Risk factors associated with the seroprevalence of leptospirosis among students at the veterinary school of Zaragoza University

Sero-prevalence of anti-Leptospira antibodies and associated risk factors in rural Rwanda: A cross-sectional study

Background

Leptospirosis is a zoonotic disease transmitted through the urine of wild and domestic animals, and is responsible for over 50,000 deaths each year. In East Africa, prevalence varies greatly, from as low as 7% in Kenya to 37% in Somalia. Transmission epidemiology also varies around the world, with research in Nicaragua showing that rodents are the most clinically important, while studies in Egypt and Chile suggest that dogs may play a more important role. There are no published studies of leptospirosis in Rwanda.

Methods & findings

We performed a cross-sectional survey of asymptomatic adults recruited from five occupational categories. Serum samples were tested using ELISA and Microscopic Agglutination Test (MAT). We found that 40.1% (151/377) of asymptomatic adults had been exposed to Leptospira spp. Almost 36.3% of positive subjects reported contact with rats (137/377) which represent 90.7% among positive leptospira serology compared with 48.2% of negative subjects (182/377) which represent 80.5% among negative leptospira serology (OR 2.37, CI 1.25–4.49) and 1.7 fold on prevalence ratio and 2.37 of odd ratio. Furthermore, being a crop farmer was significantly associated with leptospirosis (OR 2.06, CI 1.29–3.28). We identified 6 asymptomatic subjects (1.6%) who met criteria for acute infection.

Conclusions

This study demonstrates a high prevalence of leptospiral antibodies infection among asymptomatic adults in rural Rwanda, particularly relative to neighboring countries. Although positive subjects were more likely to report rat contact, we found no independent association between rats and leptospirosis infection. Nonetheless, exposure was high among crop farmers, which is supportive of the hypothesis that rats together with domestic livestock might contribute to the transmission.

Further studies are needed to understand infecting Leptospira servers and elucidate the transmission epidemiology in Rwanda and identify means of host transmitters.

Leptospirosis is the most widespread zoonosis in the world, and infections are underappreciated in regions of the world where it may be mistaken for malaria and other tropical illnesses. We performed a seroprevalence study of leptospirosis in healthy asymptomatic adults in Rwanda. Among 377 subjects, we found evidence of infection in 40.1% (151 / 377), which is higher than in neighboring countries such as Kenya (7 to 16%), Tanzania (10 to 15.8%) and Uganda (15%). Our data suggest that leptospirosis may be a common cause of febrile illness in Rwanda, but further studies are needed to differentiate active from asymptomatic.

Leptospira infection and shedding in dogs in Thailand

BACKGROUND

Leptospirosis is a widespread zoonosis and has been recognized as a re-emerging infectious disease in humans and dogs, but prevalence of Leptospira shedding in dogs in Thailand is unknown. The aim of this study was to determine urinary shedding of Leptospira in dogs in Thailand, to evaluate antibody prevalence by microscopic agglutination test (MAT) and enzyme-linked immunosorbent assay (ELISA), and to assess risk factors for Leptospira infection. In Northern, Northeastern, and Central Thailand, 273 stray (n = 119) or client-owned (n = 154) dogs from rural (n = 139) or urban (n = 134) areas were randomly included. Dogs that had received antibiotics within 4 weeks prior to sampling were excluded. No dog had received vaccination against Leptospira. Urine was evaluated by real-time polymerase chain reaction (PCR) specific for lipL32 gene of pathogenic Leptospira. Additionally, urine was cultured for 6 months in Ellinghausen-McCullough-Johnson-Harris (EMJH) medium. Antibodies were measured by ELISA and MAT against 24 serovars belonging to 15 serogroups and 1 undesignated serogroup. Risk factor analysis was performed with backwards stepwise selection based on Wald.

