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Beauté J, Innocenti F, Aristodimou A, Špačková M, Eves C, Kerbo N, Rimhanen-Finne R, Picardeau M, Faber M, Dougas G, Halldórsdóttir AM, Jackson S, Leitēna V, Vergison A, Borg ML, Pijnacker R, Sadkowska-Todys M, Martins JV, Rusu LC, Grilc E, Estévez-Reboredo RM, Niskanen T, Westrell T. Epidemiology of reported cases of leptospirosis in the EU/EEA, 2010 to 2021. Euro Surveill 2024; 29:2300266. [PMID: 38362624 PMCID: PMC10986659 DOI: 10.2807/1560-7917.es.2024.29.7.2300266] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Accepted: 11/09/2023] [Indexed: 02/17/2024] Open
Abstract
BackgroundLeptospirosis is a zoonotic disease caused by bacteria of the genus Leptospira. Humans are infected by exposure to animal urine or urine-contaminated environments. Although disease incidence is lower in Europe compared with tropical regions, there have been reports of an increase in leptospirosis cases since the 2000s in some European countries.AimWe aimed to describe the epidemiology of reported cases of leptospirosis in the European Union/European Economic Area (EU/EEA) during 2010-2021 and to identify potential changes in epidemiological patterns.MethodsWe ran a descriptive analysis of leptospirosis cases reported by EU/EEA countries to the European Centre for Disease Prevention and Control with disease during 2010-2021. We also analysed trends at EU/EEA and national level.ResultsDuring 2010-2021, 23 countries reported 12,180 confirmed leptospirosis cases corresponding to a mean annual notification rate of 0.24 cases per 100,000 population. Five countries (France, Germany, the Netherlands, Portugal and Romania) accounted for 79% of all reported cases. The highest notification rate was observed in Slovenia with 0.82 cases per 100,000 population. Overall, the notification rate increased by 5.0% per year from 2010 to 2021 (95% CI: 1.2-8.8%), although trends differed across countries.ConclusionThe notification rate of leptospirosis at EU/EEA level increased during 2010-2021 despite including the first 2 years of the COVID-19 pandemic and associated changes in population behaviours. Studies at (sub)national level would help broaden the understanding of differences at country-level and specificities in terms of exposure to Leptospira, as well as biases in diagnosis and reporting.
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Affiliation(s)
- Julien Beauté
- European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
| | - Francesco Innocenti
- European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
- Epidemiology Unit, Regional Health Agency of Tuscany, Florence, Italy
| | | | - Michaela Špačková
- Centre for Epidemiology and Microbiology, Department of Infectious Diseases Epidemiology, National Institute of Public Health, Prague, Czechia
| | - Caroline Eves
- Department of Infectious Disease Epidemiology and Prevention, Statens Serum Institut, Copenhagen, Denmark
| | - Natalia Kerbo
- Department of Communicable Diseases Epidemiology, Health Board, Tallinn, Estonia
| | - Ruska Rimhanen-Finne
- Department of Health Security, Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Mathieu Picardeau
- Institut Pasteur, Unité Biologie des spirochètes, Centre National de Référence de la Leptospirose, Paris, France
| | - Mirko Faber
- Department of Infectious Disease Epidemiology, Robert Koch-Institute (RKI), Berlin, Germany
| | - Georgios Dougas
- Directorate of Epidemiological Surveillance and Intervention for Infectious Diseases, National Public Health Organization, Athens, Greece
| | | | - Sarah Jackson
- Health Protection Surveillance Centre, Dublin, Ireland
| | | | | | - Maria Louise Borg
- Infectious Disease Prevention and Control Unit, Health Promotion and Disease Prevention Directorate, Pieta, Malta
| | - Roan Pijnacker
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands
| | | | - João Vieira Martins
- Directorate of Information and Analysis, Directorate-General of Health, Lisbon, Portugal
| | - Lavinia Cipriana Rusu
- National Centre for Surveillance and Control if Communicable Diseases, National Institute of Public Health, Bucharest, Romania
| | - Eva Grilc
- National Institute of Public Health, Ljubljana, Slovenia
| | | | - Taina Niskanen
- European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
| | - Therese Westrell
- European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
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Arboleda M, Mejía-Torres M, Posada M, Restrepo N, Ríos-Tapias P, Rivera-Pedroza LA, Calle D, Sánchez-Jiménez MM, Marín K, Agudelo-Flórez P. Molecular Diagnosis as an Alternative for Public Health Surveillance of Leptospirosis in Colombia. Microorganisms 2023; 11:2759. [PMID: 38004770 PMCID: PMC10673046 DOI: 10.3390/microorganisms11112759] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Revised: 10/24/2023] [Accepted: 10/30/2023] [Indexed: 11/26/2023] Open
Abstract
Leptospirosis represents a public health problem in Colombia. However, the underreporting of the disease is an unfortunate reality, with a clear trend towards a decrease in cases since 2019, when the guidelines for its confirmatory diagnosis changed with the requirement of two paired samples. The purpose of this review is to highlight the importance of leptospirosis. While the access to rapid diagnosis is available at practically all levels of care for dengue and malaria, leptospirosis-a doubly neglected disease-deserves recognition as a serious public health problem in Colombia. In this manner, it is proposed that molecular tests are a viable diagnostic alternative that can improve the targeted treatment of the patient and the timeliness of data and case reporting to SIVIGILA, and reduce the underreporting of the disease. Taking advantage of the strengthened technological infrastructure derived from the SARS-CoV-2 pandemic for molecular diagnosis in Colombia, with a network of 227 laboratories distributed throughout the national territory, with an installed capacity for PCR testing, it is proposed that molecular diagnosis can be used as an alternative for early diagnosis. This would allow case confirmation through the public health network in Colombia, and, together with the microagglutination (MAT) technique, the epidemiological surveillance of this disease in this country would be strengthened.
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Affiliation(s)
- Margarita Arboleda
- Tropical Medicine Group, Colombian Institute of Tropical Medicine, Sabaneta 055450, Colombia; (M.M.-T.); (M.P.); (N.R.); (P.R.-T.); (L.A.R.-P.); (D.C.); (M.M.S.-J.); (K.M.)
| | - Mariana Mejía-Torres
- Tropical Medicine Group, Colombian Institute of Tropical Medicine, Sabaneta 055450, Colombia; (M.M.-T.); (M.P.); (N.R.); (P.R.-T.); (L.A.R.-P.); (D.C.); (M.M.S.-J.); (K.M.)
| | - Maritza Posada
- Tropical Medicine Group, Colombian Institute of Tropical Medicine, Sabaneta 055450, Colombia; (M.M.-T.); (M.P.); (N.R.); (P.R.-T.); (L.A.R.-P.); (D.C.); (M.M.S.-J.); (K.M.)
| | - Nicaela Restrepo
- Tropical Medicine Group, Colombian Institute of Tropical Medicine, Sabaneta 055450, Colombia; (M.M.-T.); (M.P.); (N.R.); (P.R.-T.); (L.A.R.-P.); (D.C.); (M.M.S.-J.); (K.M.)
| | - Paola Ríos-Tapias
- Tropical Medicine Group, Colombian Institute of Tropical Medicine, Sabaneta 055450, Colombia; (M.M.-T.); (M.P.); (N.R.); (P.R.-T.); (L.A.R.-P.); (D.C.); (M.M.S.-J.); (K.M.)
| | - Luis Alberto Rivera-Pedroza
- Tropical Medicine Group, Colombian Institute of Tropical Medicine, Sabaneta 055450, Colombia; (M.M.-T.); (M.P.); (N.R.); (P.R.-T.); (L.A.R.-P.); (D.C.); (M.M.S.-J.); (K.M.)
| | - David Calle
- Tropical Medicine Group, Colombian Institute of Tropical Medicine, Sabaneta 055450, Colombia; (M.M.-T.); (M.P.); (N.R.); (P.R.-T.); (L.A.R.-P.); (D.C.); (M.M.S.-J.); (K.M.)
| | - Miryan M. Sánchez-Jiménez
- Tropical Medicine Group, Colombian Institute of Tropical Medicine, Sabaneta 055450, Colombia; (M.M.-T.); (M.P.); (N.R.); (P.R.-T.); (L.A.R.-P.); (D.C.); (M.M.S.-J.); (K.M.)
| | - Katerine Marín
- Tropical Medicine Group, Colombian Institute of Tropical Medicine, Sabaneta 055450, Colombia; (M.M.-T.); (M.P.); (N.R.); (P.R.-T.); (L.A.R.-P.); (D.C.); (M.M.S.-J.); (K.M.)
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Hagiya H, Koyama T, Otsuka F. Epidemiological Characteristics and Trends in the Incidence of Leptospirosis in Japan: A Nationwide, Observational Study from 2006 to 2021. Am J Trop Med Hyg 2023; 109:589-594. [PMID: 37487568 PMCID: PMC10484259 DOI: 10.4269/ajtmh.23-0131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Accepted: 05/23/2023] [Indexed: 07/26/2023] Open
Abstract
During this age of climate change, the incidence of tropical diseases may change. This study compared the epidemiological characteristics and trends of leptospirosis in Japan between the endemic region, Okinawa, and the rest of the country. Infectious Diseases Weekly Reports were used to determine the numbers and crude incidence rates of leptospirosis. Data were stratified by sex, age, the estimated location of the infection, the notified regions, and the reporting month. A joinpoint regression analysis was performed to estimate the annual percentage change (APC). During the 16-year study period (2006-2021), 543 leptospirosis cases were reported, with male dominance (86.2%). Approximately half of these cases were reported from Okinawa (47.1%). The patients were relatively younger in Okinawa (20-29 years, 23.4%; 30-39 years, 20.7%) than outside Okinawa. The frequency of imported cases was significantly higher outside Okinawa (0.4% versus 14.3%). The incidences of leptospirosis in and outside Okinawa were apparently higher during the summer and typhoon seasons. The annual crude incidence ratios were 20-200 times higher in Okinawa than in the rest of the country. The average APCs for the entire study period in Okinawa and the rest of Japan were 1.6% (95% CI: -5.9 to 9.6) and -1.8% (95% CI: -7.8 to 4.6), respectively, without any particular trends. Collectively, the patient profile of leptospirosis differed between Okinawa (younger men) and outside Okinawa (middle- or older-aged men with a history of traveling abroad). The disease remains a neglected tropical disease; continuous surveillance with close monitoring is required.
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Affiliation(s)
- Hideharu Hagiya
- Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Kitaku, Okayama, Japan
| | - Toshihiro Koyama
- Department of Health Data Science, Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama University, Okayama, Japan
| | - Fumio Otsuka
- Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Kitaku, Okayama, Japan
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Yamamoto Y, Hagiya H, Hayashi R, Otsuka F. Case Report: Leptospirosis after a Typhoon Disaster Outside the Endemic Region, Japan. Am J Trop Med Hyg 2023; 109:587-588. [PMID: 37524329 PMCID: PMC10484281 DOI: 10.4269/ajtmh.23-0133] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2023] [Accepted: 06/27/2023] [Indexed: 08/02/2023] Open
Abstract
Leptospirosis is a zoonotic disease that primarily affects people in tropical and subtropical areas worldwide. Owing to the temperate climate of Japan, leptospirosis is not endemic across the country. Domestic cases of leptospirosis have been mainly reported in Okinawa and the southwestern subtropical islands, but not in the other regions. Here, we describe a case of leptospirosis that developed and was diagnosed outside the domestically endemic region. Notably, disease onset occurred shortly after the patient experienced a flood after a typhoon disaster. With global warming, the international prevalence of leptospirosis may change. Physicians outside currently endemic areas must be aware of this tropical disease.
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Affiliation(s)
- Yukichika Yamamoto
- Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Hideharu Hagiya
- Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Ruiko Hayashi
- Department of Internal Medicine, Kosei General Hospital, Hiroshima, Japan
| | - Fumio Otsuka
- Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
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Cordonin C, Gomard Y, Monadjem A, Schoeman MC, Le Minter G, Lagadec E, Gudo ES, Goodman SM, Dellagi K, Mavingui P, Tortosa P. Ancestral African Bats Brought Their Cargo of Pathogenic Leptospira to Madagascar under Cover of Colonization Events. Pathogens 2023; 12:859. [PMID: 37513706 PMCID: PMC10385254 DOI: 10.3390/pathogens12070859] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2023] [Revised: 06/06/2023] [Accepted: 06/16/2023] [Indexed: 07/30/2023] Open
Abstract
Madagascar is home to an extraordinary diversity of endemic mammals hosting several zoonotic pathogens. Although the African origin of Malagasy mammals has been addressed for a number of volant and terrestrial taxa, the origin of their hosted zoonotic pathogens is currently unknown. Using bats and Leptospira infections as a model system, we tested whether Malagasy mammal hosts acquired these infections on the island following colonization events, or alternatively brought these bacteria from continental Africa. We first described the genetic diversity of pathogenic Leptospira infecting bats from Mozambique and then tested through analyses of molecular variance (AMOVA) whether the genetic diversity of Leptospira hosted by bats from Mozambique, Madagascar and Comoros is structured by geography or by their host phylogeny. This study reveals a wide diversity of Leptospira lineages shed by bats from Mozambique. AMOVA strongly supports that the diversity of Leptospira sequences obtained from bats sampled in Mozambique, Madagascar, and Comoros is structured according to bat phylogeny. Presented data show that a number of Leptospira lineages detected in bat congeners from continental Africa and Madagascar are imbedded within monophyletic clades, strongly suggesting that bat colonists have indeed originally crossed the Mozambique Channel while infected with pathogenic Leptospira.
