Serological and microbiological findings on 3 farms with equine leptospiral abortions

Identification of equine mares as reservoir hosts for pathogenic species of Leptospira

Equine leptospirosis can result in abortion, stillbirth, neonatal death, placentitis, and uveitis. Horses can also act as subclinical reservoir hosts of infection, which are characterized as asymptomatic carriers that persistently excrete leptospires and transmit disease. In this study, PCR and culture were used to assess urinary shedding of pathogenic Leptospira from 37 asymptomatic mares. Three asymptomatic mares, designated as H2, H8, and H9, were PCR-positive for lipL32, a gene specific for pathogenic species of Leptospira. One asymptomatic mare, H9, was culture-positive, and the recovered isolate was classified as L. kirschneri serogroup Australis serovar Rushan. DNA capture and enrichment of Leptospira genomic DNA from PCR-positive, culture-negative samples determined that asymptomatic mare H8 was also shedding L. kirschneri serogroup Australis, whereas asymptomatic mare H2 was shedding L. interrogans serogroup Icterohaemorrhagiae. Sera from all asymptomatic mares were tested by the microscopic agglutination test (MAT) and 35 of 37 (94.6%) were seropositive with titers ranging from 1:100 to 1:3200. In contrast to asymptomatic mares, mare H44 presented with acute spontaneous abortion and a serum MAT titer of 1:102,400 to L. interrogans serogroup Pomona serovar Pomona. Comparison of L. kirschneri serogroup Australis strain H9 with that of L. interrogans serogroup Pomona strain H44 in the hamster model of leptospirosis corroborated differences in virulence of strains. Since lipopolysaccharide (LPS) is a protective antigen in bacterin vaccines, the LPS of strain H9 (associated with subclinical carriage) was compared with strain H44 (associated with spontaneous abortion). This revealed different LPS profiles and immunoreactivity with reference antisera. It is essential to know what species and serovars of Leptospira are circulating in equine populations to design efficacious vaccines and diagnostic tests. Our results demonstrate that horses in the US can act as reservoir hosts of leptospirosis and shed diverse pathogenic Leptospira species via urine. This report also details the detection of L. kirschneri serogroup Australis serovar Rushan, a species and serotype of Leptospira, not previously reported in the US.

Leptospirosis: An important infectious disease in North American horses

North American horses are commonly exposed to Leptospira organisms. Leptospira Bratislava is the most common infecting serovar but this serovar has not been confirmed to cause clinical disease in North American horses. Leptospira Pomona type kennewicki is responsible for most of the clinical diseases (leptospirosis) in North American horses. Leptospirosis is most commonly associated with diseases of the placenta and fetus, the kidneys and the eyes in horses. In-utero infections in pregnant mares may result in abortion, neonatal illness or birth of an antibody positive healthy foal. Acute renal failure in younger horses and recurrent uveitis in adult horses are other well documented clinical syndromes of leptospirosis. Abortions, neonatal disease and acute renal failure are caused by a subacute infection, while horses with Leptospira associated recurrent uveitis develop ocular disease months or years after the initial Leptospira infection. Diagnosis of Leptospirosis is made by a combination of antigen or antibody testing methods. Mares that abort following Leptospira infection have no additional clinical signs at the time of abortion but may shed the offending Leptospira spp. in the urine for several weeks. Antibiotic treatments are sometimes used in hopes of decreasing Leptospira shedding in infected horses or prophylactically in exposed pregnant mares but documentation of efficacy is lacking. Horses with Leptospira - associated acute renal failure can be successfully treated with antibiotics and supportive care. Recurrent uveitis is commonly associated with leptospirosis in North American horses and although horses may have chronic intraocular infection triggering an immune disease, systemic antimicrobial therapy has not been effective in eliminating the organism from the eye. An equine approved Leptospira Pomona type kennewicki vaccine is now available in North America.

