against two or more serovars. The most frequently detected antibodies were those against the serovar Icterohaemorrhagiae. The present study confirmed the presence of multiple pathogenic serovars in wildlife throughout Slovenia. It can be concluded that wild animals are reservoirs for at least some of the leptospiral serovars and are a potential source of leptospirosis for other wild and domestic animals, as well as for humans.
Collapse
Affiliation(s)
- Diana Žele-Vengušt
- Institute of Pathology, Wild Animals, Fish and Bees, Veterinary Faculty, University of Ljubljana, Gerbičeva 60, 1000 Ljubljana, Slovenia;
| | - Renata Lindtner-Knific
- Institute of Poultry, Birds, Small Mammals and Reptiles, Veterinary Faculty, University of Ljubljana, Gerbičeva 60, 1000 Ljubljana, Slovenia; (R.L.-K.); (N.M.-H.)
| | - Nina Mlakar-Hrženjak
- Institute of Poultry, Birds, Small Mammals and Reptiles, Veterinary Faculty, University of Ljubljana, Gerbičeva 60, 1000 Ljubljana, Slovenia; (R.L.-K.); (N.M.-H.)
| | - Klemen Jerina
- Department of Forestry and Renewable Forest Resources, Biotechnical Faculty, Večna pot 83, 1000 Ljubljana, Slovenia;
| | - Gorazd Vengušt
- Institute of Pathology, Wild Animals, Fish and Bees, Veterinary Faculty, University of Ljubljana, Gerbičeva 60, 1000 Ljubljana, Slovenia;
- Correspondence: ; Tel.: +386-1-4779-196
| |
Collapse
|
9
|
Abstract
European orthohantaviruses (Puumala orthohantavirus (PUUV); Dobrava-Belgrade orthohantavirus (DOBV), genotype Kurkino; Tula orthohantavirus (TULV)), and Leptospira spp. are small mammal-associated zoonotic pathogens that cause diseases with potentially similar symptoms in humans. We investigated the frequency of Leptospira spp. and hantavirus single and double infections in small mammals from 22 sites in Thuringia, central Germany, during 2017. TULV infections were detected at 18 of 22 sites (mean prevalence 13.8%, 93/674). PUUV infections were detected at four of 22 sites (mean prevalence 1.5%, 7/471), and respective PUUV sequences formed a novel phylogenetic clade, but DOBV infections were not detected at all. Leptospira infections were detected at 21 of 22 sites with the highest overall prevalence in field voles (Microtus agrestis) with 54.5% (6/11) and common voles (Microtus arvalis) with 30.3% (205/676). Leptospira–hantavirus coinfections were found in 6.6% (44/671) of common voles but only in two of 395 bank voles. TULV and Leptospira coinfection probability in common voles was driven by individual (age) and population-level factors. Coinfections seemed to be particularly associated with sites where Leptospira spp. prevalence exceeded 35%. Future investigations should evaluate public health consequences of this strong spatial clustering of coinfections.
Collapse
|
10
|
Samrot AV, Sean TC, Bhavya KS, Sahithya CS, Chan-drasekaran S, Palanisamy R, Robinson ER, Subbiah SK, Mok PL. Leptospiral Infection, Pathogenesis and Its Diagnosis-A Review. Pathogens 2021; 10:pathogens10020145. [PMID: 33535649 PMCID: PMC7912936 DOI: 10.3390/pathogens10020145] [Citation(s) in RCA: 36] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2020] [Revised: 12/05/2020] [Accepted: 12/09/2020] [Indexed: 12/22/2022] Open
Abstract
Leptospirosis is a perplexing conundrum for many. In the existing literature, the pathophysiological mechanisms pertaining to leptospirosis is still not understood in full. Considered as a neglected tropical zoonotic disease, leptospirosis is culminating as a serious problem worldwide, seemingly existing as co-infections with various other unrelated diseases, including dengue and malaria. Misdiagnosis is also common as non-specific symptoms are documented extensively in the literature. This can easily lead to death, as the severe form of leptospirosis (Weil's disease) manifests as a complex of systemic complications, especially renal failure. The virulence of Leptospira sp. is usually attributed to the outer membrane proteins, including LipL32. With an armament of virulence factors at their disposal, their ability to easily adhere, invade and replicate within cells calls for a swift refinement in research progress to establish their exact pathophysiological framework. As an effort to reconstitute the current knowledge on leptospirosis, the basis of leptospiral infection, including its risk factors, classification, morphology, transmission, pathogenesis, co-infections and clinical manifestations are highlighted in this review. The various diagnostic techniques are also outlined with emphasis on their respective pros and cons.
