Risk factors associated with leptospirosis in dogs from Northern California: 2001-2010

Time for change? A systematic review with meta-analysis of leptospires infecting dogs to assess vaccine compatibility in Brazil

Dogs are thought to be highly exposed to environmental pathogenic leptospires, possibly acting as potential sources of infection for zoonotic transmission. Vaccination stands as the cornerstone strategy to prevent disease and urinary shedding in dogs, yet the success of vaccination is highly dependent on the correspondence of leptospires circulating locally with those used in vaccine compositions. To provide evidence for vaccine compatibility, and to assess whether there are regional differences on serogroup distribution, we conducted a systematic review with meta-analysis on serological data, characterization of leptospiral isolates and risk factors for seropositivity in dogs from Brazil. Studies reporting canine leptospirosis within the Brazilian territory were eligible for inclusion, and methodology was validated by PROSPERO under registration CRD42020204187. Six electronic databases were searched, and data regarding population, methods, and outcomes were extracted. Sixty-one studies were included to access serogroup distribution and risk factors, with a pooled positivity rate of 19.7% in dog population. Serological evidence indicates that Canicola, Icterohaemorrhagiae and Autumnalis are the most frequently found serogroups. Twenty-eight records were included to access leptospiral strains isolated in Brazil, with n = 56 strains characterized as serogroups Canicola, n = 37 as Icterohaemorrhagiae, n = 2 as Pomona, and n = 1 strain as Australis and Sejroe each. Risk factor analysis revealed that stray dogs, puppies or elderly dogs, male dogs and dogs kept by tutors with poor social and economic conditions are at high risk for infection. The present study revealed overall good compatibility of leptospiral strains circulating locally with those used in vaccines against canine leptospirosis in Brazil. The circulation of serovars Pomona and Grippotyphosa has not been consistently demonstrated, and the inclusion of these serovars in local vaccines cannot be supported by our results. The results also provided serological evidence for the circulation of Serogroup Autumnalis among the studied populations.

Potential Drivers for the Re-Emergence of Canine Leptospirosis in the United States and Canada

Canine leptospirosis is an important zoonotic disease in many countries. This review examines potential drivers for increased diagnoses of canine leptospirosis in the United States and Canada, using the epidemiologic triad of agent-environment-host as a template. Leptospira spp. are classified into more than 250 serovars, but in many laboratories only 6 are routinely tested for in serologic agglutination tests of canine sera. Leptospiral infections in dogs may potentially go undetected with unemployed or currently employed diagnostic methods. Disease transmission from infected reservoir hosts usually occurs via urine-contaminated environmental sources such as water. Direct contact between infected and susceptible individuals, environmental factors such as climate changes in temperature and/or rainfall, and increasing number and urbanization of reservoir hosts may greatly increase dog exposure risks. A dog's lifestyle may influence exposure risk to leptospirosis, but vaccination based on proper identification of circulating serogroups dramatically reduces post-exposure infections. Regrettably, resistance to vaccination by veterinarians and dog owners leaves a large number of dogs at risk for this zoonotic disease.

Canine leptospirosis in Canada, test-positive proportion and risk factors (2009 to 2018): A cross-sectional study

Over the past decade, there has been an apparent increased frequency and widened distribution of canine leptospirosis in Canada, however, this has been minimally investigated. Availability and clinical uptake of Leptospira polymerase chain reaction (PCR)-based testing of dogs in Canada may provide important insight into the epidemiology of this canine and zoonotic infectious disease. Study objectives were to evaluate clinical canine Leptospira PCR test results from a large commercial laboratory to determine temporal and spatial distribution in Canada and identify dog, geographic and temporal risk factors for test-positive dogs. This cross-sectional study analyzed data obtained from IDEXX Laboratories, Inc. on 10,437 canine Leptospira PCR tests (blood and/or urine) submitted by Canada-based veterinarians (July 2009 to May 2018). Multivariable logistic regression was used to identify risk factors for test-positive dogs. Test-positive proportion varied widely annually (4.8–14.0%) and by location. Provinces with the highest test-positive proportion over the study period were Nova Scotia (18.5%) and Ontario (9.6%), with the prairie provinces (Manitoba and Alberta combined) having the lowest proportion (1.0%); the northern territories could not be evaluated due to limited testing. In the final model, dog age, sex, breed, month, and year test performed, and location (urban/rural, province) of the practice submitting the sample were significant predictors of a positive Leptospira PCR test. Dogs less than one year of age (OR = 2.1; 95% CI: 1.6–2.9), male sex (OR = 1.3; 1.1–1.5), toy breed (OR = 3.3; 2.5–4.4), and samples submitted from an urban practice (OR = 1.3; 1.0–1.8) had the greatest odds of a positive Leptospira PCR test as compared to referent groups. Significant two-way interactions between province-month and year-month highlight the complex spatial and temporal influences on leptospirosis occurrence in this region. Our work suggests a high incidence of canine leptospirosis regionally within Canada. Identifiable dog and location factors may assist in future targeted prevention efforts.