A study of leptospirosis in South African horses and associated risk factors

Most leptospiral infections in horses are asymptomatic; however, acute disease manifestations as well as reproductive failure and recurrent uveitis have been reported. In South Africa, the epidemiology of the disease in horses is not well documented. A serosurvey to determine what serovars were present in horses from Gauteng, KwaZulu-Natal and Western Cape Provinces and to get an estimate of the seroprevalence of leptospirosis was carried out from January 2013 until April 2014 with the assistance of four large equine hospitals located in these provinces. Furthermore, associations between potential risk factors and both seropositive horses to the predominant serovar Bratislava and to Leptospira spp. were statistically evaluated using univariate analysis and multivariable logistic regression models. A total of 663 horse sera were collected and tested against a panel of 24 leptospiral serovars using the microscopic agglutination test. The most predominant serovars in Gauteng were Bratislava [32%, 95% CI: 29-35%]; Djasiman [10.4%, 95% CI: 8-12%] and Arborea [8.9%, 95% CI: 7-11%], in the Western Cape Province, Bratislava [27.35%, 95% CI: 23-32]; Djasiman [15.4%, 95% CI: 12-19%] and Arborea [14.5%, 95% CI: 11-18%] and in KwaZulu-Natal, Bratislava [39.4%, 95% CI: 34-44%]; Arborea [9.6%, 95% CI: 7-13%]; and Tarassovi [7.7%, 95% CI: 5-10%] respectively. Twenty one serovars representing 17 serogroups were detected with serovar Bratislava being the most serodominant. The apparent prevalence to one or more serovars of Leptospira spp. at a serum dilution of 1:100 in Gauteng, KwaZulu-Natal and Western Cape Provinces were 49%; 37% and 32% respectively. The true prevalence was calculated for each province taking into account the clustering effect during the sampling and was found to be between 24 and 74% in Gauteng; 26-39% in the Western Cape and 20-54% in KwaZulu-Natal. Nooitgedacht (South African horse breed) horses were found to be at greater risk of being seropositive to both serovar Bratislava (OR=5.08) and Leptospira spp. (OR=6.3). Similarly, horses residing on properties with forestry in the vicinity were found to be at greater risk of being seropositive to both serovar Bratislava (OR=9.3) and Leptospira spp. (OR=5.2). This study has shown that a high proportion of horses in South Africa are exposed to a wide range of serovars, inferring a complex epidemiology. It also describes for the first time new serovars of Leptospira in South African horses that have not previously been reported.

Preliminary evaluation of a dual antigen ELISA to distinguish vaccinated from Leptospira infected horses

Immunogenic proteins of Leptospira interrogans serovar Pomona type kennewicki (Lk) including Sph1, LigA, Hsp15 and LipL45 (Qlp42) are up-regulated in infected horses but are undetectable or expressed in trace amounts on cultured organisms. In contrast, LipL32 is abundant on cultured Lk and elicits infection antibody responses. The aim of this study was to develop an ELISA based on LipL32 or Lk sonicate and host-induced proteins to differentiate vaccine from infection serum antibody. IgG specific for recombinant Sph1, LigA, Lk90 (LigA; 379-1225 a.a), Hsp15, LipL45 and LipL32 of Lk were assayed in sera of horses infected naturally with Lk and before and after immunisation with serovar Pomona bacterin. Infection but not vaccine sera reacted strongly with Sph1, LigA and Lk90. LipL45 and Hsp15 reacted moderately with infection sera and weakly with vaccine sera. Lk sonicate and LipL32 reacted strongly with both infection and vaccine sera. As expected, culture-based vaccine failed to stimulate antibody to host-induced proteins. Therefore a dual antigen ELISA based on Lk sonicate or LipL32 combined with host-induced Sph1 and Lk90 will be valuable in differentiating infection from vaccine responses.

Multiple specificities of immunoglobulin M in equine fetuses infected with Leptospira interrogans indicate a competent immune response

REASONS FOR PERFORMING STUDY

Foals of mares infected with Leptospira interrogans serovar Pomona type kennewicki (Lk) may be aborted/stillborn or delivered as healthy foals. Is fetal survival explained in part by the immune response of the fetus to Leptospira antigens?

OBJECTIVES

To describe an outbreak of Leptospira abortion in which infected mares delivered dead/sick or normal foals and determine specificities of antibody in a collection of 54 fetuses from similar outbreaks.

STUDY DESIGN

Outbreak investigation in combination with a case-control study of a larger set of samples from aborted fetuses.

METHODS

Serology and polymerase chain reaction (PCR) on urine and amniotic fluids were used to diagnose infection during an outbreak of Leptospira abortion. Specificities of immunoglobulin (Ig)M, IgGa and IgGb for recombinant proteins of Lk in archived fluids of fetuses from similar outbreaks were compared by ELISA with those of fluids of fetuses not infected with Leptospira spp.

RESULTS

Five fetuses of 11 infected mares in an outbreak survived in utero in the presence of persistent placental infection and were healthy at foaling. Fetuses of 6 mares in the outbreak were aborted or died soon after birth. Significantly greater (P<0.05) IgM reactivity with all recombinant proteins and with Lk sonicate was observed in 54 archived fluids from Leptospira infected fetuses than in fluids of 30 of non-Leptospira infected fetuses. Low levels of IgGa and IgGb specific for LipL32 and Lk sonicate and traces of LigA and Hsp15 specific IgGa were detected in a minority of archived fluids from Leptospira infected fetuses.