Collapse
Affiliation(s)
- Antony V. Samrot
- School of Bioscience, Faculty of Medicine, Bioscience and Nursing, MAHSA University, Jenjarom, Selangor 42610, Malaysia;
- Correspondence: (A.V.S.); (P.L.M.)
| | - Tan Chuan Sean
- School of Bioscience, Faculty of Medicine, Bioscience and Nursing, MAHSA University, Jenjarom, Selangor 42610, Malaysia;
| | - Karanam Sai Bhavya
- Department of Biotechnology, School of Bio and Chemical Engineering, Sathyabama Institute of Science and Technology, Jeppiaar Nagar, Chennai, Tamil Nadu 627 011, India; (K.S.B.); (C.S.S.); (S.C.); (R.P.)
| | - Chamarthy Sai Sahithya
- Department of Biotechnology, School of Bio and Chemical Engineering, Sathyabama Institute of Science and Technology, Jeppiaar Nagar, Chennai, Tamil Nadu 627 011, India; (K.S.B.); (C.S.S.); (S.C.); (R.P.)
| | - SaiPriya Chan-drasekaran
- Department of Biotechnology, School of Bio and Chemical Engineering, Sathyabama Institute of Science and Technology, Jeppiaar Nagar, Chennai, Tamil Nadu 627 011, India; (K.S.B.); (C.S.S.); (S.C.); (R.P.)
| | - Raji Palanisamy
- Department of Biotechnology, School of Bio and Chemical Engineering, Sathyabama Institute of Science and Technology, Jeppiaar Nagar, Chennai, Tamil Nadu 627 011, India; (K.S.B.); (C.S.S.); (S.C.); (R.P.)
| | - Emilin Renitta Robinson
- Department of Food Processing Technology, Karunya Institute of Technology and Science, Coimbatore, Tamil Nadu 641 114, India;
| | - Suresh Kumar Subbiah
- Department of Medical Microbiology and Parasitology, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, UPM Serdang, Selangor 43400, Malaysia;
- Department of Biotechnology, Bharath Institute of Higher Education and Research (BIHER), Selaiyur, Tamil Nadu 600 073, India
- Genetics and Regenerative Medicine Research Centre, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, UPM Serdang, Selangor 43400, Malaysia
| | - Pooi Ling Mok
- Department of Biotechnology, Bharath Institute of Higher Education and Research (BIHER), Selaiyur, Tamil Nadu 600 073, India
- Genetics and Regenerative Medicine Research Centre, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, UPM Serdang, Selangor 43400, Malaysia
- Department of Biomedical Science, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, UPM Serdang, Selangor 43400, Malaysia
- Department of Clinical Laboratory Sciences, College of Applied Medical Sciences, Jouf University, Sakaka P.O. Box 2014, Aljouf Province, Saudi Arabia
- Correspondence: (A.V.S.); (P.L.M.)
| |
Collapse
|
11
|
Sunil-Chandra NP, Jayaweera JAAS, Kumbukgolla W, Jayasundara MVML. Association of Hantavirus Infections and Leptospirosis With the Occurrence of Chronic Kidney Disease of Uncertain Etiology in the North Central Province of Sri Lanka: A Prospective Study With Patients and Healthy Persons. Front Cell Infect Microbiol 2020; 10:556737. [PMID: 33117726 PMCID: PMC7578220 DOI: 10.3389/fcimb.2020.556737] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Accepted: 08/28/2020] [Indexed: 12/30/2022] Open
Abstract
Chronic Kidney disease of uncertain etiology (CKDu) has become a significant disease burden, affecting farming community of Sri Lanka and the exact etiology, which could be multifactorial, is not hitherto established. This study is aimed to determine the association of past hantavirus infection and leptospirosis with the occurrence of CKDu. A cohort (n = 179) of known CKDu patients living in high-CKDu prevalent areas of Anuradhapura district of Sri Lanka was compared with a group of 49 healthy, sex-matched younger blood relatives of CKDu patients (control-1) and another 48 healthy, age, and sex-matched individuals living in low-CKDu prevalent area (control-2) of the same district where same life style and climate conditions prevail. Fifty out of 179 (27.9%) CKDu patients, 16/49 (32.7%) of control-1 and 7/48 (14.6%) of control-2 were found positive for IgG antibodies to Puumala, Hantaan or both strains of hantaviruses. Hantaan strain specificity was found to be predominant in all study groups. Hantavirus IgG sero-prevalence of healthy individuals living in low-CKDu prevalent area was significantly lower compared to CKDu patients and healthy younger blood relatives living in high-CKDu prevalent areas (p = 0.03). Past hantavirus infection possesses a significant risk for the occurrence of CKDu (OR = 4.5; 95% CI-3.1-5.4, p = 0.02). In contrast, IgG seroprevalence to hantaviruses was not significantly different in CKDu patients and healthy younger blood relatives living in high-CKDu prevalent areas indicating past hantavirus infection has no association with the occurrence of CKDu or possibly, younger relatives may develop CKDu in subsequent years. Seroprevalence to leptospirosis showed no significant difference between CKDu patients and healthy controls.