Clinical, diagnostic, and epidemiological features of a community-wide outbreak of canine leptospirosis in a low-prevalence region (Maricopa County, Arizona)

OBJECTIVE

To describe clinical, diagnostic, and epidemiological features of an outbreak of leptospirosis in dogs in Maricopa County, Ariz, from January 2016 through June 2017.

ANIMALS

71 case and 281 control dogs.

PROCEDURES

Cases were classified as confirmed, probable, suspect, or not a case on the basis of medical record data that fulfilled clinical, diagnostic, and epidemiological criteria. Potential exposures were assessed by owner survey. For the case-control investigation, control dogs were recruited through owner completion of a July 2017 survey. Summary statistics and ORs for case dog lifestyle factors were reported.

RESULTS

54 dogs were classified as confirmed and 17 as probable cases. For 4 dogs of a household cluster (5 confirmed and 3 probable), the highest microscopic agglutination titer was for serovar Djasiman (Leptospira kirschneri detected by PCR assay), and for 13 dogs of a community outbreak (49 confirmed and 14 probable cases), the highest titer was for serovar Canicola (Leptospira interrogans detected by PCR assay). The 44 case dogs included in the case-control investigation were 7.7 (95% CI, 3.5 to 16.7) and 2.9 times (95% CI, 1.3 to 6.6) as likely as control dogs to have visited dog daycare or to have been kenneled overnight at a boarding facility, respectively, 30 days prior to the onset of clinical signs or diagnosis.

CONCLUSIONS AND CLINICAL RELEVANCE

Diagnostic and epidemiological findings indicated 2 outbreaks. Transmission where dogs congregated likely propagated the community outbreak. Outbreaks of leptospiral infections can occur in regions of low prevalence, and a dog's exposure to areas where dogs congregate should be considered when making Leptospira vaccination recommendations.

A cross-sectional study of environmental, dog, and human-related risk factors for positive canine leptospirosis PCR test results in the United States, 2009 to 2016

Background

Canine leptospirosis is a reemerging zoonotic disease concern in North America, and a better understanding of its epidemiology is needed. Wide-scale use and subsequent analyses of polymerase chain reaction (PCR) testing may provide additional insight into leptospirosis. This study aimed to describe temporal trends, to descriptively map, and to identify environmental, dog, and human-level factors associated with positive canine leptospirosis PCR test results in the United States.

Results

Data obtained from IDEXX Laboratories, Inc. on 40,118 canine leptospirosis PCR tests run in the United States between 2009 and 2016 were evaluated. Climate and socioeconomic (e.g. urban influence, income) data were obtained from public databases. Choropleth maps were created to identify high test-positive proportion areas and a cross-sectional analysis was completed with generalized (univariable, followed by multivariable) mixed logistic regression models accounting for county within state to identify significant predictors for a positive test. Overall test-positive proportion was 5.4% across the United States, with the regional point estimate highest in the southwest (8.1%). In the final multivariable model, the odds of a positive test were greater for male dogs (Odds Ratio [OR] = 1.28) and dogs 0–4 years of age (ORs ranged from 0.35–0.71 for the other age groups). The odds of a positive test were greater for dogs living in areas with wet environmental conditions (OR = 1.24). Season and temperature, as well as the interaction between them, were significant predictors of a positive test. Dogs had a greater probability of testing positive during cool temperatures (< 4 °C) compared to the other temperature categories in the fall season.

Conclusions

These findings based on PCR testing allow for an improved understanding of factors influencing a positive canine leptospirosis PCR test and will assist targeted education and prevention efforts.