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Affiliation(s)
- Colette Cordonin
- Unité Mixte de Recherche PIMIT "Processus Infectieux en Milieu Insulaire Tropical", Centre National de la Recherche Scientifique 9192, Institut National de la Santé Et de la Recherche Médicale 1187, Institut de Recherche pour le Développement 249, Université de La Réunion, Plateforme de Recherche CYROI, 97490 Sainte Clotilde, Réunion
| | - Yann Gomard
- Unité Mixte de Recherche PIMIT "Processus Infectieux en Milieu Insulaire Tropical", Centre National de la Recherche Scientifique 9192, Institut National de la Santé Et de la Recherche Médicale 1187, Institut de Recherche pour le Développement 249, Université de La Réunion, Plateforme de Recherche CYROI, 97490 Sainte Clotilde, Réunion
| | - Ara Monadjem
- Department of Biological Sciences, University of Eswatini, Private Bag 4, Kwaluseni M202, Eswatini
- Department of Zoology and Entomology, Mammal Research Institute, University of Pretoria, Private Bag 20, Hatfield 0028, South Africa
| | - M Corrie Schoeman
- School of Life Sciences, University of KwaZulu-Natal, Durban 4000, South Africa
| | - Gildas Le Minter
- Unité Mixte de Recherche PIMIT "Processus Infectieux en Milieu Insulaire Tropical", Centre National de la Recherche Scientifique 9192, Institut National de la Santé Et de la Recherche Médicale 1187, Institut de Recherche pour le Développement 249, Université de La Réunion, Plateforme de Recherche CYROI, 97490 Sainte Clotilde, Réunion
| | - Erwan Lagadec
- Unité Mixte de Recherche PIMIT "Processus Infectieux en Milieu Insulaire Tropical", Centre National de la Recherche Scientifique 9192, Institut National de la Santé Et de la Recherche Médicale 1187, Institut de Recherche pour le Développement 249, Université de La Réunion, Plateforme de Recherche CYROI, 97490 Sainte Clotilde, Réunion
| | | | - Steven M Goodman
- Negaunee Integrative Research Center, Field Museum of Natural History, Chicago, IL 60605, USA
- Association Vahatra, BP 3972, Antananarivo 101, Madagascar
| | - Koussay Dellagi
- Unité Mixte de Recherche PIMIT "Processus Infectieux en Milieu Insulaire Tropical", Centre National de la Recherche Scientifique 9192, Institut National de la Santé Et de la Recherche Médicale 1187, Institut de Recherche pour le Développement 249, Université de La Réunion, Plateforme de Recherche CYROI, 97490 Sainte Clotilde, Réunion
| | - Patrick Mavingui
- Unité Mixte de Recherche PIMIT "Processus Infectieux en Milieu Insulaire Tropical", Centre National de la Recherche Scientifique 9192, Institut National de la Santé Et de la Recherche Médicale 1187, Institut de Recherche pour le Développement 249, Université de La Réunion, Plateforme de Recherche CYROI, 97490 Sainte Clotilde, Réunion
| | - Pablo Tortosa
- Unité Mixte de Recherche PIMIT "Processus Infectieux en Milieu Insulaire Tropical", Centre National de la Recherche Scientifique 9192, Institut National de la Santé Et de la Recherche Médicale 1187, Institut de Recherche pour le Développement 249, Université de La Réunion, Plateforme de Recherche CYROI, 97490 Sainte Clotilde, Réunion
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Tan XY, Citartan M, Chinni SV, Ahmed SA, Tang TH. Biocomputational Identification of sRNAs in Leptospira interrogans Serovar Lai. Indian J Microbiol 2023; 63:33-41. [PMID: 37188232 PMCID: PMC10172424 DOI: 10.1007/s12088-022-01050-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Accepted: 12/02/2022] [Indexed: 12/24/2022] Open
Abstract
Regulatory small RNAs (sRNA) are RNA transcripts that are not translated into proteins but act as functional RNAs. Pathogenic Leptospira cause an epidemic spirochaetal zoonosis, Leptospirosis. It is speculated that Leptospiral sRNAs are involved in orchestrating their pathogenicity. In this study, biocomputational approach was adopted to identify Leptospiral sRNAs. In this study, two sRNA prediction programs, i.e., RNAz and nocoRNAc, were employed to screen the reference genome of Leptospira interrogans serovar Lai. Out of 126 predicted sRNAs, there are 96 cis-antisense sRNAs, 28 trans-encoded sRNAs and 2 sRNAs that partially overlap with protein-coding genes in a sense orientation. To determine whether these candidates are expressed in the pathogen, they were compared with the coverage files generated from our RNA-seq datasets. It was found out that 7 predicted sRNAs are expressed in mid-log phase, stationary phase, serum stress, temperature stress and iron stress while 2 sRNAs are expressed in mid-log phase, stationary phase, serum stress, and temperature stress. Besides, their expressions were also confirmed experimentally via RT-PCR. These experimentally validated candidates were also subjected to mRNA target prediction using TargetRNA2. Taken together, our study demonstrated that biocomputational strategy can serve as an alternative or as a complementary strategy to the laborious and expensive deep sequencing methods not only to uncover putative sRNAs but also to predict their targets in bacteria. In fact, this is the first study that integrates computational approach to predict putative sRNAs in L. interrogans serovar Lai. Supplementary Information The online version contains supplementary material available at 10.1007/s12088-022-01050-9.
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Affiliation(s)
- Xinq Yuan Tan
- Advanced Medical and Dental Institute (AMDI), Universiti Sains Malaysia, Bertam, 13200 Kepala Batas, Penang Malaysia
| | - Marimuthu Citartan
- Advanced Medical and Dental Institute (AMDI), Universiti Sains Malaysia, Bertam, 13200 Kepala Batas, Penang Malaysia
| | - Suresh Venkata Chinni
- Department of Biotechnology, Faculty of Applied Sciences, AIMST University, 08100 Bedong, Kedah Malaysia
| | - Siti Aminah Ahmed
- Advanced Medical and Dental Institute (AMDI), Universiti Sains Malaysia, Bertam, 13200 Kepala Batas, Penang Malaysia
| | - Thean-Hock Tang
- Advanced Medical and Dental Institute (AMDI), Universiti Sains Malaysia, Bertam, 13200 Kepala Batas, Penang Malaysia
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Premarathne SS, Gamage C, Chandrajith R, Ratnatunge NV, Wijetunge S, Wazil A, Chou LF, Ko YC, Huang CT, Yang HY, Fonseka A, Sonnadara T, Herath D, Hewavitharane P, Yang CW, Nanayakkara N. Leptospirosis: A Potential Culprit for Chronic Kidney Disease of Uncertain Etiology. Nephron Clin Pract 2023; 147:510-520. [PMID: 36809758 PMCID: PMC10568603 DOI: 10.1159/000528703] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2022] [Accepted: 10/23/2022] [Indexed: 02/23/2023] Open
Abstract
PURPOSE Chronic kidney disease of uncertain etiology (CKDu) is an environmental nephropathy in which the etiological factors are yet uncertain. Leptospirosis, a spirochetal infection that is common among agricultural communities, has been identified as a potential etiology for CKDu beyond environmental nephropathy. Although CKDu is a chronic kidney disease, in endemic regions, an increasing number of cases are reported with features suggestive of acute interstitial nephritis without any known reason (AINu), with or without background CKD. The study hypothesizes that exposure to pathogenic leptospires is one of the causative factors for the occurrence of AINu. METHOD This study was carried out using 59 clinically diagnosed AINu patients, 72 healthy controls from CKDu endemic region (endemic controls [ECs]), and 71 healthy controls from CKDu non-endemic region (non-endemic controls [NECs]). RESULTS The seroprevalence of 18.6, 6.9, and 7.0% was observed in the AIN (or AINu), EC, and NEC groups, respectively, from the rapid IgM test. Among 19 serovars tested, the highest seroprevalence was observed at 72.9, 38.9, and 21.1% in the AIN (AINu), EC, and NEC groups, respectively, by microscopic agglutination test (MAT), particularly for serovar Leptospira santarosai serovar Shermani. This emphasizes the presence of infection in AINu patients, and this also suggests that Leptospira exposure might play an important role in AINu. CONCLUSION These data suggest that exposure to Leptospira infection could be one of the possible causative factors for the occurrence of AINu, which may lead to CKDu in Sri Lanka.
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Affiliation(s)
- Shakila Sudarshani Premarathne
- Centre for Research, National Hospital, Kandy, Sri Lanka
- Department of Microbiology, Faculty of Medicine, University of Peradeniya, Kandy, Sri Lanka
| | - Chandika Gamage
- Department of Microbiology, Faculty of Medicine, University of Peradeniya, Kandy, Sri Lanka
| | - Rohana Chandrajith
- Depatment of Geology, Faculty of Science, University of Peradeniya, Kandy, Sri Lanka
| | | | - Sulochana Wijetunge
- Department of Pathology, Faculty of Medicine, University of Peradeniya, Kandy, Sri Lanka
| | - Abdul Wazil
- Nephrology and Kidney Transplant Unit, National Hospital, Kandy, Sri Lanka
| | - Li-Fang Chou
- Kidney Research Center, Chang Gung Memorial Hospital, Linkou, Taiwan
| | - Yi-Ching Ko
- Kidney Research Center, Chang Gung Memorial Hospital, Linkou, Taiwan
| | | | - Huang-Yu Yang
- Kidney Research Center, Chang Gung Memorial Hospital, Linkou, Taiwan
- Department of Nephrology, Chang Gung Memorial Hospital, Linkou, Taiwan
- College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Amanda Fonseka
- Department of Microbiology, Faculty of Medicine, University of Peradeniya, Kandy, Sri Lanka
| | | | | | | | - Chih-Wei Yang
- Kidney Research Center, Chang Gung Memorial Hospital, Linkou, Taiwan
- Department of Nephrology, Chang Gung Memorial Hospital, Linkou, Taiwan
- College of Medicine, Chang Gung University, Taoyuan, Taiwan
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Tokarevich NK, Blinova OV. Leptospirosis in Vietnam. RUSSIAN JOURNAL OF INFECTION AND IMMUNITY 2022. [DOI: 10.15789/2220-7619-liv-1988] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Leptospirosis poses a serious public health problem in many countries because about 1 million people suffer annually from this severe, often fatal, infection. At present, its importance has been increasing due to development of integration processes, globalization and intensification of economic activities, inevitable anthropogenic transformation of landscapes as well as rise in number of people with occupational risk of pathogen exposure. The burden of human leptospirosis is expected to rise with demographic shifts and climate change that result in heavy rainfall and flooding. Regarding leptospirosis, Southeast Asia, including Vietnam, is among the most vulnerable global regions. The objective of the review was to analyze available published data on the spread of leptospirosis in Vietnam. More than 100 research articles were analyzed allowing to state that in Vietnam synanthropic rodents (rats), agricultural (buffaloes, cattle, pigs) and domestic animals (cats, dogs) are the main sources of leptospirosis infection in humans. It is essential that rats (cats and dogs also) in Vietnam are used for food. Among all farm animals, pigs are of maximal importance as a source of infection in humans. In Vietnam, Leptospira prevalence in pigs varies widely, up to 73%. It depends significantly on the location, farm size, age and gender of animals, etc. A large variety of Leptospira serovars have been identified in pigs in Vietnam: Tarassovi, Bratislava, Australis, Javanica, Autumnalis, Grippotyphosa, and some others. Official Vietnam reporting of leptospirosis cases based on clinical data does not reflect the real-life incidence rate in humans. However, the available seroprevalence studies reveal that, on average, about 10% of the Vietnamese population are infected with Leptospira. Work in agriculture is the dominant risk factor for acquiring this infection. The highest Leptospira seroprevalence rates were detected in farmers, 63.2%. Serovar diversity is typical for pathogenic Leptospira circulating in Vietnam. In humans, the most frequent are antibodies to Hebdomadis, Wolffi and Icterohaemorrhagiae, but the frequency varied markedly across the country depending on the site, possibly with relation to the environment, as well as with economic activity of the local population. In Vietnam, geographic, climatic and social differences between northern, central and southern regions contribute to the specificity of local leptospirosis epidemiology. This emphasizes the advisability of developing special measures for leptospirosis prevention taking into account regional peculiarities.