Collapse
Affiliation(s)
- N P Sunil-Chandra
- Department of Medical Microbiology, Faculty of Medicine, University of Kelaniya, Kelaniya, Sri Lanka
| | - J A A S Jayaweera
- Faculty of Medicine & Allied Sciences, Rajarata University of Sri Lanka, Anuradhapura, Sri Lanka
| | - W Kumbukgolla
- Faculty of Medicine & Allied Sciences, Rajarata University of Sri Lanka, Anuradhapura, Sri Lanka
| | - M V M L Jayasundara
- Department of Medical Microbiology, Faculty of Medicine, University of Kelaniya, Kelaniya, Sri Lanka
| |
Collapse
|
12
|
Meeting report: Eleventh International Conference on Hantaviruses. Antiviral Res 2020; 176:104733. [PMID: 32068071 DOI: 10.1016/j.antiviral.2020.104733] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2020] [Accepted: 02/01/2020] [Indexed: 12/24/2022]
Abstract
The 2019 11th International Conference on Hantaviruses (ICH 2019) was organized by the International Society for Hantaviruses (ISH), and held on September 1-4, 2019, at the Irish College, in Leuven, Belgium. These ICHs have been held every three years since 1989. ICH 2019 was attended by 158 participants from 33 countries. The current report summarizes research presented on all aspects of hantavirology: ecology; pathogenesis and immune responses; virus phylogeny, replication and morphogenesis; epidemiology; vaccines, therapeutics and prevention; and clinical aspects and diagnosis.
Collapse
|
13
|
Schønning MH, Phelps MD, Warnasekara J, Agampodi SB, Furu P. A Case-Control Study of Environmental and Occupational Risks of Leptospirosis in Sri Lanka. ECOHEALTH 2019; 16:534-543. [PMID: 31664587 DOI: 10.1007/s10393-019-01448-w] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/11/2018] [Accepted: 08/07/2019] [Indexed: 06/10/2023]
Abstract
Sri Lanka has one of the highest incidences of human leptospirosis worldwide. Outbreaks of this zoonotic infection are related to the monsoons and flooding. The study investigates risk factors associated with environmental, animal and occupational exposure while acknowledging the potential bias due to hanta viral infections in the study samples. Data were obtained from structured interviews with 483 patients (276 cases and 207 controls). Risk exposures were studied for the entire population and for two stratified occupational groups: non-paddy workers and paddy workers. A higher odds ratio (OR) of leptospirosis transmission for paddy workers was observed compared to non-paddy workers (OR 1.905, 95% CI 1.274-2.856). Rat exposure was not associated with a significant higher risk for any of the groups. Instead, cattle and household animals seemed to be important for transmission of leptospirosis to humans, especially among non-paddy workers (OR 10.655, 95% CI 1.213-93.582). Leptospirosis in paddy workers was associated with environmental factors linked to contamination and wetness in paddy fields. Interestingly, abandoned paddy fields were found to have a protective effect against transmission to paddy workers (OR 0.421, 95% CI 0.237-0.748). Keeping animals on these dryer fields may act as a boundary for contamination of paddy fields with infectious animal urine. This finding may be considered as a public health intervention targeting leptospirosis among paddy workers.
Collapse
Affiliation(s)
- Marie Hellung Schønning
- Global Health Section, Department of Public Health, University of Copenhagen, Oster Farimagsgade 5, 1014, Copenhagen K, Denmark
| | - Matthew David Phelps
- Global Health Section, Department of Public Health, University of Copenhagen, Oster Farimagsgade 5, 1014, Copenhagen K, Denmark
| | - Janith Warnasekara
- Department of Community Medicine, Faculty of Medicine and Allied Sciences, Rajarata University of Sri Lanka, Saliyapura, Sri Lanka
| | - Suneth B Agampodi
- Department of Community Medicine, Faculty of Medicine and Allied Sciences, Rajarata University of Sri Lanka, Saliyapura, Sri Lanka
| | - Peter Furu
- Global Health Section, Department of Public Health, University of Copenhagen, Oster Farimagsgade 5, 1014, Copenhagen K, Denmark.
| |
Collapse
|
14
|
Wild Rats, Laboratory Rats, Pet Rats: Global Seoul Hantavirus Disease Revisited. Viruses 2019; 11:v11070652. [PMID: 31319534 PMCID: PMC6669632 DOI: 10.3390/v11070652] [Citation(s) in RCA: 44] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2019] [Revised: 06/28/2019] [Accepted: 06/28/2019] [Indexed: 12/16/2022] Open
Abstract
Recent reports from Europe and the USA described Seoul orthohantavirus infection in pet rats and their breeders/owners, suggesting the potential emergence of a “new” public health problem. Wild and laboratory rat-induced Seoul infections have, however, been described since the early eighties, due to the omnipresence of the rodent reservoir, the brown rat Rattus norvegicus. Recent studies showed no fundamental differences between the pathogenicity and phylogeny of pet rat-induced Seoul orthohantaviruses and their formerly described wild or laboratory rat counterparts. The paucity of diagnosed Seoul virus-induced disease in the West is in striking contrast to the thousands of cases recorded since the 1980s in the Far East, particularly in China. This review of four continents (Asia, Europe, America, and Africa) puts this “emerging infection” into a historical perspective, concluding there is an urgent need for greater medical awareness of Seoul virus-induced human pathology in many parts of the world. Given the mostly milder and atypical clinical presentation, sometimes even with preserved normal kidney function, the importance of simple but repeated urine examination is stressed, since initial but transient proteinuria and microhematuria are rarely lacking.