CONCLUSION

Although mainly mediated by IgM, a high level of immune competence in aborted fetuses was evidenced by the multiplicity of Leptospira proteins targeted. This is likely to contribute to survival of foals in mares with evidence of placental infection at foaling as detailed in a typical outbreak.

Equine recurrent uveitis: Human and equine perspectives

Equine recurrent uveitis (ERU) is a spontaneous disease characterised by repeated episodes of intraocular inflammation. The epidemiology of ERU has not been fully elucidated, but the condition appears to be much more common in horses than is recurrent uveitis in humans, especially in certain breeds and geographical regions. Both humans and horses show a similarly altered immune response and a marked autoimmune response as the primary disease pathophysiology. However, an inciting cause is not always clear. Potential inciting factors in horses include microbial agents such as Leptospira spp. Microbial factors and genetic predisposition to the disease may provide clues as to why the horse appears so susceptible to this disease. The aim of this review is to discuss the immunology and genetics of ERU, compare the disease in horses with autoimmune anterior uveitis in humans, and discuss potential reasons for the increased prevalence in the horse.

The role of leptospirosis in reproductive disorders in horses

Leptospirosis is a zoonotic disease of global importance and has a worldwide distribution. This infection displays clear seasonal nature in some regions of the tropics, where the rainy season is marked by high temperatures. Household and wild animals carry leptospires and contribute to their dissemination in nature. Transmission mainly occurs by contact with water contaminated with the urine of infected animals, and consequently, it is quite widespread especially in times of rain, since many areas are subject to flooding and have poor sanitation. Serological tests demonstrate that Leptospira sp. infection in horses occurs worldwide and that the predominant serovar may vary depending on the region or infection sources. Besides systemic and ocular manifestations, leptospirosis in horses has been recognized as an important disease of the reproductive system, since it leads to the birth of weak foals, stillbirths or neonatal mortality, and mainly to abortion, usually after the sixth month of pregnancy. In this context, this review aims to gather and discuss information about the role of leptospirosis in reproductive disorders in horses.

Seroprevalence of Leptospira spp. in clinically healthy racing horses in Korea

Leptospirosis is a zoonotic disease of global importance, and has a worldwide distribution. The present study aimed to determine leptospiral seroprevalence in clinically healthy racing horses from all three racecourses in Korea. Serum samples from 1,226 racing horses were examined using a microscopic agglutination test to detect the presence of antibodies against 18 Leptospira serovars. Of the tested samples, 307 (25.0%) were found to be positive. The distribution of seroprevalence differed significantly by racecourse (P=0.004); the Jeju course had the highest incidence (31.1%), followed by the Seoul (25.2%) and Busan (19.5%) racecourses. Seasonal variation in seropositivity was also apparent (P=0.000), being lower in spring (13.0%) and winter (12.5%), and higher in summer (36.7%) and autumn (34.7%). No significant age- or gender-related difference in seroprevalence was noted in this study (P>0.05). Seroprevalence was higher (P=0.006) among ponies than among thoroughbreds. Sejroe was the most frequently detected serovar (n=236), followed by Bratislava (n=35), Ballum (n=16), Autumnalis (n=10), and Canicola (n=10). The majority of serum titers were relatively low; most values ranged from 1:100 (n=217) to 1:200 (n=69). These results suggest that the Sejroe serovar may be maintained in the racing horse population in Korea.

Leptospirosis in squirrels imported from United States to Japan

We diagnosed leptospirosis in 2 patients exposed to southern flying squirrels imported from the United States to Japan. Patients worked with exotic animals in their company. Leptospira isolates from 1 patient and 5 of 10 squirrels at the company were genetically and serologically identical and were identified as Leptospira kirschneri.

Molecular detection of Leptospira kirschneri in tissues of a prematurely born foal

Leptospirosis was identified to be the possible cause of premature birth in a foal on a farm with a history of repeated abortions. Using an appropriate polymerase chain reaction (PCR) assay, the presence of Leptospira kirschneri was detected in the tissues of the prematurely born foal. Further confirmation of L. kirschneri was obtained by nucleotide sequence analysis of the PCR-amplified DNA fragment and the partial 16S ribosomal RNA gene sequence. This report further supports mounting evidence that a PCR assay capable of detecting L. kirschneri should be included in routine diagnostic investigations in which Leptospira spp. infection is suspected.