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Al Hariri YK, Sulaiman SAS, Khan AH, Adnan AS, Al-Ebrahem SQ. Determinants of prolonged hospitalization and mortality among leptospirosis patients attending tertiary care hospitals in northeastern state in peninsular Malaysia: A cross sectional retrospective analysis. Front Med (Lausanne) 2022; 9:887292. [PMID: 36160172 PMCID: PMC9500579 DOI: 10.3389/fmed.2022.887292] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Accepted: 07/28/2022] [Indexed: 11/13/2022] Open
Abstract
BackgroundLeptospirosis is the most common anthropozoonosis worldwide and imposes a major public health problem in many tropical countries. It is a leading cause of disease burden in form of mortality, morbidity and hospital admission. Identifying patients at high risk for mortality or for prolonged hospitalization may save lives and preserve economy. The aim of the current study is to identify significant factors associated with disease mortality and prolonged hospitalization.DesignCress-sectional retrospective study.SettingsTertiary care teaching hospitals in Kelantan, Peninsular Malaysia.ParticipantsAdult patients proven to have leptospirosis depending on IgM ELISA were classified into two classes depending on prolonged hospitalization (>7 days or ≤ 7 days) and mortality (fatal cases or non-fatal cases). Patients' clinico-laboratory data were compared according to these two outcomes using the appropriate statistical test.ResultsOf the 525 patients enrolled, 136 (25.9%) had prolonged hospitalization. The mean length of stay was 6.77 ± 5.68 days. Logistic regression analysis identified acute kidney injury (AKI) (OR 2.3), Jaundice (OR 2.7), elevated alanine aminotransferase (ALT) (OR 2), and prolonged prothrombin time (PT) (OR 1.9) independently associated with prolonged hospitalization. Case fatality rate was 6.48% and around one third of fatal cases had prolonged hospitalization of more than seven days. Factors associated with leptospirosis mortality included age >40 years (p < 0.001), patients presented with tachypnea (p = 0.002), pulmonary infiltrate (p < 0.001), T-wave changes (p < 0.001), atrial fibrillation (p = 0.013), conducting abnormality (p < 0.001), chronic kidney diseases (p < 0.001), multiple organ dysfunctions (p < 0.0010), respiratory failure (p < 0.001), pneumonia (p < 0.001), sepsis (p = 0.004), low venous PH (p = 0.042), AKI (P < 0.001), elevated AST (p < 0.001) or ALT (p = 0.004), hypoalbuminemia (p < 0.001), rhabdomyolysis (p < 0.001), severe thrombocytopenia (p = 0.042), prolonged PT (p < 0.001) or prolonged aPTT (p < 0.017).ConclusionsSignificant proportion of leptospirosis patients (25.9%) had prolonged hospital stay and less proportion died (6.48%). Early identifying patients with factors associated with prolonged hospitalization and death will positively impact practitioners' decisions regarding the proper and fast course of management including ICU admission.
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Affiliation(s)
- Yassin K. Al Hariri
- Department of Clinical Sciences, Ajman University, Ajman, United Arab Emirates
- *Correspondence: Yassin K. Al Hariri
| | - Syed A. S. Sulaiman
- Department of Clinical Pharmacy, School of Pharmaceutical Sciences, Universiti Sains Malaysia, Penang, Malaysia
- Advanced Medical and Dental Institute, Universiti Sains Malaysia (USM), Penang, Malaysia
| | - Amer H. Khan
- Department of Clinical Pharmacy, School of Pharmaceutical Sciences, Universiti Sains Malaysia, Penang, Malaysia
- Amer H. Khan
| | - Azreen S. Adnan
- Management Science University (MSU) Medical Centre, Shah Alam, Selangor, Malaysia
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Warnasekara J, Srimantha S, Senavirathna I, Kappagoda C, Farika N, Nawinna A, Agampodi S. The variable presence of Leptospira in the environment; an epidemiological explanation based on serial analysis of water samples. PLoS One 2022; 17:e0263719. [PMID: 35167605 PMCID: PMC8846531 DOI: 10.1371/journal.pone.0263719] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2021] [Accepted: 01/25/2022] [Indexed: 11/19/2022] Open
Abstract
Human leptospirosis involves the classic epidemiological triad (agent, host and environment); hence the investigations should include the knowledge on Leptospira within the animals and the environment. The objectives of this study are to explore the abundance of Leptospira in different climate zones of Sri Lanka and to describe the presence of Leptospira in the same water source at serial time points. First, water and soil samples were collected from different parts of Sri Lanka (Component-1); second, water sampling continued only in the dry zone (Component-2). Finally, serial water sampling from ten open wells was performed at five different time points (Component-3). Quantitative PCR of water and metagenomic sequencing of soil were performed to detect Leptospira. Three replicates for each sample were used for PCR testing, and positive result of two or more replicates was defined as 'strongly positive,' and one positive replicate was defined as positive. In the water and soil sample analysis in the whole country (Component-1), two out of 12 water sites were positive, and both were situated in the wet zone. Very small quantities of the genus Leptospira were detected by 16 amplicon analysis of soil in all 11 sites. In the dry zone water sample analysis (Component-2), only samples from 6 out of 26 sites were positive, of which one site was strongly positive. In the serial sample analysis (Component-3), Six, five, four, five, and six wells were positive in serial measurements. All wells were positive for at least one time point, while only one well was positive for all five time points. Proximity to the tank and greater distances from the main road were associated with strong positive results for Leptospira (P<0.05). The presence of Leptospira was not consistent, indicating the variable abundance of Leptospira in the natural environment. This intermittent nature of positivity could be explained by the repetitive contamination by animal urine.
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Affiliation(s)
- Janith Warnasekara
- Faculty of Medicine and Allied Sciences, Department of Community Medicine, Rajarata University of Sri Lanka, Saliyapura, Sri Lanka
| | - Shalka Srimantha
- Faculty of Medicine and Allied Sciences, Department of Community Medicine, Rajarata University of Sri Lanka, Saliyapura, Sri Lanka
| | - Indika Senavirathna
- Faculty of Medicine and Allied Sciences, Department of Community Medicine, Rajarata University of Sri Lanka, Saliyapura, Sri Lanka
- Faculty of Medicine and Allied Sciences, Department of Biochemistry, Rajarata University of Sri Lanka, Saliyapura, Sri Lanka
| | - Chamila Kappagoda
- Faculty of Medicine and Allied Sciences, Department of Community Medicine, Rajarata University of Sri Lanka, Saliyapura, Sri Lanka
| | - Nirmani Farika
- Faculty of Medicine and Allied Sciences, Department of Community Medicine, Rajarata University of Sri Lanka, Saliyapura, Sri Lanka
| | - Achala Nawinna
- Faculty of Medicine and Allied Sciences, Rajarata University of Sri Lanka, Saliyapura, Sri Lanka
| | - Suneth Agampodi
- Faculty of Medicine and Allied Sciences, Department of Community Medicine, Rajarata University of Sri Lanka, Saliyapura, Sri Lanka
- Department of Internal Medicine, Section of Infectious Diseases, School of Medicine, Yale University, New Haven, Connecticut, United States of America
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11
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Evaluation of a genus-specific rGroEL 1-524 IgM-ELISA and commercial ELISA kits during the course of leptospirosis in Thailand. Sci Rep 2021; 11:19785. [PMID: 34611273 PMCID: PMC8492722 DOI: 10.1038/s41598-021-99377-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Accepted: 09/23/2021] [Indexed: 01/29/2023] Open
Abstract
In the present study, we developed a genus-specific rGroEL1-524 IgM-ELISA assay for use in screening diagnosis of suspected leptospirosis among acute undifferentiated febrile illness patients during acute fever. The diagnostic accuracies of the rGroEL1–524 IgM-ELISA, commercial Panbio IgM-ELISA, and Virion-Serion Classic IgG-ELISA were evaluated using 133 Thai leptospirosis sera and 210 controls. Sensitivities were 91.7%, 59.6%, and 17.7% for acute infection, and the specificities were 92.6%, 90.2%, and 88.3% for the non-leptospirosis control, respectively. The rGroEL1-524 IgM-ELISA had high sensitivity, at 92.3% and 91.7%, among culture-positive and MAT-negative cases at 1–3 days post-onset of symptoms (DPO1–3), respectively. Impaired specificity on scrub typhus was found, possibly from antibody cross-reaction to ortholog GroEL. Commercial Panbio IgM-ELISA had sensitivities at DPO1–3 of 30.8% and 41.7% for culture-positive and MAT-negative cases whereas Virion-Serion IgG-ELISA showed sensitivities of 5.9% and 13.3%, respectively. The rGroEL1-524 IgM-ELISA could be useful as a screening test for early diagnosis. The performance of the commercial ELISA suggests the applicability of IgM-ELISA for diagnosis, while IgG-ELISA is useful for seroprevalence surveys. However, confirmation by reference tests is recommended.
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Chacko CS, Lakshmi S S, Jayakumar A, Binu SL, Pant RD, Giri A, Chand S, UP N. A short review on leptospirosis: Clinical manifestations, diagnosis and treatment. CLINICAL EPIDEMIOLOGY AND GLOBAL HEALTH 2021. [DOI: 10.1016/j.cegh.2021.100741] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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13
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Silva JCR, Marvulo MFV, Ferreira F, Dias RA, Ferreira Neto JS, Heinemann MB, Andrade Filho GV, Souza GO, Lima Filho CDF, Magalhães FJR, Lilenbaum W, Dellagostin OA, de Oliveira NR, Jorge S, Kremer FS, Santos CM, Esteves SB, Miotto BA. Seroepidemiological investigation of animal leptospirosis and molecular characterization of the first Leptospira strain isolated from Fernando de Noronha archipelago, Brazil. Transbound Emerg Dis 2021; 68:2477-2488. [PMID: 33159384 DOI: 10.1111/tbed.13915] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2020] [Revised: 10/29/2020] [Accepted: 11/03/2020] [Indexed: 11/30/2022]
Abstract
Leptospirosis has been widely reported in insular environments worldwide, characterizing a major public health threat. Although low-genetic biodiversity is expected in these regions, the introduction of domestic and synanthropic mammals may contribute to the wider diversity of leptospiral strains in insular settings. This study proposes a large-scale seroepidemiological investigation of Leptospira infection in animals from Fernando de Noronha archipelago and describes the characterization of the first leptospiral strain ever isolated from an insular setting in Brazil. A total of 1,265 blood samples from domestic (n = 682), synanthropic (n = 133) and wild (n = 450) animals were collected between 2007 and 2014, totalling 12 species. The presence of anti-Leptospira spp. antibodies was investigated by the microscopic agglutination test (MAT), and kidney samples from 20 synanthropic rodents were collected for the isolation of Leptospira spp. The leptospires recovered were further characterized by serogrouping with polyclonal antibodies, whole-genome sequencing and multilocus sequence typing (MLST). The MAT results revealed the presence of agglutinins in 90 samples (7.1%) and the most frequently found serogroup was Icterohaemorrhagiae (n = 57) in practically all species included. Viable leptospires were recovered from one brown rat, and characterization revealed that the isolate belongs to L. interrogans serogroup Pyrogenes. The results suggest that synanthropic rodents might play an important role in leptospiral infection among wildlife and domestic species in the archipelago.
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Affiliation(s)
- Jean Carlos Ramos Silva
- Laboratório de Saúde Única, Epidemiologia e Geoprocessamento, Departamento de Medicina Veterinária, Universidade Federal Rural de Pernambuco, Recife, Brazil
- Instituto Brasileiro para Medicina da Conservação - Tríade, Recife, Brazil
| | - Maria Fernanda Vianna Marvulo
- Instituto Brasileiro para Medicina da Conservação - Tríade, Recife, Brazil
- Centro Universitário Max Planck, Indaiatuba, Brazil
| | - Fernando Ferreira
- Departamento de Medicina Veterinária Preventiva e Saúde Animal, Faculdade de Medicina Veterinária e Zootecnia, Universidade de São Paulo, São Paulo, Brazil
| | - Ricardo Augusto Dias
- Departamento de Medicina Veterinária Preventiva e Saúde Animal, Faculdade de Medicina Veterinária e Zootecnia, Universidade de São Paulo, São Paulo, Brazil
| | - José Soares Ferreira Neto
- Departamento de Medicina Veterinária Preventiva e Saúde Animal, Faculdade de Medicina Veterinária e Zootecnia, Universidade de São Paulo, São Paulo, Brazil
| | - Marcos Bryan Heinemann
- Departamento de Medicina Veterinária Preventiva e Saúde Animal, Faculdade de Medicina Veterinária e Zootecnia, Universidade de São Paulo, São Paulo, Brazil
| | - Geraldo Vieira Andrade Filho
- Laboratório de Saúde Única, Epidemiologia e Geoprocessamento, Departamento de Medicina Veterinária, Universidade Federal Rural de Pernambuco, Recife, Brazil
| | - Gisele Oliveira Souza
- Departamento de Medicina Veterinária Preventiva e Saúde Animal, Faculdade de Medicina Veterinária e Zootecnia, Universidade de São Paulo, São Paulo, Brazil
| | | | | | - Walter Lilenbaum
- Laboratório de Bacteriologia Veterinária, Departamento de Microbiologia e Parasitologia, Universidade Federal Fluminense, Niterói, Brazil
| | - Odir Antonio Dellagostin
- Programa de Pós-graduação em Biotecnologia, Centro de Desenvolvimento Tecnológico, Universidade Federal de Pelotas, Pelotas, Brazil
| | - Natasha Rodrigues de Oliveira
- Programa de Pós-graduação em Biotecnologia, Centro de Desenvolvimento Tecnológico, Universidade Federal de Pelotas, Pelotas, Brazil
| | - Sérgio Jorge
- Programa de Pós-graduação em Biotecnologia, Centro de Desenvolvimento Tecnológico, Universidade Federal de Pelotas, Pelotas, Brazil
| | - Frederico Schmitt Kremer
- Programa de Pós-graduação em Biotecnologia, Centro de Desenvolvimento Tecnológico, Universidade Federal de Pelotas, Pelotas, Brazil
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Time series models for prediction of leptospirosis in different climate zones in Sri Lanka. PLoS One 2021; 16:e0248032. [PMID: 33989292 PMCID: PMC8121312 DOI: 10.1371/journal.pone.0248032] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2021] [Accepted: 04/26/2021] [Indexed: 12/28/2022] Open
Abstract
In tropical countries such as Sri Lanka, where leptospirosis—a deadly disease with a high mortality rate—is endemic, prediction is required for public health planning and resource allocation. Routinely collected meteorological data may offer an effective means of making such predictions. This study included monthly leptospirosis and meteorological data from January 2007 to April 2019 from Sri Lanka. Factor analysis was first used with rainfall data to classify districts into meteorological zones. We used a seasonal autoregressive integrated moving average (SARIMA) model for univariate predictions and an autoregressive distributed lag (ARDL) model for multivariable analysis of leptospirosis with monthly average rainfall, temperature, relative humidity (RH), solar radiation (SR), and the number of rainy days/month (RD). Districts were classified into wet (WZ) and dry (DZ) zones, and highlands (HL) based on the factor analysis of rainfall data. The WZ had the highest leptospirosis incidence; there was no difference in the incidence between the DZ and HL. Leptospirosis was fluctuated positively with rainfall, RH and RD, whereas temperature and SR were fluctuated negatively. The best-fitted SARIMA models in the three zones were different from each other. Despite its known association, rainfall was positively significant in the WZ only at lag 5 (P = 0.03) but was negatively associated at lag 2 and 3 (P = 0.04). RD was positively associated for all three zones. Temperature was positively associated at lag 0 for the WZ and HL (P < 0.009) and was negatively associated at lag 1 for the WZ (P = 0.01). There was no association with RH in contrast to previous studies. Based on altitude and rainfall data, meteorological variables could effectively predict the incidence of leptospirosis with different models for different climatic zones. These predictive models could be effectively used in public health planning purposes.