Collapse
|
15
|
Thailand orthohantavirus infection in patients with chronic kidney disease of unknown aetiology in Sri Lanka. Arch Virol 2018; 164:267-271. [DOI: 10.1007/s00705-018-4053-x] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2018] [Accepted: 09/19/2018] [Indexed: 10/28/2022]
|
16
|
Infections and the kidney: a tale from the tropics. Pediatr Nephrol 2018; 33:1317-1326. [PMID: 28879600 DOI: 10.1007/s00467-017-3785-2] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2017] [Revised: 08/01/2017] [Accepted: 08/10/2017] [Indexed: 01/30/2023]
Abstract
Tropical infections are caused by a variety of bacteria, viruses and parasitic organisms across varying geographical regions and are more often reported in adults than in children. Most of the infections are acute, presenting as a febrile illness with involvement of multiple organ systems, including the kidney. The gamut of renal manifestations extends from asymptomatic urinary abnormalities to acute kidney injury and-albeit rarely-chronic kidney disease. Tropical infections can involve the glomerular, tubulointerstitial and vascular compartments of the kidney. Leptospirosis, malaria, dengue, rickettsial fever and schistosomiasis are the most prevalent tropical infections which affect the kidneys of children living in the tropics. In this review we discuss renal involvement in these most prevalent tropical infections.
Collapse
|
17
|
Kurucz K, Madai M, Bali D, Hederics D, Horváth G, Kemenesi G, Jakab F. Parallel Survey of Two Widespread Renal Syndrome-Causing Zoonoses:Leptospiraspp. andHantavirusin Urban Environment, Hungary. Vector Borne Zoonotic Dis 2018; 18:200-205. [DOI: 10.1089/vbz.2017.2204] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Affiliation(s)
- Kornélia Kurucz
- Virological Research Group, Szentágothai Research Centre, University of Pécs, Pécs, Hungary
| | - Mónika Madai
- Virological Research Group, Szentágothai Research Centre, University of Pécs, Pécs, Hungary
- Department of Genetics and Molecular Biology, Faculty of Sciences, University of Pécs, Pécs, Hungary
| | - Dominika Bali
- Virological Research Group, Szentágothai Research Centre, University of Pécs, Pécs, Hungary
- Department of Genetics and Molecular Biology, Faculty of Sciences, University of Pécs, Pécs, Hungary
| | - Dávid Hederics
- Virological Research Group, Szentágothai Research Centre, University of Pécs, Pécs, Hungary
- Department of Genetics and Molecular Biology, Faculty of Sciences, University of Pécs, Pécs, Hungary
| | - Győző Horváth
- Department of Ecology, Institute of Biology, Faculty of Sciences, University of Pécs, Pécs, Hungary
| | - Gábor Kemenesi
- Virological Research Group, Szentágothai Research Centre, University of Pécs, Pécs, Hungary
- Department of Genetics and Molecular Biology, Faculty of Sciences, University of Pécs, Pécs, Hungary
| | - Ferenc Jakab
- Virological Research Group, Szentágothai Research Centre, University of Pécs, Pécs, Hungary
- Department of Genetics and Molecular Biology, Faculty of Sciences, University of Pécs, Pécs, Hungary
| |
Collapse
|
18
|
Wijkström J, Jayasumana C, Dassanayake R, Priyawardane N, Godakanda N, Siribaddana S, Ring A, Hultenby K, Söderberg M, Elinder CG, Wernerson A. Morphological and clinical findings in Sri Lankan patients with chronic kidney disease of unknown cause (CKDu): Similarities and differences with Mesoamerican Nephropathy. PLoS One 2018. [PMID: 29513702 PMCID: PMC5841753 DOI: 10.1371/journal.pone.0193056] [Citation(s) in RCA: 47] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
In Sri Lanka, an endemic of chronic kidney disease of unknown origin (CKDu) is affecting rural communities. The endemic has similarities with Mesoamerican Nephropathy (MeN) in Central America, however it has not yet been clarified if the endemics are related diagnostic entities. We designed this study of kidney biopsies from patients with CKDu in Sri Lanka to compare with MeN morphology. Eleven patients with CKDu were recruited at the General Hospital, Polonnaruwa, using similar inclusion and exclusion criteria as our previous MeN studies. Inclusion criteria were 20–65 years of age and plasma creatinine 100–220 μmol/L. Exclusion criteria were diabetes mellitus, uncontrolled hypertension and albuminuria >1g/24h. Kidney biopsies, blood and urine samples were collected, and participants answered a questionnaire. Included participants were between 27–61 years of age and had a mean eGFR of 38±14 ml/min/1.73m2. Main findings in the biopsies were chronic glomerular and tubulointerstitial damage with glomerulosclerosis (8–75%), glomerular hypertrophy and mild to moderate tubulointerstitial changes. The morphology was more heterogeneous and interstitial inflammation and vascular changes were more common compared to our previous studies of MeN. In two patients the biopsies showed morphological signs of acute pyelonephritis but urine cultures were negative. Electrolyte disturbances with low levels of serum sodium, potassium, and/or magnesium were common. In the urine, only four patients displayed albuminuria, but many patients exhibited elevated α-1-microglobulin and magnesium levels. This is the first study reporting detailed biochemical and clinical data together with renal morphology, including electron microscopy, from Sri Lankan patients with CKDu. Our data show that there are many similarities in the biochemical and morphological profile of the CKDu endemics in Central America and Sri Lanka, supporting a common etiology. However, there are differences, such as a more mixed morphology, more interstitial inflammation and vascular changes in Sri Lankan patients.
