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Douchet L, Menkes C, Herbreteau V, Larrieu J, Bador M, Goarant C, Mangeas M. Climate-driven models of leptospirosis dynamics in tropical islands from three oceanic basins. PLoS Negl Trop Dis 2024; 18:e0011717. [PMID: 38662800 DOI: 10.1371/journal.pntd.0011717] [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: 10/12/2023] [Revised: 05/07/2024] [Accepted: 04/05/2024] [Indexed: 05/08/2024] Open
Abstract
BACKGROUND Leptospirosis is a neglected zoonosis which remains poorly known despite its epidemic potential, especially in tropical islands where outdoor lifestyle, vulnerability to invasive reservoir species and hot and rainy climate constitute higher risks for infections. Burden remains poorly documented while outbreaks can easily overflow health systems of these isolated and poorly populated areas. Identification of generic patterns driving leptospirosis dynamics across tropical islands would help understand its epidemiology for better preparedness of communities. In this study, we aim to model leptospirosis seasonality and outbreaks in tropical islands based on precipitation and temperature indicators. METHODOLOGY/PRINCIPAL FINDINGS We adjusted machine learning models on leptospirosis surveillance data from seven tropical islands (Guadeloupe, Reunion Island, Fiji, Futuna, New Caledonia, and Tahiti) to investigate 1) the effect of climate on the disease's seasonal dynamic, i.e., the centered seasonal profile and 2) inter-annual anomalies, i.e., the incidence deviations from the seasonal profile. The model was then used to estimate seasonal dynamics of leptospirosis in Vanuatu and Puerto Rico where disease incidence data were not available. A robust model, validated across different islands with leave-island-out cross-validation and based on current and 2-month lagged precipitation and current and 1-month lagged temperature, can be constructed to estimate the seasonal dynamic of leptospirosis. In opposition, climate determinants and their importance in estimating inter-annual anomalies highly differed across islands. CONCLUSIONS/SIGNIFICANCE Climate appears as a strong determinant of leptospirosis seasonality in tropical islands regardless of the diversity of the considered environments and the different lifestyles across the islands. However, predictive and expandable abilities from climate indicators weaken when estimating inter-annual outbreaks and emphasize the importance of these local characteristics in the occurrence of outbreaks.
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Affiliation(s)
- Léa Douchet
- ENTROPIE, IRD, Univ Reunion, CNRS, IFREMER, Univ Nouvelle Calédonie, Nouméa, New Caledonia
- ESPACE-DEV, IRD, Univ Montpellier, Univ. Antilles, Univ Guyane, Univ Réunion, Phnom Penh, Cambodia
| | - Christophe Menkes
- ENTROPIE, IRD, Univ Reunion, CNRS, IFREMER, Univ Nouvelle Calédonie, Nouméa, New Caledonia
| | - Vincent Herbreteau
- ESPACE-DEV, IRD, Univ Montpellier, Univ. Antilles, Univ Guyane, Univ Réunion, Phnom Penh, Cambodia
- Institut Pasteur du Cambodge, Epidemiology and Public Health Unit, Phnom Penh, Cambodia
| | - Joséphine Larrieu
- ENTROPIE, IRD, Univ Reunion, CNRS, IFREMER, Univ Nouvelle Calédonie, Nouméa, New Caledonia
| | - Margot Bador
- CECI Université de Toulouse, CERFACS/CNRS, Toulouse, France
| | - Cyrille Goarant
- Institut Pasteur in New Caledonia, Leptospirosis Research and Expertise Unit, Nouméa, New Caledonia
- Public Health Division, The Pacific Community, Nouméa, New Caledonia
| | - Morgan Mangeas
- ENTROPIE, IRD, Univ Reunion, CNRS, IFREMER, Univ Nouvelle Calédonie, Nouméa, New Caledonia
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Kumar D, Prasad ML, Kumar M, Munda SS, Vidyapati. An Insight Into Various Manifestations of Leptospirosis: A Unique Case Series From a State in Eastern India. Cureus 2024; 16:e56802. [PMID: 38659535 PMCID: PMC11042753 DOI: 10.7759/cureus.56802] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/23/2024] [Indexed: 04/26/2024] Open
Abstract