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15
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Karim AJ, Abbas ZM. Histopathology of the kidney and seroprevalence of leptospirosis in wild rats in Baghdad Province, Iraq. INTERNATIONAL JOURNAL OF ONE HEALTH 2021. [DOI: 10.14202/ijoh.2021.19-30] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Background and Aim: Leptospirosis, caused by pathogenic leptospires, is a globally emerging infectious disease affecting both humans and animals, which act as reservoirs, with large outbreaks worldwide. The role of rats in dispersing leptospirosis was never investigated in Iraq. Because of the seriousness of the disease and the scarce data regarding this disease in Iraq, this study determines the incidence of leptospirosis in rats and its renal histopathological profile.
Materials and Methods: Of 211 captured rats, 82 apparently healthy rats were included in this study. After euthanatizing, 3-5-ml blood was collected by cardiac puncture. Approximately 0.5 cm3 of the kidney was collected for routine histopathology and stained using hematoxylin and eosin (H&E) and Warthin–Starry (WS) stains. Blood smears were prepared and stained with the WS stain.
Results: All rats (100%) with different age groups were immunoglobulin G (IgG)-positive, and 90.24% of them had the IgG against leptospiral antigens in kidney tissues. The juvenile age group had higher IgG levels than other age groups. Considering sex, no significant differences in the overall results were observed. Serum concentrations of blood urea nitrogen and creatinine showed significant increments in the sub-adult and adult IgG- positive groups compared with the IgG-negative groups. No significant alterations were observed in the juvenile group. Using WS stains, 13 and 1 blood smears and 0 and 8 kidney tissues were positive for leptospires in the sub-adult and adult groups, respectively. Microscopical findings of the renal cortex and medulla in the sub-adult IgG-positive group showed hemorrhage, glomerular deterioration, tubular cell degeneration and necrosis with cast formation, periarterial edema, and focal hemorrhage with congestion of peritubular arteries. The adult IgG-positive group revealed deterioration similar to that in the sub-adult group and tended to be chronic. No leptospires were observed using H&E staining.
Conclusion: IgG-positive carrier rats refer to previously exposed or infected rats. Understanding the risk of transmitting the disease to human and animals through a carrier rat's urine is highly predicted and possible mitigation of zoonotic transmission.
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Affiliation(s)
- Abdulkarim Jafar Karim
- Unit of Zoonotic Diseases, College of Veterinary Medicine, University of Baghdad, Baghdad, Iraq
| | - Zainab Majid Abbas
- Department of Pathological Analysis, Babylon Technical Institute, Al-Furat Al-Awsat Technical University, Babylon, Iraq
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16
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Truitt ZG, Poon-Kwong B, Bachoon DS, Otero E. Seasonal shifts in the presence of pathogenic leptospires, Escherichia coli, and physicochemical properties in coastal rivers and streams of Puerto Rico. JOURNAL OF ENVIRONMENTAL QUALITY 2020; 49:1264-1272. [PMID: 33016462 DOI: 10.1002/jeq2.20091] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/10/2020] [Revised: 04/14/2020] [Accepted: 05/05/2020] [Indexed: 05/21/2023]
Abstract
Leptospirosis is an emerging zoonotic disease in the Caribbean region and the island of Puerto Rico. Information on the presence of pathogenic Leptospira in rivers and streams of Puerto Rico is currently lacking. This study aimed to evaluate seasonal shifts in the presence of pathogenic leptospires and the level of Escherichia coli from 32 coastal locations in Puerto Rico's dry and wet seasons. Physicochemical parameters (temperature, salinity, pH, and dissolved oxygen) were determined at each site. The temperature (25.8 °C) and pH (average 7.6) values were all within acceptable USEPA regulatory standards. Thirty-eight percent of the sites of the dry season and 28% of the wet season sites contained dissolved oxygen levels ≤4 mg L-1 , which is relatively low. In the dry season, 19 sites (59%) and 18 (56%) of the wet season sites had E. coli counts >410 most probable number (MPN) 100 ml-1 and would be considered unsafe for recreational use. The lipl32 gene quantitative polymerase chain reaction assay was used for the detection of pathogenic leptospires in the samples. Low concentrations of pathogenic leptospires (<60 genome copies 100 ml-1 ) at Camuy, Espíritu Santo, Río Guayanilla, Quebrada Majagual, and Río Fajardo were detected during the wet season. Pathogenic leptospires were detected (∼40 genome copies 100 ml-1 ) at only one site, Loíza, during the dry season. There was no predictable relationship between the physicochemical parameters, concentrations of E. coli, and the presence of pathogenic leptospires in water samples.
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Affiliation(s)
- Zamara G Truitt
- Dep. of Biological and Environmental Sciences, Georgia College and State Univ., Milledgeville, GA, 31061, USA
| | - B Poon-Kwong
- Dep. of Biological and Environmental Sciences, Georgia College and State Univ., Milledgeville, GA, 31061, USA
| | - D S Bachoon
- Dep. of Biological and Environmental Sciences, Georgia College and State Univ., Milledgeville, GA, 31061, USA
| | - E Otero
- Dep. of Marine Sciences, Univ. of Puerto Rico, Mayaguez Campus, P.O. Box 9013, Mayaguez, PR, 00681, USA
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17
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Rath RS, Dixit AM, Koparkar AR, Kharya P, Joshi HS. COVID-19 pandemic in India: A Comparison of pandemic pattern in Selected States. Nepal J Epidemiol 2020; 10:856-864. [PMID: 32874699 PMCID: PMC7423401 DOI: 10.3126/nje.v10i2.28960] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2020] [Revised: 06/29/2020] [Accepted: 06/30/2020] [Indexed: 11/30/2022] Open
Abstract
The COVID-19 pandemic currently expanded its roots to the 206 countries in the world. The morbidity and mortality are not only threat to humans but also its impact on economy is indirectly affecting us. The current review was done to find trend in various states of India. Data was collected from Ministry of Health and Family Welfare and descriptive analysis of the distribution of COVID-19 cases in different states of India. First case of COVID-19 was diagnosed in southernmost state Kerala and after that it has spread to all other states, but situations are more worsen in states with high international migration. Maharashtra is now the most affected state followed by Delhi. Among epidemic curve of all these states, Maharashtra has rapidly growing epidemic curve with highest slope, whereas Kerala has the lowest. When we compared the day wise cumulative case fatality rate, it was found that the case fatality rate of the states like Maharashtra, Madhya Pradesh & Rajasthan showed decrease in the case fatality rate over the period. Population density is also one of the key determinants of social interaction and thus the spread of disease specifically in communicable diseases. Government of India had taken many strong initiatives e.g. 40 days nation-wide lockdown, thermal screening at airport, announcement of relief packages for poor and quarantine of outsiders but still there are many missed opportunities like, early stoppage of international traffic, compulsory quarantine for all international travellers, better contact tracing, strong law and order and better preparedness plan.
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Affiliation(s)
- Rama Shankar Rath
- Assistant Professor, Department of Community Medicine & Family Medicine, All India Institute of Medical Sciences, Gorakhpur
| | - Anand Mohan Dixit
- Department of Community Medicine & Family Medicine, All India Institute of Medical Sciences, Gorakhpur
| | - Anil Ramesh Koparkar
- Department of Community Medicine & Family Medicine, All India Institute of Medical Sciences, Gorakhpur
| | - Pradip Kharya
- Department of Community Medicine & Family Medicine, All India Institute of Medical Sciences, Gorakhpur
| | - Hari Shanker Joshi
- Department of Community Medicine & Family Medicine, All India Institute of Medical Sciences, Gorakhpur
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Karpagam KB, Ganesh B. Leptospirosis: a neglected tropical zoonotic infection of public health importance-an updated review. Eur J Clin Microbiol Infect Dis 2020; 39:835-846. [PMID: 31898795 DOI: 10.1007/s10096-019-03797-4] [Citation(s) in RCA: 83] [Impact Index Per Article: 20.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2019] [Accepted: 12/09/2019] [Indexed: 02/07/2023]
Abstract
Leptospirosis is a zoonotic and waterborne disease worldwide. It is a neglected, reemerging disease of global public health importance with respect to morbidity and mortality both in humans and animals. Due to negligence, rapid, unplanned urbanization, and poor sanitation, leptospirosis emerges as a leading cause of acute febrile illness in many of the developing countries. Every individual has a risk of getting infected as domestic and wild animals carry leptospires; the at-risk population varies from the healthcare professionals, animal caretakers, farmers and agricultural workers, fishermen, rodent catchers, water sports people, National Disaster Response Force (NDRF) personnel, people who volunteer rescue operations in flood-affected areas, sanitary workers, sewage workers, etc. The clinical manifestations of leptospirosis range from flu-like illness to acute kidney failure (AKF), pneumonia, jaundice, pulmonary hemorrhages, etc. But many rare and uncommon clinical manifestations are being reported worldwide. This review will cover all possible updates in leptospirosis from occurrence, transmission, rare clinical manifestations, diagnosis, treatment, and prophylactic measures that are currently available, their advantages and the future perspectives, elaborately. There are less or very few reviews on leptospirosis in recent years. Thus, this work will serve as background knowledge for the current understanding of leptospirosis for researchers. This will provide a detailed analysis of leptospirosis and also help in finding research gaps and areas to focus on regarding future research perspectives.
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Affiliation(s)
- Krishnan Baby Karpagam
- Laboratory Division, ICMR-National Institute of Epidemiology, R-127, 2nd Main Road, TNHB, Ayapakkam, Chennai, Tamil Nadu, 600 077, India.,University of Madras, Chennai, India
| | - Balasubramanian Ganesh
- Laboratory Division, ICMR-National Institute of Epidemiology, R-127, 2nd Main Road, TNHB, Ayapakkam, Chennai, Tamil Nadu, 600 077, India. .,University of Madras, Chennai, India.
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Yatbantoong N, Chaiyarat R. Factors Associated with Leptospirosis in Domestic Cattle in Salakphra Wildlife Sanctuary, Thailand. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16061042. [PMID: 30909452 PMCID: PMC6466321 DOI: 10.3390/ijerph16061042] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/29/2019] [Revised: 03/14/2019] [Accepted: 03/18/2019] [Indexed: 01/21/2023]
Abstract
Leptospirosis found in cattle (Bos taurus indicus) has potentially increased in economic impact. The objective was to investigate the factors associated with leptospirosis in cattle in the protected area. We investigated the seroprevalence of leptospirosis in cattle in Salakphra Wildlife Sanctuary, Thailand. Serum was collected to investigate the seroprevalence by agglutination test and their associated factors. From a total of 513 samples, antibodies against Leptospira were detected in 92.2% of samples. Within a total of 42 herds, the serovar with the highest prevalence was L interrogans serovar Tarassovi (92.9%). Most leptospirosis was found in medium-sized herds with the highest concentrations in cattle farms close to cities (52.4%, p < 0.05). Seroprevalence was associated with herd size, raising pattern in the dry and wet seasons, grazing distance, number of years that cattle were kept in the farm, the introduction of new cattle into the farm, and keeping some pets in the farm. The results of the study suggest that keeping cattle in larger herds, raising pattern and distance, keeping period, and introducing new cattle and having pets impart potential risk of increasing leptospirosis exposure. These results indicate that cattle are important hosts of Leptospira in Thailand and may act as sentinels of Leptospira infection for wildlife and people in the protected areas.
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Affiliation(s)
- Nantawan Yatbantoong
- Department of Large Animal and Wildlife Clinical Science, Faculty of Veterinary Medicine, Kasetsart University, Kampheangsean Campus, Kampheangsean 73140, Thailand.
| | - Rattanawat Chaiyarat
- Wildlife and Plant Research Center, Faculty of Environment and Resource Studies, Mahidol University, Nakhonpathom 73170, Thailand.