Collapse
Affiliation(s)
- Julia Wijkström
- Division of Renal Medicine, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden
- * E-mail:
| | - Channa Jayasumana
- Department of Pharmacology, Faculty of Medicine, Rajarata University of Sri Lanka, Saliyapura, Sri Lanka
| | | | | | | | - Sisira Siribaddana
- Faculty of Medicine, Rajarata University of Sri Lanka, Saliyapura, Sri Lanka
| | - Anneli Ring
- Clinical Pathology and Cytology, Karolinska University Hospital, Stockholm, Sweden
| | - Kjell Hultenby
- Division of CRC, Department of Laboratory Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Magnus Söderberg
- Clinical Pathology and Cytology, Karolinska University Hospital, Stockholm, Sweden
- Pathology, Drug Safety and Metabolism, IMED Biotech Unit, AstraZeneca, Gothenburg, Sweden
| | - Carl-Gustaf Elinder
- Division of Renal Medicine, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden
| | - Annika Wernerson
- Division of Renal Medicine, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden
| |
Collapse
|
19
|
Abstract
PURPOSE OF REVIEW The definitive diagnosis of leptospirosis, which results from infection with spirochetes of the genus Leptospira, currently relies on the use of culture, serological testing (microscopic agglutination testing), and molecular detection. The purpose of this review is to describe new molecular diagnostics for Leptospira and discuss advancements in the use of available methods. RECENT FINDINGS Efforts have been focused on improving the clinical sensitivity of Leptospira detection using molecular methods. In this review, we describe a reoptimized pathogenic species-specific real-time PCR (targeting lipL32) that has demonstrated improved sensitivity, findings by two groups that real-time reverse-transcription PCR assays targeting the 16S rrs gene can improve detection, and two new loop-mediated amplification techniques. Quantitation of leptospiremia, detection in different specimen types, and the complementary roles played by molecular detection and microscopic agglutination testing will be discussed. Finally, a protocol for Leptospira strain subtyping using variable number tandem repeat targets and high-resolution melting will be described. SUMMARY Molecular diagnostics have an established role for the diagnosis of leptospirosis and provide an actionable diagnosis in the acute setting. The use of real-time reverse-transcription PCR for testing serum/plasma and cerebrospinal fluid, when available, may improve the detection of Leptospira without decreasing clinical specificity.
Collapse
|
20
|
Herath NJ, Kamburapola CJ, Agampodi SB. Severe leptospirosis and pancreatitis; A case series from a leptospirosis outbreak in Anuradhapura district, Sri Lanka. BMC Infect Dis 2016; 16:644. [PMID: 27821124 PMCID: PMC5100107 DOI: 10.1186/s12879-016-2010-4] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2016] [Accepted: 11/02/2016] [Indexed: 01/07/2023] Open
Abstract
Background Acute pancreatitis is identified as an atypical and rare presentation of leptospirosis. In this report, we discuss a case series of severe leptospirosis with pancreatitis as a main complication during an unusual outbreak of leptospirosis in Anuradhapura district, Sri Lanka. Case presentation We retrospectively reviewed clinical presentation, investigations, treatment and outcome of six confirmed cases of severe leptospirosis admitted to intensive care unit (ICU) of Teaching Hospital, Anuradhapura, within a three months period from November 2014 to January 2015. All six patients were previously healthy paddy farmers presented with fever, myalgia and arthralgia. Four patients had abdominal pain, nausea and vomiting on admission. Hypotension, Neutrophilic leukocytosis and thrombocytopaenia was detected in all patients in the initial stage. Four patients had serum amylase more than 900 (range 941–2420). All patients had acute kidney injury and hepatitis. Significantly elevated amylase and low serum calcium were present in 4 cases. Five patients recovered without any evidence of residual organ damage, but one succumbed to the illness. Conclusion This case series emphasizes the importance of identification of acute pancreatitis as a common complication of Leptospirosis, in order to reduce mortality and morbidity.