The Dynamic Nature of Canine and Feline Infectious Disease Risks in the Twenty-first Century

Canine and feline infectious diseases are constantly changing in frequency and location. Numerous drivers or determinants of these changes are suspected, including emergence of new pathogens; change in virulence and resistance of existing pathogens; change in land use, climate, and weather; travel and trade; habitat destruction and urbanization; change in animal-animal contact networks; host susceptibility; availability and uptake of prevention measures; and change in ability to detect pathogens and track diseases. This article explores each of these proposed drivers and examines examples of feline and canine diseases likely to be influenced by them.

SEROEPIDEMIOLOGIC SURVEY OF CANINE LEPTOSPIROSIS IN NORTHERN TAIWAN DURING 2008–2015

Leptospirosis is an important infectious zoonosis that may cause life-threatening illness in both humans and animals. This study aimed to identify the serovars of Leptospira using the microscopic agglutination test (MAT) and the effect of season on serum-positive cases detected in National Taiwan University Veterinary Hospital from August 2008 to September 2015. This study also compared the characteristics of serum-positive and serum-negative cases. Among 159 suspected cases, 78 serum-positive (MAT titer [Formula: see text]) and 81 serum-negative cases were identified. In serum-positive cases, the most common pathogenic serovars were Canicola (18.2%), Icterohaemorrhagiae (23.6%), and Shermani (20.0%). Significantly more serum-positive cases were identified in fall (September to November) than other seasons ([Formula: see text]). Dogs aged 1–5 years (odds ratio [Formula: see text] 1.7) were more likely to be identified as being serum-positive cases of canine leptospirosis than serum-negative cases. However, no significant difference was observed regarding breed, gender, and regional distribution. The serum concentrations of liver enzymes, total bilirubin, blood urea nitrogen, and creatinine were elevated in both serum-positive and serum-negative cases, with no significance. White blood cell (WBC) counts of serum-positive cases were statistically higher than those of serum-negative cases ([Formula: see text]). In conclusion, more precaution must be taken with dogs aged 1–5 years because of their higher risk of leptospirosis; additionally, significantly elevated WBC count may be a suitable indicator in suspected cases of canine leptospirosis.

Characterization of leptospirosis among dogs in Oregon, 2007-2011

OBJECTIVE

To characterize the demographics, exposure risks, and outcomes for dogs with leptospirosis in Oregon between 2007 and 2011 and to identify geographic and temporal distributions of known cases of canine leptospirosis within the state during this period.

DESIGN

Retrospective descriptive epidemiological study.

ANIMALS

72 dogs.

PROCEDURES

Reports of laboratory tests for leptospirosis and zoonosis reporting forms voluntarily submitted by veterinarians to the Oregon Health Authority were evaluated to identify dogs with leptospirosis during the study period; data were also collected by examination of medical records or by telephone surveys with veterinarians from reporting facilities.

RESULTS

72 confirmed cases of leptospirosis were identified; surveys were completed for 65 cases. Seasonal and spatial distributions coincided with rainfall patterns for the state, with most cases diagnosed in the spring and in the western part of the state. Common exposure risks included contact with water in the environment (14/65) and contact with wildlife (14); 33 dogs had no history of known exposure risks. Among dogs with other conditions at the time of diagnosis (26/64), dermatitis, otitis, or both were the most commonly reported findings (9/26). Of 65 dogs, 44 recovered, 12 died or were euthanized because of leptospirosis, and 9 were lost to follow-up.

CONCLUSIONS AND CLINICAL RELEVANCE

Distribution of canine leptospirosis cases in Oregon fit the rainfall theory pattern. Dermatologic conditions were present in 9 of 64 (14%) dogs that had a diagnosis of leptospirosis; however, further investigation is needed to determine whether such conditions predispose dogs to the disease.

Prevalence of antibodies against Borrelia burgdorferi, Anaplasma phagocytophilum, and Leptospira interrogans serovars in Bernese Mountain Dogs

OBJECTIVE

Bernese Mountain Dogs (BMD) have a higher prevalence of Borrelia burgdorferi sensu lato (Bbsl) antibodies than other breeds, but it is not known whether this is the case for other pathogens. Therefore, the aim of the study was to determine the frequency and level of specific antibodies against members of the Bbsl group, Anaplasma phagocytophilum (Ap), and Leptospira (L.) interrogans serovars in BMD and compare the results with those found in dogs of other breeds.