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Warnasekara J, Koralegedara I, Agampodi S. Estimating the burden of leptospirosis in Sri Lanka; a systematic review. BMC Infect Dis 2019; 19:119. [PMID: 30727968 PMCID: PMC6364467 DOI: 10.1186/s12879-018-3655-y] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2018] [Accepted: 12/21/2018] [Indexed: 12/18/2022] Open
Abstract
Background Although the assessment of disease burden should be a priority for allocating resources, leptospirosis is grossly underestimated despite its true burden in Sri Lanka. This study aimed to assess the morbidity and mortality of leptospirosis based on routine surveillance data, hospital reported data and scientific publications from Sri Lanka. Method A systematic review was carried out, and Pub Med, MEDLINE®, BIOSIS Previews, Zoological Record, Web of Science Core Collection, Current Contents Connect, KCI-Korean Journal Database, BIOSIS Citation Index, Data Citation Index, SciELO Citation Index and Google Scholar databases were searched. Quarterly epidemiological bulletin (QEB), indoor morbidity & mortality returns (IMMR) and hand searches of local literature were performed in local libraries. Forty-two relevant full texts, 32 QEBs, and 8 IMMR were included in the full text review. Adjustments were made for under diagnosis, underreporting and chance variability. Results The estimated annual caseload of leptospirosis in Sri Lanka from 2008 to 2015, was 10,423, and the cumulative annual incidence of leptospirosis that required hospitalization was 52.1 (95% CI 51.7–52.6) per 100,000 people. The estimated number of annual deaths due to leptospirosis was approximately 730 (95% CI 542–980), with an estimated pooled case fatality ratio of 7.0% (95% CI 5.2–9.4). The most common organs involved were the kidney, liver and heart, with median rates of 48.7, 30, and 14.2%, respectively. Conclusion Our systematic review shows gross underestimation of the true leptospirosis burden in the national statistics of Sri Lanka, and the hospitalization rates estimated in our study were compatible with the total burden estimate of 300·6 (95% CI 96·54–604·23) per 100,000 people published previously. Electronic supplementary material The online version of this article (10.1186/s12879-018-3655-y) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Janith Warnasekara
- Department of Community Medicine, Faculty of Medicine and Allied Sciences, Rajarata University of Sri Lanka, Saliyapura, 50008, Sri Lanka.
| | - Iresha Koralegedara
- Department of Community Medicine, Faculty of Medicine and Allied Sciences, Rajarata University of Sri Lanka, Saliyapura, 50008, Sri Lanka
| | - Suneth Agampodi
- Department of Community Medicine, Faculty of Medicine and Allied Sciences, Rajarata University of Sri Lanka, Saliyapura, 50008, Sri Lanka
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Mavridou A, Pappa O, Papatzitze O, Dioli C, Kefala AM, Drossos P, Beloukas A. Exotic Tourist Destinations and Transmission of Infections by Swimming Pools and Hot Springs-A Literature Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:E2730. [PMID: 30513967 PMCID: PMC6313699 DOI: 10.3390/ijerph15122730] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/05/2018] [Revised: 11/18/2018] [Accepted: 11/29/2018] [Indexed: 02/06/2023]
Abstract
A growing number of people undertake international travel, and yet faster growth of such travel is expected in the tropics. Information on the hazards presented by pool and hot spring waters in tropical countries is very limited. This review aims to collate available information on pool water quality, alongside data on cases and outbreaks associated with swimming in pools in tropical regions affecting both local populations and travellers. Bacteria species commonly causing cases and outbreaks in the tropics as well as elsewhere in the world were excluded, and the review focuses on studies related to pathogens that, with the exception of Cryptosporidium, are unusual in more temperate climates. Studies concerning subtropical countries were included in the light of climate change. Diseases transmitted by vectors breeding in poorly maintained, neglected or abandoned pools were also included. 83 studies dealing with Microsporidia, Leptospira spp., Schistosomas spp., Cryptosporidium spp., Acanthamoeba spp., Naegleria spp., Clostridium trachomatis, viruses, and vectors breeding in swimming pool and hot tub waters, and fulfilling predefined criteria, have been included in our survey of the literature. In conclusion, prevention strategies for pool safety in the tropics are imperative. Public health authorities need to provide guidance to westerners travelling to exotic destinations on how to protect their health in swimming pools.
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Affiliation(s)
- Athena Mavridou
- Department of Biomedical Sciences, University of West Attica, 12243 Egaleo, Greece.
| | - Olga Pappa
- Department of Biomedical Sciences, University of West Attica, 12243 Egaleo, Greece.
- Central Public Health Laboratory, Hellenic Centre of Disease Control and Prevention, 15123 Maroussi, Greece.
| | - Olga Papatzitze
- Department of Biomedical Sciences, University of West Attica, 12243 Egaleo, Greece.
- West Attica General Hospital, "Santa Barbara", 12351 Santa Barbara, Greece.
| | - Chrysa Dioli
- Department of Biomedical Sciences, University of West Attica, 12243 Egaleo, Greece.
| | | | - Panagiotis Drossos
- Department of Biomedical Sciences, University of West Attica, 12243 Egaleo, Greece.
| | - Apostolos Beloukas
- Department of Biomedical Sciences, University of West Attica, 12243 Egaleo, Greece.
- Institute of Infection and Global Health, University of Liverpool, Liverpool L69 3BX, UK.
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de Vries SG, Visser BJ, Stoney RJ, Wagenaar JFP, Bottieau E, Chen LH, Wilder-Smith A, Wilson M, Rapp C, Leder K, Caumes E, Schwartz E, Hynes NA, Goorhuis A, Esposito DH, Hamer DH, Grobusch MP. Leptospirosis among Returned Travelers: A GeoSentinel Site Survey and Multicenter Analysis-1997-2016. Am J Trop Med Hyg 2018; 99:127-135. [PMID: 29761761 PMCID: PMC6085784 DOI: 10.4269/ajtmh.18-0020] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2018] [Accepted: 04/04/2018] [Indexed: 12/24/2022] Open
Abstract
Leptospirosis is a potentially fatal emerging zoonosis with worldwide distribution and a broad range of clinical presentations and exposure risks. It typically affects vulnerable populations in (sub)tropical countries but is increasingly reported in travelers as well. Diagnostic methods are cumbersome and require further improvement. Here, we describe leptospirosis among travelers presenting to the GeoSentinel Global Surveillance Network. We performed a descriptive analysis of leptospirosis cases reported in GeoSentinel from January 1997 through December 2016. We included 180 travelers with leptospirosis (mostly male; 74%; mostly tourists; 81%). The most frequent region of infection was Southeast Asia (52%); the most common source countries were Thailand (N = 52), Costa Rica (N = 13), Indonesia, and Laos (N = 11 each). Fifty-nine percent were hospitalized; one fatality was reported. We also distributed a supplemental survey to GeoSentinel sites to assess clinical and diagnostic practices. Of 56 GeoSentinel sites, three-quarters responded to the survey. Leptospirosis was reported to have been most frequently considered in febrile travelers with hepatic and renal abnormalities and a history of freshwater exposure. Serology was the most commonly used diagnostic method, although convalescent samples were reported to have been collected infrequently. Within GeoSentinel, leptospirosis was diagnosed mostly among international tourists and caused serious illness. Clinical suspicion and diagnostic workup among surveyed GeoSentinel clinicians were mainly triggered by a classical presentation and exposure history, possibly resulting in underdiagnosis. Suboptimal usage of available diagnostic methods may have resulted in additional missed, or misdiagnosed, cases.
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Affiliation(s)
- Sophia G. de Vries
- Center for Tropical Medicine and Travel Medicine, Academic Medical Center (AMC), University of Amsterdam (UvA), Amsterdam, The Netherlands
| | - Benjamin J. Visser
- Center for Tropical Medicine and Travel Medicine, Academic Medical Center (AMC), University of Amsterdam (UvA), Amsterdam, The Netherlands
| | - Rhett J. Stoney
- Travelers’ Health Branch, Division of Global Migration and Quarantine, Centers for Disease Control and Prevention (CDC), Atlanta, Georgia
| | - Jiri F. P. Wagenaar
- Department of Medical Microbiology, Leptospirosis Reference Center, Academic Medical Center (AMC), University of Amsterdam (UvA), Amsterdam, The Netherlands
| | - Emmanuel Bottieau
- Department of Clinical Sciences, Institute of Tropical Medicine, Antwerp, Belgium
| | - Lin H. Chen
- Travel Medicine Center, Mount Auburn Hospital, Cambridge, Massachusetts
- Harvard Medical School, Boston, Massachusetts
| | - Annelies Wilder-Smith
- Lee Kong Chian School of Medicine, Nanyang Technological University Singapore, Singapore
- Institute of Public Health, University of Heidelberg, Heidelberg, Germany
| | - Mary Wilson
- School of Medicine Global Health Sciences, University of California, San Francisco, San Francisco, California
| | - Christophe Rapp
- Service des Maladies Infectieuses et Tropicales, Hôpital d'Instruction des Armées Bégin, Paris, France
- CMETE Travel clinic, Paris, France
| | - Karin Leder
- School of Epidemiology and Preventive Medicine, Monash University, Melbourne, Australia
- Victorian Infectious Disease Service, Royal Melbourne Hospital at the Doherty Institute for Infection and Immunity, Melbourne, Australia
| | - Eric Caumes
- Service des Maladies Infectieuses et Tropicales, Hôpital Pitié-Salpêtrière, Sorbonne Université, Paris, France
| | - Eli Schwartz
- Department of Internal Medicine “C”, The Center of Geographical Medicine, Sheba Medical Center, Tel HaShomer, Ramat Gan, Israel
- Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Noreen A. Hynes
- Division of Infectious Diseases, Geographic Medicine Center, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Abraham Goorhuis
- Center for Tropical Medicine and Travel Medicine, Academic Medical Center (AMC), University of Amsterdam (UvA), Amsterdam, The Netherlands
| | - Douglas H. Esposito
- Travelers’ Health Branch, Division of Global Migration and Quarantine, Centers for Disease Control and Prevention (CDC), Atlanta, Georgia
| | - Davidson H. Hamer
- Department of Global Health, Boston University School of Public Health, Boston, Maryland
| | - Martin P. Grobusch
- Center for Tropical Medicine and Travel Medicine, Academic Medical Center (AMC), University of Amsterdam (UvA), Amsterdam, The Netherlands
- Institute of Tropical Medicine, University of Tübingen, Tübingen, Germany
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Pratt N, Rajeev S. Leptospira seroprevalence in animals in the Caribbean region: A systematic review. Acta Trop 2018; 182:34-42. [PMID: 29457993 DOI: 10.1016/j.actatropica.2018.02.011] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2017] [Revised: 01/14/2018] [Accepted: 02/11/2018] [Indexed: 12/25/2022]
Abstract
This systematic review summarises the data published on the Leptospira seroprevalence, serovar diversity and distribution among animal species in the Caribbean region. Following Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines, and checklist, relevant articles were identified and data were extracted and recorded. The review provided Leptospira seroprevalence data from 16 Caribbean islands (Barbados, Trinidad, Grenada, Puerto Rico, Saint Croix, St. Kitts and Nevis, Jamaica, Antigua, Carriacou, Dominica, Guadalupe, Martinique, Monserrat, St. Lucia, St. Maarten, and St. Vincent) in a variety of animal species. Reviewing the literature highlighted the limited amount of data available from limited number of islands. Many of the studies conducted have recorded seroprevalences based on variable and small samples sizes. Besides, serovar panels used for MAT were not consistent between studies. The review indicates that the Leptospira exposure in a given geographic location may change with time and climatic and environmental conditions, and highlights the need to conduct continual surveillance in tropical countries where the climate supports the survival of Leptospira in the environment. Specific attention must be given to standardization of MAT panels and protocols and providing training across laboratories involved in testing. Further, animal and environment testing to isolate and identify circulating Leptospira spp. in a geographic region must actively be pursued. This knowledge is important to implement geographically specific control programs, as risk factors of Leptospira transmission is favoured by various factors such as change in climatic conditions, urbanization, encroachment of wildlife inhabitation, import/export of animals, increase in adventure travel, and water related recreational activities.
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Rodriguez-Valero N, Moriñigo HM, Martínez MJ, Peiró A, Oliveira I, Bodro M, Gómez-Junyent J, Gascon J, Muñoz J. Leptospirosis in Spanish travelers returning from Chiang Mai: A case series. Travel Med Infect Dis 2018. [PMID: 29526720 DOI: 10.1016/j.tmaid.2018.02.013] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
BACKGROUND Leptospirosis is an important zoonosis worldwide, nevertheless is often poor recognized in non tropical settings. In Thailand is becoming an emerging disease and Chiang Mai could become a popular spot to acquire the disease amongst travelers. METHODS We describe three cases of imported leptospirosis undifferentiated fever after travelling to Thailand during the summer of 2015 diagnosed at two Spanish hospitals. RESULTS Our three patients probably acquired leptospirosis while swimming in freshwater around Chiang Mai, a Thailand's northern region with moderate incidence of leptopirosis. Travelers had normal white blood cell counts and low platelets, suggesting leptospirosis after ruling out other imported diseases such as malaria, dengue or typhoid. CONCLUSION As recent findings point out, low platelets and normal white blood cell counts are clinical features that could help the clinician to suspect Leptospirosis infection. It should be always considered as a cause of fever, particularly if travelers come from a tropical country and have had contact with water or flooding, especially during rainy season.