Collapse
Affiliation(s)
- N J Herath
- Teaching Hospital, Anuradhapura, Sri Lanka
| | | | - S B Agampodi
- Department of Community Medicine, Faculty of Medicine and Allied Sciences, Rajarata University of Sri Lanka, Saliyapura, 50008, Sri Lanka.
| |
Collapse
|
21
|
Safronetz D, Sacko M, Sogoba N, Rosenke K, Martellaro C, Traoré S, Cissé I, Maiga O, Boisen M, Nelson D, Oottamasathien D, Millett M, Garry RF, Branco LM, Doumbia S, Feldmann H, Traoré MS. Vectorborne Infections, Mali. Emerg Infect Dis 2016; 22:340-2. [PMID: 26812625 PMCID: PMC4734548 DOI: 10.3201/eid2202.150688] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
|
22
|
Bandara K, Weerasekera MM, Gunasekara C, Ranasinghe N, Marasinghe C, Fernando N. Utility of modified Faine's criteria in diagnosis of leptospirosis. BMC Infect Dis 2016; 16:446. [PMID: 27554098 PMCID: PMC4995749 DOI: 10.1186/s12879-016-1791-9] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2016] [Accepted: 08/18/2016] [Indexed: 01/06/2023] Open
Abstract
Background Leptospirosis is a globally emerging zoonotic disease and an important public health threat in developing countries. Diagnosis of leptospirosis is mainly based on clinical presentations in resource poor countries. World Health Organization (WHO) has introduced “Faine’s criteria” for diagnosis of leptospirosis. This study was conducted to evaluate the usefulness of modified Faine’s criteria (with amendment) 2012 to detect leptospirosis in resource poor settings. Methods Blood samples of 168 patients who fulfilled the inclusion criteria admitted between January 2013 to January 2014 were tested by a commercial immunochromatographic assay (Leptocheck WB, India), microscopic agglutination test (MAT) and polymerase chain reaction (PCR) methods. Leptospirosis was confirmed by a single MAT titre ≥1:400 and / or by a positive PCR. Diagnosis of leptospirosis was made using the clinical, epidemiological and laboratory data according to modified Faine’s criteria (with amendment) 2012. Results Leptospirosis was confirmed in 39 % (n = 66) by MAT and/or PCR. When modified Faine’s criteria (MAT ≥ 1.400 &/ or PCR), was evaluated against LERG confirmed cases sensitivity, specificity, positive predictive value and negative predictive values were 95.45 %, 56.86 %, 58.88 %, 95.08 % respectively. The modified Faine’s criteria with rapid immunochromatographic assay only had a sensitivity, specificity, positive predictive value and negative predictive value 89.39 %, 58.82 %, 58.42 %, and 89.55 % respectively. Conclusion The modified Faine’s criteria which utilized only immunochromatographic assay (leptocheck IgM) in Part C was found to be useful tool for diagnosing leptospirosis in a resource poor setting.
Collapse
Affiliation(s)
- Kanchana Bandara
- General Sir John Kotelawala Defense University, Rathmalana, Sri Lanka
| | - Manjula Manoji Weerasekera
- Department of Microbiology, Faculty of Medical Sciences, University of Sri Jayewardenepura, Gangodawila, Tangalle, Sri Lanka.
| | - Chinthika Gunasekara
- Department of Microbiology, Faculty of Medical Sciences, University of Sri Jayewardenepura, Gangodawila, Tangalle, Sri Lanka
| | | | - Chamil Marasinghe
- Department of Medicine, Faculty of Medical Sciences, University of Sri Jayewardenepura, Gangodawila, Nugegoda, Sri Lanka
| | - Neluka Fernando
- Department of Microbiology, Faculty of Medical Sciences, University of Sri Jayewardenepura, Gangodawila, Tangalle, Sri Lanka
| |
Collapse
|
23
|
Gamage CD, Sarathkumara YD. Chronic kidney disease of uncertain etiology in Sri Lanka: Are leptospirosis and Hantaviral infection likely causes? Med Hypotheses 2016; 91:16-19. [DOI: 10.1016/j.mehy.2016.04.009] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2016] [Revised: 04/05/2016] [Accepted: 04/07/2016] [Indexed: 11/28/2022]
|
24
|
Clement J, Colson P, Saegeman V, Lagrou K, Van Ranst M. 'Bedside assessment' of acute hantavirus infections and their possible classification into the spectrum of haemophagocytic syndromes. Eur J Clin Microbiol Infect Dis 2016; 35:1101-6. [PMID: 27101352 DOI: 10.1007/s10096-016-2638-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2016] [Accepted: 03/20/2016] [Indexed: 11/29/2022]
Abstract
Hantavirus infections, recently renamed 'hantavirus fever' (HTVF), belong to the most common but also most underestimated zoonoses in the world. A small number of reports described the so-called 'lipid paradox' in HTVF, i.e. the striking contrast between a very low serum total cholesterol and/or high-density lipoprotein cholesterol (HDLc), and a paradoxical concomitant hypertriglyceridaemia. In a prospective study, with patients being their own control after illness, we wanted to verify if this quick and easy 'bedside test' was robust enough to warrant a preliminary diagnosis of acute kidney injury (AKI) caused by HTVF. The study cohort consisted of 58 Belgian cases (mean age 44 years), admitted with varying degrees of AKI and of thrombocytopaenia, both characteristic for presumptive HTVF. All cases were sero-confirmed as having acute HTVF. At or shortly after hospital admission, a significant (p < 0.001) decrease of total cholesterol and HDLc was found in comparison with normalised levels in the same cohort, quantified a few days after spontaneous AKI recovery. Conversely, fasting triglyceride levels during HTVF infection were significantly (p < 0.001) higher during illness than after recovery. This 'lipid paradox' was most outspoken in severe HTVF cases, often accompanying, or even predicting, major kidney or lung complications. Thus, this 'bedside assessment' seems to hold even promise for presumptive diagnosis of more severe so-called 'hantavirus cardio-pulmonary syndrome' (HCPS) cases, mostly described hitherto in the New World. In more severe AKI cases, the mean total cholesterol was significantly lower (p = 0.02) than in milder cases, i.e. cases with peak serum creatinine levels of < 1.5 mg/dL. Thrombocytopaenia, generally accepted as the severity index in HTVF, appeared, moreover, significantly correlated with serum levels of total cholesterol (R = 0.52, p < 0.001) and with serum levels of HDLc (R = 0.45, p < 0.01). A link with the novel clinical entity of haemophagocytic syndromes, also characterised by manifest hypertriglyceridaemia, is discussed.