[Epidemiologic study of bovine and human leptospirosis in eastern Brazilian Amazon]

The seroprevalence study for leptospirosis in bovines and humans was realized in family holder farms along the Transamazon Highway. The prevalence of bovine leptospirosis was 97% [90.9 - 99.5%] of farms with at least one positive animal according to microscopic agglutination test for the leptospirosis diagnostic. In 61.2% of the tested herds, the serovar hardjo was the most common, followed by the serovar bratislava (9%) and the serovar shermani (4.5%). The serologic prevalence of leptospirosis in humans was 32.8% [23.4 - 43.5%] in family groups with at least one positive individual according to microscopic agglutination test for the leptospirosis diagnostic. In 9% of family groups, the serovar bratislava was the most common, while serovar hardjo and grippotyphosa accounted for 6% and 4.5%, respectively. The impact of these results is discussed in relation to animal production and public health. Suggestions have been proposed in order to improve the situation in the region.

Antibody isotypes in sera of equine fetuses aborted due to Leptospira interrogans serovar pomona-type kennewicki infection

Leptospira-specific antibody isotypes in sera of late term equine fetuses aborted due to Leptospira interrogans serovar pomona-type kennewicki infection were characterized and compared with those of their dams. IgM was the dominant Leptospira-Specific isotype in both fetuses and mares. However, IgGa was the isotype in highest concentration in petal sera and strong Leptospira-specific IgGa but no IgGb and little or no IgG(T) were detected. In contrast, although IgGb was quantitatively the dominant isotype in mares serum, Leptospira-specific serum IgG in aborting mares was dominated by IgG(T) but also included large amounts of IgGa and IgGb. IgGa and IgGb were quantitatively the dominant isotypes in sera of fetuses and mares, respectively. Affinity purified IgGa from fetuses did not agglutinate leptospires but serum devoid of IgGa did, suggesting that IgM is the principal agglutinating antibody. It is concluded that the equine fetus is deficient in IgGb and IgG(T) synthesis.

Emergent causes of placentitis and abortion

The clinical signs, laboratory findings, diagnosis, epidemiology, treatment, and prevention and control of two emerging causes of placentitis and abortion in horses are described in this article. Leptospirosis has been reported as a significant cause of fetal loss in horses in Kentucky, Northern Ireland, and England. Most abortions result from infection by serovars kennewicki or bratislava. Nocardioform placentitis has become the most common cause of placentitis in central Kentucky horses. Nocardioform placentitis is associated with infection by unnamed, gram-positive, filamentous, branching bacteria, and is characterized by distinctive changes in the placental membranes.

Differentiation of Leptospira interrogans isolates by IS1500 hybridization and PCR assays

Genetic variability among Leptospira interrogans (sensu stricto) serovars was assessed by Southern blot hybridization and PCR analyses. The experiments used probes directed to sequences in a recently described insertion element, IS1500. Hybridization analysis showed that IS1500 was present on polymorphic fragments and that differences in these patterns could be used to identify serovars. Hybridization analysis was also useful in discriminating between serovar pomona type kennewicki isolates, making possible the identification of 15 previously unrecognized genetic groups. A PCR assay was developed in which the primers are positioned near the terminal inverted repeats of the element and directed outward. This assay yielded characteristic amplification patterns from isolates, allowing them to be identified. We applied these assays to several new animal isolates of L. interrogans from Nicaragua, which recently had an outbreak of human leptospirosis. Three groups of isolates were identified: one strain of serovar pomona type kennewicki and two genetically distinct groups of isolates which may be genetic intermediates between serovars canicola and portlandvere. The IS-based typing assays described should be useful for epidemiological analysis of leptospirosis.

An outbreak of abortion in mares associated with Salmonella abortusequi infection

An abortion outbreak occurred in a herd of 38 horses, 26 of which were pregnant mares. Twenty-one mares aborted between 5-10 months of gestation. In no case were there indications of impending abortion. Pathoanatomical, histopathological, virological and bacteriological examinations were carried out on 4 aborted fetuses. Histopathology identified Gram-negative bacteria compatible with salmonella in all 4 placentae. By subsequent bacteriological examination Salmonella abortusequi was isolated as the single causative agent in each case. Nonmotile Salmonella abortusequi with antigenic formula 4,12:-:- was isolated from one of the 4 fetuses. The described episode of equine abortion clearly indicates that Salmonella abortusequi has not been eradicated from Europe as previously thought.