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Affiliation(s)
- Natalia Rodriguez-Valero
- ISGlobal, Barcelona Centre for International Health Research (CRESIB), Hospital Clínic (Department of International Health)-Universitat de Barcelona, Barcelona, Spain.
| | - Helena Moza Moriñigo
- Department of International Health, Hospital Universitario Virgen de la Salud, Toledo, Spain
| | - Miguel J Martínez
- Department of Clinical Microbiology, Hospital Clinic de Barcelona, Spain
| | - Aida Peiró
- Department of Clinical Microbiology, Hospital Clinic de Barcelona, Spain
| | - Ines Oliveira
- ISGlobal, Barcelona Centre for International Health Research (CRESIB), Hospital Clínic (Department of International Health)-Universitat de Barcelona, Barcelona, Spain
| | - Marta Bodro
- Department of Infectious Diseases, Hospital Clinic Barcelona, Spain
| | - Joan Gómez-Junyent
- ISGlobal, Barcelona Centre for International Health Research (CRESIB), Hospital Clínic (Department of International Health)-Universitat de Barcelona, Barcelona, Spain
| | - Joaquim Gascon
- ISGlobal, Barcelona Centre for International Health Research (CRESIB), Hospital Clínic (Department of International Health)-Universitat de Barcelona, Barcelona, Spain
| | - Jose Muñoz
- ISGlobal, Barcelona Centre for International Health Research (CRESIB), Hospital Clínic (Department of International Health)-Universitat de Barcelona, Barcelona, Spain.
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Pissawong T, Maneewatchararangsri S, Ritthisunthorn N, Soonthornworasiri N, Reamtong O, Adisakwattana P, Kalambaheti T, Chaisri U, Doungchawee G. Immunodominance of LipL32 93-272 peptides revealed by leptospirosis sera and therapeutic monoclonal antibodies. JOURNAL OF MICROBIOLOGY, IMMUNOLOGY, AND INFECTION = WEI MIAN YU GAN RAN ZA ZHI 2018; 53:11-22. [PMID: 29500044 DOI: 10.1016/j.jmii.2017.12.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/18/2017] [Revised: 10/30/2017] [Accepted: 12/12/2017] [Indexed: 12/01/2022]
Abstract
BACKGROUND/PURPOSE Leptospirosis is a neglected zoonosis, imposing significant human and veterinary public health burdens. In this study, recombinant LipL3293-147 and LipL32148-184 middle domain of LipL3293-184, and LipL32171-214, and LipL32215-272 of c-terminal LipL32171-272 truncations were defined for immunodominance of the molecule during Leptospira infections revealed by leptospirosis sera. RESULTS IgM-dominant was directed to highly surface accessible LipL32148-184 and Lipl32171-214. IgG dominance of LipL32148-184 revealed by rabbit anti-Leptospira sera and convalescent leptospirosis paired sera were mapped to highly accessible surface of middle LipL32148-184 truncation whereas two LipL32148-184 and LipL32215-272 truncations were IgG-dominant when revealed by single leptospirosis sera. The IgM-dominant of LipL32148-214 and IgG-dominant LipL32148-184 peptides have highly conserved amino acids of 70% identity among pathogenic and intermediate Leptospira species and were mapped to the highly surface accessible area of LipL32 molecule that mediated interaction of host components. IgG dominance of two therapeutic epitopes located at LipL32243-253 and LipL32122-130 of mAbLPF1 and mAbLPF2, respectively has been shown less IgG-dominant (<30%), located outside IgG-dominant regions characterized by leptospirosis paired sera. CONCLUSION The IgM- and IgG-dominant LipL32 could be further perspectives for immunodominant LipL32-based serodiagnosis and LipL32 epitope-based vaccine.
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Affiliation(s)
- Tippawan Pissawong
- Chulabhorn International College of Medicine, Thammasat University, Pathumthani 12120, Thailand
| | - Santi Maneewatchararangsri
- Department of Molecular Tropical Medicine and Genetics, Faculty of Tropical Medicine, Mahidol University, Bangkok 10400, Thailand.
| | - Nonglucksanawan Ritthisunthorn
- Department of Molecular Tropical Medicine and Genetics, Faculty of Tropical Medicine, Mahidol University, Bangkok 10400, Thailand
| | - Ngamphol Soonthornworasiri
- Department of Tropical Hygiene, Faculty of Tropical Medicine, Mahidol University, Bangkok 10400, Thailand
| | - Onrapak Reamtong
- Department of Molecular Tropical Medicine and Genetics, Faculty of Tropical Medicine, Mahidol University, Bangkok 10400, Thailand
| | - Poom Adisakwattana
- Department of Helminthology, Faculty of Tropical Medicine, Mahidol University, Bangkok 10400, Thailand
| | - Thareerat Kalambaheti
- Department of Microbiology and Immunology, Faculty of Tropical Medicine, Mahidol University, Bangkok 10400, Thailand
| | - Urai Chaisri
- Department of Tropical Pathology, Faculty of Tropical Medicine, Mahidol University, Bangkok 10400, Thailand
| | - Galayanee Doungchawee
- Department of Pathobiology, Faculty of Science, Mahidol University, Bangkok 10400, Thailand
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Yaakob Y, Rodrigues KF, Opook F, William T, John DV. Recombinant LipL32 Protein Developed Using a Synthetic Gene Detects Leptospira-specific Antibodies in Human Serum Samples. Malays J Med Sci 2018; 24:44-51. [PMID: 29386971 DOI: 10.21315/mjms2017.24.5.5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2017] [Accepted: 07/13/2017] [Indexed: 10/18/2022] Open
Abstract
Background Synthetic biology is emerging as a viable alternative for the production of recombinant antigens for diagnostic applications. It offers a safe alternative for the synthesis of antigenic principles derived from organisms that pose a high biological risk. Methods Here, we describe an enzyme-linked immunosorbent assay (ELISA) using the synthetic recombinant LipL32 (rLipL32) protein expressed in Escherichia coli for the detection of Leptospira-specific antibodies in human serum samples. The rLipL32-based ELISA was compared with a microscopic agglutination test (MAT), which is currently used as the gold standard for the diagnosis of leptospirosis. Results Our results showed that all the MAT-positive serum samples were positive for Leptospira-specific IgG in an ELISA, while 65% (n = 13) of these samples were also positive for Leptospira-specific IgM. In the MAT-negative serum samples, 80% and 55% of the samples were detected as negative by an ELISA for Leptospira-specific IgM and IgG, respectively. Conclusion An ELISA using the synthetic rLipL32 antigen was able to distinguish Leptospira-specific IgM (sensitivity 65% and specificity 80%) and IgG (sensitivity 100% and specificity 55%) in human serum samples and has the potential to serve as a rapid diagnostic test for leptospirosis.
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Affiliation(s)
- Yuszniahyati Yaakob
- Biotechnology Research Institute, Universiti Malaysia Sabah, Kota Kinabalu, Sabah, Malaysia
| | | | - Fernandes Opook
- Biotechnology Research Institute, Universiti Malaysia Sabah, Kota Kinabalu, Sabah, Malaysia
| | | | - Daisy Vanitha John
- Biotechnology Research Institute, Universiti Malaysia Sabah, Kota Kinabalu, Sabah, Malaysia
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Systematic review and meta-analysis on Schistosoma mansoni infection prevalence, and associated risk factors in Brazil. Parasitology 2018; 145:1000-1014. [PMID: 29295718 DOI: 10.1017/s0031182017002268] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
We performed a systematic review and meta-analysis on the prevalence and factors associated with Schistosoma mansoni infection in Brazil. We searched the PubMed, Web of Science and Latin-American and Caribbean System on Health Sciences Information (LILACS) databases, scientific publications articles, according to The PRISMA Statement, from 2000 to 2016. A total of 27 studies were included according to the established criteria. The prevalence of S. mansoni infection varied widely, from 0·1 to 73·1%, based on Kato-Katz technique. Of the identified studies, 42·9% were performed in the state of Minas Gerais, and 33·3% were performed in the northeast region of Brazil. We identified sex, age, education level, family income, contact with water and the presence of the intermediate host snail as major risk factors associated with infection. The meta-analysis summarized a high prevalence rate pooled for Schistosoma mansoni. On the other hand, the analysis of the subgroup showed a highly significant reduction of the prevalence rate after control measures. The epidemiological factors evidenced in the studies show the influence of environmental and social conditions on the occurrence of schistosomiasis.
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29
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Rood EJJ, Goris MGA, Pijnacker R, Bakker MI, Hartskeerl RA. Environmental risk of leptospirosis infections in the Netherlands: Spatial modelling of environmental risk factors of leptospirosis in the Netherlands. PLoS One 2017; 12:e0186987. [PMID: 29065186 PMCID: PMC5655435 DOI: 10.1371/journal.pone.0186987] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2017] [Accepted: 10/11/2017] [Indexed: 12/29/2022] Open
Abstract
Leptospirosis is a globally emerging zoonotic disease, associated with various climatic, biotic and abiotic factors. Mapping and quantifying geographical variations in the occurrence of leptospirosis and the surrounding environment offer innovative methods to study disease transmission and to identify associations between the disease and the environment. This study aims to investigate geographic variations in leptospirosis incidence in the Netherlands and to identify associations with environmental factors driving the emergence of the disease. Individual case data derived over the period 1995–2012 in the Netherlands were geocoded and aggregated by municipality. Environmental covariate data were extracted for each municipality and stored in a spatial database. Spatial clusters were identified using kernel density estimations and quantified using local autocorrelation statistics. Associations between the incidence of leptospirosis and the local environment were determined using Simultaneous Autoregressive Models (SAR) explicitly modelling spatial dependence of the model residuals. Leptospirosis incidence rates were found to be spatially clustered, showing a marked spatial pattern. Fitting a spatial autoregressive model significantly improved model fit and revealed significant association between leptospirosis and the coverage of arable land, built up area, grassland and sabulous clay soils. The incidence of leptospirosis in the Netherlands could effectively be modelled using a combination of soil and land-use variables accounting for spatial dependence of incidence rates per municipality. The resulting spatially explicit risk predictions provide an important source of information which will benefit clinical awareness on potential leptospirosis infections in endemic areas.
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Affiliation(s)
- Ente J. J. Rood
- KIT Royal Tropical Institute, Health dept., Amsterdam, The Netherlands
- * E-mail:
| | - Marga G. A. Goris
- WHO/FAO/OIE and National Collaborating Centre for Reference and Research on Leptospirosis, Amsterdam, The Netherlands
| | - Roan Pijnacker
- KIT Royal Tropical Institute, Health dept., Amsterdam, The Netherlands
| | - Mirjam I. Bakker
- KIT Royal Tropical Institute, Health dept., Amsterdam, The Netherlands
| | - Rudy A. Hartskeerl
- WHO/FAO/OIE and National Collaborating Centre for Reference and Research on Leptospirosis, Amsterdam, The Netherlands
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Caimi K, Repetto SA, Varni V, Ruybal P. Leptospira species molecular epidemiology in the genomic era. INFECTION GENETICS AND EVOLUTION 2017; 54:478-485. [PMID: 28818623 DOI: 10.1016/j.meegid.2017.08.013] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/15/2017] [Revised: 07/26/2017] [Accepted: 08/13/2017] [Indexed: 10/19/2022]
Abstract
Leptospirosis is a zoonotic disease which global burden is increasing often related to climatic change. Hundreds of whole genome sequences from worldwide isolates of Leptospira spp. are available nowadays, together with online tools that permit to assign MLST sequence types (STs) directly from raw sequence data. In this work we have applied R7L-MLST to near 500 genomes and strains collection globally distributed. All 10 pathogenic species as well as intermediate were typed using this MLST scheme. The correlation observed between STs and serogroups in our previous work, is still satisfied with this higher dataset sustaining the implementation of MLST to assist serological classification as a complementary approach. Bayesian phylogenetic analysis of concatenated sequences from R7-MLST loci allowed us to resolve taxonomic inconsistencies but also showed that events such as recombination, gene conversion or lateral gene transfer played an important role in the evolution of Leptospira genus. Whole genome sequencing allows us to contribute with suitable epidemiologic information useful to apply in the design of control strategies and also in diagnostic methods for this illness.
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Affiliation(s)
- K Caimi
- Instituto Nacional de Tecnología Agropecuaria (INTA), Instituto de Biotecnología, Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Buenos Aires, Argentina
| | - S A Repetto
- Universidad de Buenos Aires, Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Instituto de Investigaciones en Microbiología y Parasitología Médica (IMPaM), Facultad de Medicina, Buenos Aires, Argentina
| | - V Varni
- Instituto Nacional de Tecnología Agropecuaria (INTA), Instituto de Biotecnología, Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Buenos Aires, Argentina
| | - P Ruybal
- Universidad de Buenos Aires, Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Instituto de Investigaciones en Microbiología y Parasitología Médica (IMPaM), Facultad de Medicina, Buenos Aires, Argentina.
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Rajeev S, Conan A, Pratt N, Beierschmitt A, Palmour R. High Leptospira seroprevalence in captive and wild-caught vervet monkeys (Chlorocebus sabeus) on the Caribbean island of Saint Kitts. J Vet Diagn Invest 2017; 29:930-934. [DOI: 10.1177/1040638717724838] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
Leptospirosis is a zoonotic disease of global importance. Very little information is available on Leptospira infection in nonhuman primates. We report herein a high seroprevalence (49.4%; 95% confidence interval: 41.6–57.2%) to Leptospira serovars in vervet monkeys ( Chlorocebus sabeus) on the Caribbean island of Saint Kitts. Monkeys bred in captivity ( n = 81) had a significantly higher seroprevalence compared to wild-caught monkeys ( n = 81; p < 0.05). Seroprevalence to serovar Bataviae was significantly higher in monkeys bred in captivity and was higher to serovar Bratislava in wild-caught monkeys ( p < 0.05). Our data confirm that exposure to various Leptospira serovars and seroconversion occurs in wild and captive vervet monkeys on the Caribbean island of Saint Kitts. Further studies are warranted to better understand epidemiology, transmission, pathology, and possible reservoir status in this species.