Collapse
Affiliation(s)
- J Clement
- National Reference Centre for Hantavirus Infections, Laboratory of Clinical and Epidemiological Virology, Rega Institute for Medical Research, KU Leuven, Leuven, Belgium.
| | - P Colson
- Emergency Unit, Clinique Sainte Elisabeth, Namur, Belgium
| | - V Saegeman
- Laboratory Medicine, University Hospitals Leuven, Leuven, Belgium.,Department of Microbiology and Immunology, KU Leuven, Leuven, Belgium
| | - K Lagrou
- Laboratory Medicine, University Hospitals Leuven, Leuven, Belgium.,Department of Microbiology and Immunology, KU Leuven, Leuven, Belgium
| | - M Van Ranst
- National Reference Centre for Hantavirus Infections, Laboratory of Clinical and Epidemiological Virology, Rega Institute for Medical Research, KU Leuven, Leuven, Belgium.,Laboratory Medicine, University Hospitals Leuven, Leuven, Belgium.,Department of Microbiology and Immunology, KU Leuven, Leuven, Belgium
| |
Collapse
|
25
|
Tadin A, Tokarz R, Markotić A, Margaletić J, Turk N, Habuš J, Svoboda P, Vucelja M, Desai A, Jain K, Lipkin WI. Molecular Survey of Zoonotic Agents in Rodents and Other Small Mammals in Croatia. Am J Trop Med Hyg 2015; 94:466-73. [PMID: 26711522 DOI: 10.4269/ajtmh.15-0517] [Citation(s) in RCA: 48] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2015] [Accepted: 11/02/2015] [Indexed: 11/07/2022] Open
Abstract
Croatia is a focus for many rodent-borne zoonosis. Here, we report a survey of 242 rodents and small mammals, including 43 Myodes glareolus, 131 Apodemus flavicollis, 53 Apodemus agrarius, three Apodemus sylvaticus, six Sorex araneus, four Microtus arvalis, one Microtus agrestis, and one Muscardinus avellanarius, collected at eight sites in Croatia over an 8-year period. Multiplex MassTag polymerase chain reaction (PCR) was used for detection of Borrelia, Rickettsia, Bartonella, Babesia, Ehrlichia, Anaplasma, Francisella tularensis, and Coxiella burnetii. Individual PCR assays were used for detection of Leptospira, lymphocytic choriomeningitis virus, orthopoxviruses, flaviviruses, hantaviruses, and Toxoplasma gondii. Of the rodents, 52 (21.5%) were infected with Leptospira, 9 (3.7%) with Borrelia miyamotoi, 5 (2%) with Borrelia afzelii, 29 (12.0%) with Bartonella, 8 (3.3%) with Babesia microti, 2 (0.8%) with Ehrlichia, 4 (1.7%) with Anaplasma, 2 (0.8%) with F. tularensis, 43 (17.8%) with hantaviruses, and 1 (0.4%) with an orthopoxvirus. Other agents were not detected. Multiple infections were found in 32 rodents (13.2%): dual infections in 26 rodents (10.7%), triple infections in four rodents (2.9%), and quadruple infections in two rodents (0.8%). Our findings indicate that rodents in Croatia harbor a wide range of bacteria and viruses that are pathogenic to humans.