RESULTS

Twelve of 273 (4.4%; 95% confidence interval (CI): 2.0-6.8%) urine samples were PCR-positive. In 1/273 dogs (0.4%; 95% CI: 0.01-1.1%) Leptospira could be cultured from urine. MAT detected antibodies in 33/273 dogs (12.1%; 95% CI: 8.2-16.0%) against 19 different serovars (Anhoa, Australis, Ballum, Bataviae, Bratislava, Broomi, Canicola, Copenhageni, Coxi, Grippotyphosa, Haemolytica, Icterohaemorrhagiae, Khorat, Paidjan, Patoc, Pyrogenes, Rachmati, Saxkoebing, Sejroe). In 111/252 dogs (44.0%; 95% CI: 37.9-50.2%) immunoglobulin M (IgM) and/or immunoglobulin G (IgG) antibodies were found by ELISA. Female dogs had a significantly higher risk for Leptospira infection (p = 0.023).

CONCLUSIONS

Leptospira shedding occurs in randomly sampled dogs in Thailand, with infection rates comparable to those of Europe and the USA. Therefore, the potential zoonotic risk should not be underestimated and use of Leptospira vaccines are recommended.

Risk factors of Leptospira infection in Mediterranean periurban micromammals

Urbanization of natural areas can change abiotic factors, providing artificial sources of humidity in summer and decreasing variation of temperatures in winter. Our study aimed at document risk factors of infection in mammal reservoirs of pathogenic Leptospira in the human/wildlife interface of a large metropolitan area. We hypothesize that survival of Leptospira and thus their prevalence in animal reservoirs should be higher in residential areas than in natural habitats, especially after the hot, dry Mediterranean summers. We established the prevalence of Leptospira spp. and identified the serovars in 353 urine samples from micromammals (chiefly the wood mouse Apodemus sylvaticus, n = 266) using direct immunofluorescence and PCR. Animals were captured in spring and autumn, 2011-2012, in two natural parks and two adjacent residential areas in periurban Barcelona (NE Spain). Overall observed prevalence of infection was 11%, ranking between 8% and 13% in the better represented host species. We observed marked differences between seasons; the probability of finding a micromammal infected in spring was three times greater than in autumn (almost four times for wood mouse). Prevalence was not related with type of habitat, micromammal relative abundance or sex of the animal. Three Leptospira species were confirmed: Leptospira interrogans (47% of cases), Leptospira borgpetersenii (41%) and Leptospira kirschneri (12%). The serovars most commonly detected were those typically hosted by rodents, and serovars Ballum and Icterohemorrhagiae were the only ones found in autumn. People living in periurban Barcelona and those visiting the natural areas of the metropolitan area face hazard of infection with rodent-borne Leptospira, especially during spring.

Zoonoses in Veterinary Students: A Systematic Review of the Literature

BACKGROUND

Veterinary students face diverse potential sources of zoonotic pathogens since the first years of their academic degree. Such sources include different animal species and pathologic materials which are used at university facilities as well as commercial clinics, farms and other external facilities.

OBJECTIVES

The present study utilizes a systematic review of the literature to identify zoonoses described in veterinary students.

DATA SOURCES

Web of Science and PubMed.

RESULTS

Of the 1,254 titles produced by the bibliographic search, 62 were included in this review. Whereas 28 of these articles (45.2%) described individual cases or outbreaks, the remaining 34 (54.8%) reported serological results. The zoonotic etiological agents described were bacteria, in 39 studies (62.9%), parasites, in 12 works (19.4%), virus, in 9 studies (14.5%) and fungi, in 2 (3.2%) of the selected articles. The selected literature included references from 24 different countries and covered the time period of the last 55 years.

LIMITATIONS

The fact that common cases of disease or cases of little clinical importance without collective repercussions are not usually published in peer-reviewed journals limits the possibility to reach conclusions from a quantitative point of view. Furthermore, most of the selected works (66.1%) refer to European or North American countries, and thus, the number of cases due to pathogens which could appear more frequently in non-occidental countries might be underestimated.