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Affiliation(s)
- Sreekumari Rajeev
- Department of Biomedical Sciences, Ross University School of Veterinary Medicine, Saint Kitts (Rajeev, Conan, Pratt, Beierschmit)
- McGill University, Montreal, Canada (Palmour)
- Behavioral Science Foundation, Saint Kitts (Palmour, Beierschmit)
| | - Anne Conan
- Department of Biomedical Sciences, Ross University School of Veterinary Medicine, Saint Kitts (Rajeev, Conan, Pratt, Beierschmit)
- McGill University, Montreal, Canada (Palmour)
- Behavioral Science Foundation, Saint Kitts (Palmour, Beierschmit)
| | - Nicola Pratt
- Department of Biomedical Sciences, Ross University School of Veterinary Medicine, Saint Kitts (Rajeev, Conan, Pratt, Beierschmit)
- McGill University, Montreal, Canada (Palmour)
- Behavioral Science Foundation, Saint Kitts (Palmour, Beierschmit)
| | - Amy Beierschmitt
- Department of Biomedical Sciences, Ross University School of Veterinary Medicine, Saint Kitts (Rajeev, Conan, Pratt, Beierschmit)
- McGill University, Montreal, Canada (Palmour)
- Behavioral Science Foundation, Saint Kitts (Palmour, Beierschmit)
| | - Roberta Palmour
- Department of Biomedical Sciences, Ross University School of Veterinary Medicine, Saint Kitts (Rajeev, Conan, Pratt, Beierschmit)
- McGill University, Montreal, Canada (Palmour)
- Behavioral Science Foundation, Saint Kitts (Palmour, Beierschmit)
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Weiss S, Menezes A, Woods K, Chanthongthip A, Dittrich S, Opoku-Boateng A, Kimuli M, Chalker V. An Extended Multilocus Sequence Typing (MLST) Scheme for Rapid Direct Typing of Leptospira from Clinical Samples. PLoS Negl Trop Dis 2016; 10:e0004996. [PMID: 27654037 PMCID: PMC5031427 DOI: 10.1371/journal.pntd.0004996] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2016] [Accepted: 08/21/2016] [Indexed: 02/04/2023] Open
Abstract
Background Rapid typing of Leptospira is currently impaired by requiring time consuming culture of leptospires. The objective of this study was to develop an assay that provides multilocus sequence typing (MLST) data direct from patient specimens while minimising costs for subsequent sequencing. Methodology and Findings An existing PCR based MLST scheme was modified by designing nested primers including anchors for facilitated subsequent sequencing. The assay was applied to various specimen types from patients diagnosed with leptospirosis between 2014 and 2015 in the United Kingdom (UK) and the Lao Peoples Democratic Republic (Lao PDR). Of 44 clinical samples (23 serum, 6 whole blood, 3 buffy coat, 12 urine) PCR positive for pathogenic Leptospira spp. at least one allele was amplified in 22 samples (50%) and used for phylogenetic inference. Full allelic profiles were obtained from ten specimens, representing all sample types (23%). No nonspecific amplicons were observed in any of the samples. Of twelve PCR positive urine specimens three gave full allelic profiles (25%) and two a partial profile. Phylogenetic analysis allowed for species assignment. The predominant species detected was L. interrogans (10/14 and 7/8 from UK and Lao PDR, respectively). All other species were detected in samples from only one country (Lao PDR: L. borgpetersenii [1/8]; UK: L. kirschneri [1/14], L. santarosai [1/14], L. weilii [2/14]). Conclusion Typing information of pathogenic Leptospira spp. was obtained directly from a variety of clinical samples using a modified MLST assay. This assay negates the need for time-consuming culture of Leptospira prior to typing and will be of use both in surveillance, as single alleles enable species determination, and outbreaks for the rapid identification of clusters. Leptospirosis is a zoonotic disease with more than 1 million cases per year globally and epidemics are increasingly reported. In this setting rapid typing is essential to identify potential clusters and transmission pathways. Typing of bacteria commonly requires bacterial isolates but culturing Leptospira is difficult and time consuming and requires invasive samples, such as blood or cerebrospinal fluid. We modified an existing typing scheme to lower the limit of detection and were able to amplify and sequence alleles directly from clinical specimens. Samples included blood (whole blood, serum, or buffy coat) and urine from patients diagnosed by PCR with leptospirosis between 2014 and 2015 in the United Kingdom and the Lao Peoples Democratic Republic. Using the sequences in phylogenetic analysis we identified the predominant Leptospira species in both countries as L. interrogans. With its increased sensitivity the modified assay allows for typing and species determination of Leptospira directly from blood or urine. It will be of use during epidemics and outbreaks for rapid identification of clusters and can support surveillance without the need to culture fastidious isolates.
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Affiliation(s)
- Sabrina Weiss
- Public Health England (PHE), National Infection Service (NIS), London, United Kingdom.,European Programme for Public Health Microbiology (EUPHEM), European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
| | - Angela Menezes
- Public Health England (PHE), National Infection Service (NIS), London, United Kingdom
| | - Kate Woods
- Public Health England (PHE), National Infection Service (NIS), London, United Kingdom.,Lao-Oxford-Mahosot Hospital-Wellcome Trust Research Unit (LOMWRU), Vientiane, Lao PDR
| | - Anisone Chanthongthip
- Lao-Oxford-Mahosot Hospital-Wellcome Trust Research Unit (LOMWRU), Vientiane, Lao PDR
| | - Sabine Dittrich
- Lao-Oxford-Mahosot Hospital-Wellcome Trust Research Unit (LOMWRU), Vientiane, Lao PDR.,Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom.,Foundation for Innovative New Diagnostics (FIND), Geneva, Switzerland
| | - Agatha Opoku-Boateng
- Public Health England (PHE), National Infection Service (NIS), London, United Kingdom
| | - Maimuna Kimuli
- Public Health England (PHE), National Infection Service (NIS), London, United Kingdom
| | - Victoria Chalker
- Public Health England (PHE), National Infection Service (NIS), London, United Kingdom
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Agampodi SB, Dahanayaka NJ, Nöckler K, Anne MS, Vinetz JM. Redefining Gold Standard Testing for Diagnosing Leptospirosis: Further Evidence from a Well-Characterized, Flood-Related Outbreak in Sri Lanka. Am J Trop Med Hyg 2016; 95:531-536. [PMID: 27402521 PMCID: PMC5014254 DOI: 10.4269/ajtmh.16-0033] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2016] [Accepted: 02/24/2016] [Indexed: 12/14/2022] Open
Abstract
A gap in the leptospirosis field remains the lack of well-characterized sample collections that allow for comparison of new methods to standard ones. In the context of a flood-related outbreak of leptospirosis evaluated in Anuradhapura, Sri Lanka, a specimen bank was obtained with detailed metadata accompanied by gold standard diagnostic test results. Blood samples collected on admission and 14 days later from suspected cases of leptospirosis were tested using microscopic agglutination test (MAT) (17 serovars), an in-house enzyme-linked immunosorbent assay (ELISA) using a locally obtained strain of Leptospira kirschneri as sonicated antigen, a commercially available ELISA based on sonicated Leptospira biflexa, and a quantitative polymerase chain reaction (qPCR) assay targeting the pathogenic Leptospira-specific 16S rRNA gene. Of 62 patients presenting within the first 2 days of illness, 31 had confirmed leptospirosis based either on paired-sample MAT or qPCR. During the acute phase, qPCR was most sensitive, detecting 74% of definitively diagnosed cases; immunoglobulin G (IgG) ELISA (in-house), IgG ELISA (commercial), and MAT had sensitivities of 35.5%, 12.0%, and 22.6%, respectively, in detecting definitively diagnosed cases using acute phase serum. Of 40 patients with paired sera, 10 were qPCR positive. Of these, five samples were negative by paired-sample MAT. Of the 11 MAT-positive samples, only five were detected using qPCR confirming that both tests are needed for maximal sensitivity. Regional leptospiral serovar-specific IgG ELISA was superior to MAT. Knowing the regionally dominant serovars improves serological sensitivity in the analysis of acute specimens by ELISA, but qPCR was most sensitive in this patient population.
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Affiliation(s)
- Suneth B. Agampodi
- Department of Community Medicine, Faculty of Medicine and Allied Sciences, Rajarata University of Sri Lanka, Sri Lanka
- Tropical Disease Research Unit (TDRU), Rajarata University of Sri Lanka, Sri Lanka
| | - Niroshan J. Dahanayaka
- Tropical Disease Research Unit (TDRU), Rajarata University of Sri Lanka, Sri Lanka
- Department of Medicine, Faculty of Medicine and Allied Sciences, Rajarata University of Sri Lanka, Sri Lanka
| | | | | | - Joseph M. Vinetz
- Division of Infectious Diseases, Department of Medicine, University of California, San Diego, California
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Sivakumar R, Balakrishnan V, Gowri P, Visalakshi J. Leptospiral Uveitis: Usefulness of Clinical Signs as Diagnostic Predictors. Ocul Immunol Inflamm 2016; 26:569-576. [DOI: 10.1080/09273948.2016.1217341] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Affiliation(s)
| | | | - Priya Gowri
- Aravind Medical Research Foundation, Madurai, India
| | - Jeyaseelan Visalakshi
- Christian Medical College and Hospital Vellore, Department of Biostatistics, Vellore, India
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36
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Herman HS, Mehta S, Cárdenas WB, Stewart-Ibarra AM, Finkelstein JL. Micronutrients and Leptospirosis: A Review of the Current Evidence. PLoS Negl Trop Dis 2016; 10:e0004652. [PMID: 27387046 PMCID: PMC4936698 DOI: 10.1371/journal.pntd.0004652] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Leptospirosis is one of the most widespread zoonoses and represents a major threat to human health. Due to the high burden of disease, limitations in diagnostics, and limited coverage and availability of effective human and veterinary vaccines, leptospirosis remains an important neglected zoonotic disease. Improved surveillance and identification of modifiable risk factors for leptospirosis are urgently needed to inform preventive interventions and reduce the risk and severity of Leptospira infection. METHODOLOGY/PRINCIPAL FINDINGS This review was conducted to examine the evidence that links micronutrient status and Leptospira infection. A total of 56 studies were included in this review: 28 in vitro, 17 animal, and 11 observational human studies. Findings indicated that Leptospira infection is associated with higher iron and calcium concentrations and hypomagnesemia. CONCLUSIONS/SIGNIFICANCE Few prospective studies and no randomized trials have been conducted to date to examine the potential role of micronutrients in Leptospira infection. The limited literature in this area constrains our ability to make specific recommendations; however, the roles of iron, calcium, and magnesium in leptospirosis represent important areas for future research. The role of micronutrients in leptospirosis risk and severity needs to be elucidated in larger prospective human studies to inform public health interventions.
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Affiliation(s)
- Heather S. Herman
- Division of Nutritional Sciences, Cornell University, Ithaca, New York, United States of America
| | - Saurabh Mehta
- Division of Nutritional Sciences, Cornell University, Ithaca, New York, United States of America
- St. John's Research Institute, Bangalore, India
| | - Washington B. Cárdenas
- Laboratorio de Biomedicina, Escuela Superior Politécnica del Litoral, ESPOL, Guayaquil, Ecuador
| | - Anna M. Stewart-Ibarra
- Department of Medicine and the Center for Global Health and Translational Science, State University of New York (SUNY) Upstate Medical University, Syracuse, New York, United States of America
| | - Julia L. Finkelstein
- Division of Nutritional Sciences, Cornell University, Ithaca, New York, United States of America
- St. John's Research Institute, Bangalore, India
- * E-mail:
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37
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Buyuktimkin B, Saier MH. Comparative analyses of transport proteins encoded within the genomes of Leptospira species. Microb Pathog 2016; 98:118-31. [PMID: 27296707 DOI: 10.1016/j.micpath.2016.06.013] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2015] [Accepted: 06/08/2016] [Indexed: 02/02/2023]
Abstract
Select species of the bacterial genus Leptospira are causative agents of leptospirosis, an emerging global zoonosis affecting nearly one million people worldwide annually. We examined two Leptospira pathogens, Leptospira interrogans serovar Lai str. 56601 and Leptospira borgpetersenii serovar Hardjo-bovis str. L550, as well as the free-living leptospiral saprophyte, Leptospira biflexa serovar Patoc str. 'Patoc 1 (Ames)'. The transport proteins of these leptospires were identified and compared using bioinformatics to gain an appreciation for which proteins may be related to pathogenesis and saprophytism. L. biflexa possesses a disproportionately high number of secondary carriers for metabolite uptake and environmental adaptability as well as an increased number of inorganic cation transporters providing ionic homeostasis and effective osmoregulation in a rapidly changing environment. L. interrogans and L. borgpetersenii possess far fewer transporters, but those that they all have are remarkably similar, with near-equivalent representation in most transporter families. These two Leptospira pathogens also possess intact sphingomyelinases, holins, and virulence-related outer membrane porins. These virulence-related factors, in conjunction with decreased transporter substrate versatility, indicate that pathogenicity arose in Leptospira correlating to progressively narrowing ecological niches and the emergence of a limited set of proteins responsible for host invasion. The variability of host tropism and mortality rates by infectious leptospires suggests that small differences in individual sets of proteins play important physiological and pathological roles.
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Affiliation(s)
- Bora Buyuktimkin
- Department of Molecular Biology, Division of Biological Sciences, University of California at San Diego, La Jolla, CA 92093-0116, USA
| | - Milton H Saier
- Department of Molecular Biology, Division of Biological Sciences, University of California at San Diego, La Jolla, CA 92093-0116, USA.