Collapse
Affiliation(s)
- Ante Tadin
- University Hospital for Infectious Diseases "Dr. Fran Mihaljević," Zagreb, Croatia; Center for Infection and Immunity, Mailman School of Public Health, Columbia University, New York, New York; Faculty of Forestry, University of Zagreb, Zagreb, Croatia; Faculty of Veterinary Medicine, University of Zagreb, Zagreb, Croatia
| | - Rafal Tokarz
- University Hospital for Infectious Diseases "Dr. Fran Mihaljević," Zagreb, Croatia; Center for Infection and Immunity, Mailman School of Public Health, Columbia University, New York, New York; Faculty of Forestry, University of Zagreb, Zagreb, Croatia; Faculty of Veterinary Medicine, University of Zagreb, Zagreb, Croatia
| | - Alemka Markotić
- University Hospital for Infectious Diseases "Dr. Fran Mihaljević," Zagreb, Croatia; Center for Infection and Immunity, Mailman School of Public Health, Columbia University, New York, New York; Faculty of Forestry, University of Zagreb, Zagreb, Croatia; Faculty of Veterinary Medicine, University of Zagreb, Zagreb, Croatia
| | - Josip Margaletić
- University Hospital for Infectious Diseases "Dr. Fran Mihaljević," Zagreb, Croatia; Center for Infection and Immunity, Mailman School of Public Health, Columbia University, New York, New York; Faculty of Forestry, University of Zagreb, Zagreb, Croatia; Faculty of Veterinary Medicine, University of Zagreb, Zagreb, Croatia
| | - Nenad Turk
- University Hospital for Infectious Diseases "Dr. Fran Mihaljević," Zagreb, Croatia; Center for Infection and Immunity, Mailman School of Public Health, Columbia University, New York, New York; Faculty of Forestry, University of Zagreb, Zagreb, Croatia; Faculty of Veterinary Medicine, University of Zagreb, Zagreb, Croatia
| | - Josipa Habuš
- University Hospital for Infectious Diseases "Dr. Fran Mihaljević," Zagreb, Croatia; Center for Infection and Immunity, Mailman School of Public Health, Columbia University, New York, New York; Faculty of Forestry, University of Zagreb, Zagreb, Croatia; Faculty of Veterinary Medicine, University of Zagreb, Zagreb, Croatia
| | - Petra Svoboda
- University Hospital for Infectious Diseases "Dr. Fran Mihaljević," Zagreb, Croatia; Center for Infection and Immunity, Mailman School of Public Health, Columbia University, New York, New York; Faculty of Forestry, University of Zagreb, Zagreb, Croatia; Faculty of Veterinary Medicine, University of Zagreb, Zagreb, Croatia
| | - Marko Vucelja
- University Hospital for Infectious Diseases "Dr. Fran Mihaljević," Zagreb, Croatia; Center for Infection and Immunity, Mailman School of Public Health, Columbia University, New York, New York; Faculty of Forestry, University of Zagreb, Zagreb, Croatia; Faculty of Veterinary Medicine, University of Zagreb, Zagreb, Croatia
| | - Aaloki Desai
- University Hospital for Infectious Diseases "Dr. Fran Mihaljević," Zagreb, Croatia; Center for Infection and Immunity, Mailman School of Public Health, Columbia University, New York, New York; Faculty of Forestry, University of Zagreb, Zagreb, Croatia; Faculty of Veterinary Medicine, University of Zagreb, Zagreb, Croatia
| | - Komal Jain
- University Hospital for Infectious Diseases "Dr. Fran Mihaljević," Zagreb, Croatia; Center for Infection and Immunity, Mailman School of Public Health, Columbia University, New York, New York; Faculty of Forestry, University of Zagreb, Zagreb, Croatia; Faculty of Veterinary Medicine, University of Zagreb, Zagreb, Croatia
| | - W Ian Lipkin
- University Hospital for Infectious Diseases "Dr. Fran Mihaljević," Zagreb, Croatia; Center for Infection and Immunity, Mailman School of Public Health, Columbia University, New York, New York; Faculty of Forestry, University of Zagreb, Zagreb, Croatia; Faculty of Veterinary Medicine, University of Zagreb, Zagreb, Croatia
| |
Collapse
|
26
|
Robertson C. Towards a geocomputational landscape epidemiology: surveillance, modelling, and interventions. GEOJOURNAL 2015; 82:397-414. [PMID: 32214618 PMCID: PMC7087791 DOI: 10.1007/s10708-015-9688-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
The ability to explicitly represent infectious disease distributions and their risk factors over massive geographical and temporal scales has transformed how we investigate how environment impacts health. While landscape epidemiology studies have shed light on many aspects of disease distribution and risk differentials across geographies, new computational methods combined with new data sources such as citizen sensors, global spatial datasets, sensor networks, and growing availability and variety of satellite imagery offer opportunities for a more integrated approach to understanding these relationships. Additionally, a large number of new modelling and mapping methods have been developed in recent years to support the adoption of these new tools. The complexity of this research context results in study-dependent solutions and prevents landscape approaches from deeper integration into operational models and tools. In this paper we consider three common research contexts for spatial epidemiology; surveillance, modelling to estimate a spatial risk distribution and the need for intervention, and evaluating interventions and improving healthcare. A framework is proposed and a categorization of existing methods is presented. A case study into leptospirosis in Sri Lanka provides a working example of how the different phases of the framework relate to real research problems. The new framework for geocomputational landscape epidemiology encompasses four key phases: characterizing assemblages, characterizing functions, mapping interdependencies, and examining outcomes. Results from Sri Lanka provide evidence that the framework provides a useful way to structure and interpret analyses. The framework reported here is a new way to structure existing methods and tools of geocomputation that are increasingly relevant to researchers working on spatially explicit disease-landscape studies.
Collapse
Affiliation(s)
- Colin Robertson
- Department of Geography and Environmental Studies, Wilfrid Laurier University, 75 University Ave West, Waterloo, ON N2L 3C5 Canada
| |
Collapse
|