CONCLUSIONS/IMPLICATIONS

The results of the present systematic review highlight the need of including training in zoonotic diseases since the first years of Veterinary Science degrees, especially focusing on biosecurity measures (hygienic measures and the utilization of the personal protective equipment), as a way of protecting students, and on monitoring programs, so as to adequately advise affected students or students suspicious of enduring zoonoses.

Serological Evidence of Exposure to Leptospira spp. in Veterinary Students and Other University Students in Trinidad and Tobago

The study compared the serological evidence of leptospirosis in 212 students in four schools (veterinary, dental, advanced nursing education and pharmacy) of the University of the West Indies (UWI), by testing for IgG immunoglobulins to Leptospira spp. using the enzyme-linked immunosorbent assay (ELISA) and the microscopic agglutination test (MAT). Overall, of 212 students tested by the ELISA, 12 (5.7%) and 31 (14.6%) were positive and borderline, respectively. Amongst the 113 veterinary students 11 (9.7%) and 19 (16.8%) were seropositive and borderline respectively compared with nonveterinary students with corresponding values of 1 (1.0%) and 12 (12.1%). The frequency of serological evidence of leptospirosis by the ELISA was statistically significantly (P < 0.05; χ(2)) higher in veterinary students, 26.5% (30 of 113) than in nonveterinary students, 13.1% (13 of 99). By the MAT, the seropositivity for leptospirosis was similar for veterinary students, 7.1% (8 of 113) and nonveterinary students, 7.1% (7 of 99). For veterinary students, the prevalent infecting serovar was Icterohaemorrhagiae Copenhageni while amongst nonveterinary students, the prevalent serovar was Australis Rachmati. Being a veterinary student was the only risk factor that was significantly associated with Leptospira infection indicating that veterinary students need to be cognizant and to practise preventive measures for leptospirosis.

Leptospirosis in wild and domestic carnivores in natural areas in Andalusia, Spain

Leptospirosis is a zoonosis that affects humans, domestic animals, and wildlife. Carnivores are at the top of the feeding chain, thus being exposed to pathogens through their preys. From June 2004 to April 2007, we analyzed for evidences of contact with 14 serovars of Leptospira interrogans Sensu Lato serum (analyzed by indirect Microscopic Agglutination Test) and urine or kidney samples (analyzed by microscopic observation, immunostaining and culture) collected from 201 wild and domestic carnivores, including 26 free-living Iberian lynx (Lynx pardinus), 33 red foxes (Vulpes vulpes), 33 Egyptian mongooses (Herpestes ichneumon), 25 common genets (Genetta genetta), two Eurasian badgers (Meles meles) and one Eurasian otter (Lutra lutra), and 53 free-roaming cats and 28 rural dogs in protected areas in Andalusia (southern Spain). Twenty-three percent of the animals presented evidences of contact, being the prevalence similar among wild (23.5%) and domestic species (22.2%). Contact with Lesptospira was detected in all the species but the otter. Prevalence was: lynx (11% by bacteriological detection, 32% by serology), fox (0%, 47%), mongoose (5%, 20%), genet (0%, 12%), badger (0%, 50%), cat (20%, 14%), dog (only serology: 36%). Serovar Icterohemorragiae accounted for 2/3 of the cases. Serovar Canicola was detected in half of the positive dogs and one lynx. Other serovars detected were Ballum, Sejroë, and Australis. No macroscopic lesions were observed in necropsied animals that showed evidence of contact with the agent, although histopathologic lesions (chiefly chronic interstitial nephritis) were observed in 7 out of the 11 microscopically analyzed individuals. Thus, L. interrogans may cause previously unrecorded disease in wild carnivores in Spain. Wild and free-roaming carnivores may not act as reservoir of L. interrogans but as a dead-end hosts, though the dog may act as reservoir of serovar Canicola. Carnivores are apparently good sentinels for the epidemiological monitorization of leptospirosis.