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38
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Binns C, Low WY. Leptospirosis: A Public Health Story Encircling the Globe. Asia Pac J Public Health 2016; 28:288-9. [PMID: 27161412 DOI: 10.1177/1010539516648021] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Colin Binns
- School of Public Health, Curtin University, Perth, Western Australia, Australia
| | - Wah Yun Low
- Research Management Center, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
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39
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Martin G, MacLachlan M, Labonté R, Larkan F, Vallières F, Bergin N. Globalization and Health: developing the journal to advance the field. Global Health 2016; 12:6. [PMID: 26961760 PMCID: PMC4785659 DOI: 10.1186/s12992-016-0143-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2016] [Accepted: 02/09/2016] [Indexed: 11/10/2022] Open
Abstract
Founded in 2005, Globalization and Health was the first open access global health journal. The journal has since expanded the field, and its influence, with the number of downloaded papers rising 17-fold, to over 4 million. Its ground-breaking papers, leading authors -including a Nobel Prize winner- and an impact factor of 2.25 place it among the top global health journals in the world. To mark the ten years since the journal's founding, we, members of the current editorial board, undertook a review of the journal's progress over the last decade. Through the application of an inductive thematic analysis, we systematically identified themes of research published in the journal from 2005 to 2014. We identify key areas the journal has promoted and consider these in the context of an existing framework, identify current gaps in global health research and highlight areas we, as a journal, would like to see strengthened.
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Affiliation(s)
- Greg Martin
- Centre for Global Health, Trinity College, University of Dublin, Dublin, Ireland.
| | - Malcolm MacLachlan
- Centre for Global Health, Trinity College, University of Dublin, Dublin, Ireland. .,School of Psychology, Trinity College, University of Dublin, Dublin, Ireland. .,Centre for Rehabilitation Studies, Stellenbosch University, Stellenbosch, South Africa. .,Palacky University, Olomouc, Czech Republic.
| | - Ronald Labonté
- School of Epidemiology, Public Health and Preventive Medicine, University of Ottawa, Ottawa, Canada
| | - Fiona Larkan
- Centre for Global Health, Trinity College, University of Dublin, Dublin, Ireland.,School of Medicine, Trinity College, University of Dublin, Dublin, Ireland
| | - Frédérique Vallières
- Centre for Global Health, Trinity College, University of Dublin, Dublin, Ireland.,School of Psychology, Trinity College, University of Dublin, Dublin, Ireland
| | - Niamh Bergin
- Masters in Global Mental Health Programme, University of Glasgow, Glasgow, Scotland
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40
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Domingo I, Cuenca M, Gimeno F, Guerrero A. Incidence of leptospirosis in Spain, 2009-2012. Rev Clin Esp 2015; 216:51-3. [PMID: 26653048 DOI: 10.1016/j.rce.2015.10.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2015] [Revised: 10/02/2015] [Accepted: 10/25/2015] [Indexed: 10/22/2022]
Affiliation(s)
- I Domingo
- Facultad de Medicina, Universidad Católica de Valencia, Valencia, España.
| | - M Cuenca
- Dirección de Investigación y Docencia, Hospital Universitario de La Ribera, Alzira, Valencia, España; Facultad de Enfermería, Universidad Católica de Valencia, Valencia, España
| | - F Gimeno
- Dirección de Investigación y Docencia, Hospital Universitario de La Ribera, Alzira, Valencia, España
| | - A Guerrero
- Facultad de Medicina, Universidad Católica de Valencia, Valencia, España; Dirección de Investigación y Docencia, Hospital Universitario de La Ribera, Alzira, Valencia, España
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41
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Malycha J, Colebourn C. Repatriated patient with leptospirosis and severe iron deficiency. J Intensive Care Soc 2015; 16:359. [DOI: 10.1177/1751143715589328] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Taylor AJ, Paris DH, Newton PN. A Systematic Review of Mortality from Untreated Scrub Typhus (Orientia tsutsugamushi). PLoS Negl Trop Dis 2015; 9:e0003971. [PMID: 26274584 PMCID: PMC4537241 DOI: 10.1371/journal.pntd.0003971] [Citation(s) in RCA: 190] [Impact Index Per Article: 21.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2015] [Accepted: 07/10/2015] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Scrub typhus, a bacterial infection caused by Orientia tsutsugamushi, is increasingly recognized as an important cause of fever in Asia, with an estimated one million infections occurring each year. Limited access to health care and the disease's non-specific symptoms mean that many patients are undiagnosed and untreated, but the mortality from untreated scrub typhus is unknown. This review systematically summarizes the literature on the untreated mortality from scrub typhus and disease outcomes. METHODOLOGY/PRINCIPAL FINDINGS A literature search was performed to identify patient series containing untreated patients. Patients were included if they were symptomatic and had a clinical or laboratory diagnosis of scrub typhus and excluded if they were treated with antibiotics. The primary outcome was mortality from untreated scrub typhus and secondary outcomes were total days of fever, clinical symptoms, and laboratory results. A total of 76 studies containing 89 patient series and 19,644 patients were included in the final analysis. The median mortality of all patient series was 6.0% with a wide range (min-max) of 0-70%. Many studies used clinical diagnosis alone and had incomplete data on secondary outcomes. Mortality varied by location and increased with age and in patients with myocarditis, delirium, pneumonitis, or signs of hemorrhage, but not according to sex or the presence of an eschar or meningitis. Duration of fever was shown to be long (median 14.4 days Range (9-19)). CONCLUSIONS Results show that the untreated mortality from scrub typhus appears lower than previously reported estimates. More data are required to clarify mortality according to location and host factors, clinical syndromes including myocarditis and central nervous system disease, and in vulnerable mother-child populations. Increased surveillance and improved access to diagnostic tests are required to accurately estimate the untreated mortality of scrub typhus. This information would facilitate reliable quantification of DALYs and guide empirical treatment strategies.
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Affiliation(s)
- Andrew J. Taylor
- Lao Oxford-Mahosot Hospital-Wellcome Trust Research Unit (LOMWRU), Microbiology Laboratory, Mahosot Hospital, Vientiane, Laos
- Centre for Tropical Medicine and Global Health, Nuffield Department of Clinical Medicine, Churchill Hospital, University of Oxford, Oxford, United Kingdom
| | - Daniel H. Paris
- Lao Oxford-Mahosot Hospital-Wellcome Trust Research Unit (LOMWRU), Microbiology Laboratory, Mahosot Hospital, Vientiane, Laos
- Centre for Tropical Medicine and Global Health, Nuffield Department of Clinical Medicine, Churchill Hospital, University of Oxford, Oxford, United Kingdom
- Mahidol–Oxford Research Unit (MORU), Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
| | - Paul N. Newton
- Lao Oxford-Mahosot Hospital-Wellcome Trust Research Unit (LOMWRU), Microbiology Laboratory, Mahosot Hospital, Vientiane, Laos
- Centre for Tropical Medicine and Global Health, Nuffield Department of Clinical Medicine, Churchill Hospital, University of Oxford, Oxford, United Kingdom
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43
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Lee MJ, Miki S, Kitagawa M, Lee WC. A Comparative Study of the Epidemiology of Human Leptospirosis in Korea and Japan between 2006 and 2012. Jpn J Infect Dis 2015; 69:259-61. [PMID: 26255729 DOI: 10.7883/yoken.jjid.2014.589] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
We undertook a comparative analysis of the epidemiology of reported human leptospirosis (HL) cases in Korea and Japan. Between 2006 and 2012, the cumulative incidence of HL in Korea was higher than that in Japan (1.26 vs. 0.14 per 100,000 population, respectively), and the total reported cases were 632 and 196, respectively. Significantly more men were infected than women in both Korea (63.0% men, P < 0.01) and Japan (87.8% men, P < 0.01). In both countries, the incidence was highest among those aged 40 years and older (60%), and peaked in autumn (78.5% cases in Korea, and 46.9% cases in Japan). However, Japan exhibited a significantly higher proportion of male cases, a younger age distribution, and less prominent seasonality. A significant difference was observed in the incidence of HL between the capital city and rural areas in Korea, but not in Japan. The differences in agricultural and forestry practices, and the efficacy or wastewater treatment infrastructure might influence the incidence level in rural areas in both countries. The differences between the 2 countries might be because of their unique geographical characteristics and variations in their levels of industrialization.
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Affiliation(s)
- Myeong-Jin Lee
- Department of Public Health, Otemae College of Nutrition
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44
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Buyuktimkin B, Saier MH. Comparative genomic analyses of transport proteins encoded within the genomes of Leptospira species. Microb Pathog 2015; 88:52-64. [PMID: 26247102 DOI: 10.1016/j.micpath.2015.07.019] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2015] [Revised: 07/21/2015] [Accepted: 07/23/2015] [Indexed: 11/17/2022]
Abstract
Select species of the bacterial genus Leptospira are causative agents of leptospirosis, an emerging global zoonosis affecting nearly one million people worldwide annually. We examined two Leptospira pathogens, Leptospira interrogans serovar Lai str. 56601 and Leptospira borgpetersenii serovar Hardjo-bovis str. L550, as well as the free-living leptospiral saprophyte, Leptospira biflexa serovar Patoc str. 'Patoc 1 (Ames)'. The transport proteins of these leptospires were identified and compared using bioinformatics to gain an appreciation for which proteins may be related to pathogenesis and saprophytism. L. biflexa possesses a disproportionately high number of secondary carriers for metabolite uptake and environmental adaptability as well as an increased number of inorganic cation transporters providing ionic homeostasis and effective osmoregulation in a rapidly changing environment. L. interrogans and L. borgpetersenii possess far fewer transporters, but those that they have are remarkably similar, with near-equivalent representation in most transporter families. These two Leptospira pathogens also possess intact sphingomyelinases, holins, and virulence-related outer membrane porins. These virulence-related factors, in conjunction with decreased transporter substrate versatility, indicate that pathogenicity was accompanied by progressively narrowing ecological niches and the emergence of a limited set of proteins responsible for host invasion. The variability of host tropism and mortality rates by infectious leptospires suggests that small differences in individual sets of proteins play important physiological and pathological roles.
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Affiliation(s)
- Bora Buyuktimkin
- Department of Molecular Biology, Division of Biological Sciences, University of California at San Diego, La Jolla, CA 92093-0116, USA
| | - Milton H Saier
- Department of Molecular Biology, Division of Biological Sciences, University of California at San Diego, La Jolla, CA 92093-0116, USA.
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45
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Taylor AJ, Paris DH, Newton PN. A Systematic Review of the Mortality from Untreated Leptospirosis. PLoS Negl Trop Dis 2015; 9:e0003866. [PMID: 26110270 PMCID: PMC4482028 DOI: 10.1371/journal.pntd.0003866] [Citation(s) in RCA: 54] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2015] [Accepted: 06/01/2015] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND Leptospirosis occurs worldwide, but the global incidence of human disease and its mortality are not well understood. Many patients are undiagnosed and untreated due to its non-specific symptoms and a lack of access to diagnostics. This study systematically reviews the literature to clarify the mortality from untreated leptospirosis. Results will help quantify the global burden of disease and guide health policies. METHODOLOGY/PRINCIPAL FINDINGS A comprehensive literature search was performed to identify untreated patient series. Included patients were symptomatic, but asymptomatic patients and those who had received antibiotics, dialysis or who were treated on Intensive Care Units were excluded. Included patients had a confirmed laboratory diagnosis by culture, PCR, or serological tests. Data was extracted and individual patient series were assessed for bias. Thirty-five studies, comprising 41 patient series and 3,390 patients, were included in the study. A high degree of bias within studies was shown due to limitations in study design, diagnostic tests and missing data. Median series mortality was 2.2% (Range 0.0-39.7%), but mortality was high in jaundiced patients (19.1%) (Range 0.0-39.7%), those with renal failure 12.1% (Range 0-25.0%) and in patients aged over 60 (60%) (Range 33.3-60%), but low in anicteric patients (0%) (Range 0-1.7%). CONCLUSIONS This systematic review contributes to our understanding of the mortality of untreated leptospirosis and provides data for the estimation of DALYs attributable to this disease. We show that mortality is significantly higher in older patients with icteric disease or renal failure but is lower in younger, anicteric patients. Increased surveillance and accurate point-of-care diagnostics are required to better understand the incidence and improve diagnosis of disease. Empirical treatment strategies should prioritize early treatment to improve outcomes from leptospirosis.
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Affiliation(s)
- Andrew J. Taylor
- Lao Oxford Mahosot Hospital Wellcome Trust Research Unit (LOMWRU), Microbiology Laboratory, Mahosot Hospital, Vientiane, Laos
- Centre for Tropical Medicine and Global Health, Nuffield Department of Clinical Medicine, Churchill Hospital, University of Oxford, Oxford, United Kingdom
| | - Daniel H. Paris
- Lao Oxford Mahosot Hospital Wellcome Trust Research Unit (LOMWRU), Microbiology Laboratory, Mahosot Hospital, Vientiane, Laos
- Centre for Tropical Medicine and Global Health, Nuffield Department of Clinical Medicine, Churchill Hospital, University of Oxford, Oxford, United Kingdom
- Mahidol–Oxford Research Unit (MORU), Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
| | - Paul N. Newton
- Lao Oxford Mahosot Hospital Wellcome Trust Research Unit (LOMWRU), Microbiology Laboratory, Mahosot Hospital, Vientiane, Laos
- Centre for Tropical Medicine and Global Health, Nuffield Department of Clinical Medicine, Churchill Hospital, University of Oxford, Oxford, United Kingdom
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