MATERIALS AND METHODS

A total of 171 healthy BMD and 57 healthy control dogs of other breeds were included in the study. Controls were large dogs (> 30 kg) with long, dark hair coats. A two-tiered testing method consisting of computerized kinetic enzyme-linked immunosorbent assay (KELA) and Western blotting was used for detection of antibodies against Bbsl, an immunofluorescence assay (IFA) was used for detection of antibodies against Ap, and microscopic agglutination test (MAT) for antibodies to 18 different serovars of L. interrogans.

RESULTS

The prevalence of anti-Bbsl antibodies was significantly higher in BMD (43.3%) than in controls (17.5%) (p < 0.001). Antibodies to Bbsl attributable to vaccination were excluded from the calculation of prevalence. Antibodies to Ap were found in 50.3% of BMD, whereas only 24.6% of the controls dogs were tested positive for Ap (p < 0.001). Antibody titers of the 18 different serovars of L. interrogans antibodies did not differ significantly between BMD and control dogs except for L. copenhageni antibody titers which were higher in BMD. Significantly higher antibody titers to L. canicola (p = 0.003), L. copenhageni (p = 0.005), L. grippothyphosa (p = 0.029) and L. vanderhoedoni (p = 0.035) were seen in BMD compared to control dogs.

CONCLUSION AND CLINICAL RELEVANCE

BMD had a higher prevalence of anti-Bbsl, anti-L. copenhageni and anti-Ap antibodies than control dogs. Significantly higher antibody titers against L. canicola (p = 0.003), L. copenhageni (p = 0.005), L. grippothyphosa (p = 0.029) and L. vanderhoedoni (p = 0.035) were seen in BMD compared with control dogs, but the reason for this and potential clinical implications are not known.

Meta-Analyses of Factors Associated with Leptospirosis in Domestic Dogs

Factors related with leptospirosis in domestic dogs have been reported worldwide. The aims of this study were to identify factors associated with this disease described in different observational studies and to combine the coinciding factors in at least four studies using meta-analyses, to obtain a pooled odds ratio (OR) as measure of infection risk. A literature search was performed in electronic databases, electronic databases of specific journals and search engines to find studies published in English, Spanish and Portuguese available from January 1960 to January 2015. Two hundred and eighteen factors were identified in 31 publications including cross-sectional and case-control studies. Finally, independent meta-analyses were performed with six different variables, which included between 4 and 8 articles. The pooled OR indicated that the variables 'mixed-breed dogs', 'flooding occurrence in the habitat of the dog' and 'working dogs' were risk factors for leptospirosis, while 'being a dog less than 1 year old' was a protective factor; however, all these associations were not statistically significant. Otherwise, the variables 'male dog' and 'urban dog' were statistically significant risk factors for infection. This study highlights the need for more formal studies on the epidemiology of canine leptospirosis. Nevertheless, the study revealed that some risk factors for infection coincided in different observational studies. These factors could be considered to raise suspicion about the disease, especially when there is a history of exposure to the bacteria.

Bacterial Zoonoses Transmitted by Household Pets: State-of-the-Art and Future Perspectives for Targeted Research and Policy Actions

The close contact between household pets and people offers favourable conditions for bacterial transmission. In this article, the aetiology, prevalence, transmission, impact on human health and preventative measures are summarized for selected bacterial zoonoses transmissible by household pets. Six zoonoses representing distinct transmission routes were selected arbitrarily based on the available information on incidence and severity of pet-associated disease caused by zoonotic bacteria: bite infections and cat scratch disease (physical injuries), psittacosis (inhalation), leptospirosis (contact with urine), and campylobacteriosis and salmonellosis (faecal-oral ingestion). Antimicrobial resistance was also included due to the recent emergence of multidrug-resistant bacteria of zoonotic potential in dogs and cats. There is a general lack of data on pathogen prevalence in the relevant pet population and on the incidence of human infections attributable to pets. In order to address these gaps in knowledge, and to minimize the risk of human infection, actions at several levels are recommended, including: (1) coordinated surveillance of zoonotic pathogens and antimicrobial resistance in household pets, (2) studies to estimate the burden of human disease attributable to pets and to identify risk behaviours facilitating transmission, and (3) education of those in charge of pets, animal caretakers, veterinarians and human medical healthcare practitioners on the potential zoonotic risks associated with exposure to pets. Disease-specific recommendations include incentives to undertake research aimed at the development of new diagnostic tests, veterinary-specific antimicrobial products and vaccines, as well as initiatives to promote best practices in veterinary diagnostic laboratories and prudent antimicrobial usage.