BACKGROUND Leptospirosis presents with highly variable clinical manifestations affecting different organ systems in different individuals. The presentation ranges from an asymptomatic or mild disease to a severe disease associated with multiorgan failure and higher mortality. Leptospirosis is highly underreported due to a lack of diagnostic modalities and less suspicion among clinicians. METHODOLOGY We present this single-center retrospective case series of 12 cases, which include various common and uncommon scenarios by which the disease can present and can be missed due to lack of suspicion. The study contains individual patient characteristics including demographic, laboratory, clinical, and treatment data. The association between these variables and mortality was analyzed using p-values and results were described. A p-value of<0.05 was considered statistically significant. RESULTS A total of 12 cases were included in the study. The male-to-female ratio was 3:1. The mean age was higher (37.75±9.81 years) in cases who died than those who recovered (34.25±14.09). Factors like history of alcoholism, presence of chronic liver disease (CLD), jaundice, acute renal failure, requirement of dialysis, and requirement of intensive care were significantly associated with increased risk of death (odds ratio >1, p-value <0.05). The most common symptom of presentation was fever in 11 (91.66%) cases. Jaundice and renal failure were significantly associated with death (odds ratio 1.2, p-value 0.04). The requirement of intensive care treatment (odds ratio 2.1, p-value 0.05) and dialysis (odds ratio 39.66, p-value 0.03) were also significantly associated with death. The percentage of death was lower in the group of patients who received combination antibiotic therapy. CONCLUSION Leptospirosis has varied presentations in different individuals and the diagnosis can be missed due to lack of specific signs and symptoms. Severe diseases involving multiple organs and preexisting comorbidities are associated with higher mortality rates. Timely diagnosis and treatment are necessary to reduce mortality and increase survival.
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Affiliation(s)
- Divakar Kumar
- Internal Medicine, Rajendra Institute of Medical Sciences, Ranchi, IND
| | | | - Mukesh Kumar
- Community Medicine, Phulo Jhano Medical College, Dumka, IND
| | - Shiv S Munda
- Internal Medicine, Rajendra Institute of Medical Sciences, Ranchi, IND
| | - Vidyapati
- Internal Medicine, Rajendra Institute of Medical Sciences, Ranchi, IND
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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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Gómez-Martín MC, Rodríguez-Benjumeda LM, de Eguilior-Mestre MC, Lozano-Domínguez MC, Luque-Márquez R, Jódar-Sánchez F, Aznar-Martín J, Donaire-Granado JA, Luque-Romero LG. [Epidemiology of leptospirosis in the wetlands of Southern Spain]. GACETA SANITARIA 2023; 37:102288. [PMID: 36804781 DOI: 10.1016/j.gaceta.2023.102288] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/15/2022] [Revised: 11/14/2022] [Accepted: 11/27/2022] [Indexed: 02/17/2023]
Abstract
OBJECTIVE To find out whether the leptospirosis incidence rate among red swamp crayfish collectors in the harvesting season is higher than in the general population, and to identify risk factors and assess the direct and indirect health costs associated with leptospirosis seroconversion. METHOD This study was carried out between 1 July 2017 and 31 March 2018 in the municipality of Isla Mayor (Seville, Spain). It took the form of a prospective cohort study (exposed population: swamp crayfish collectors; non-exposed population: general population). The population was invited to take part in a prevalence study to be conducted using the ELISA qualitative technique, and informed consent was obtained from those who agreed. Negative serology cases were then included in the cohort study. Both cohorts were monitored clinically and symptomatic cases were serology tested. A second serum sample was taken from the swamp crayfish collectors at the end of the monitoring period to detect asymptomatic cases. Serovars were confirmed by microscopic agglutination testing. A bivariate descriptive analysis was carried out and cumulative incidence and relative risk were calculated, with positive serology being taken as the dependent variable. RESULTS A total of 278 people were included in the study, of whom 92 made up the swamp crayfish collectors cohort and 186 the general population cohort. Women made up 46.8% of the sample, but only 29.3% of the collectors cohort. The mean age was 45.1 (±16.4) years. Nine cases of seroconversion were detected: eight among swamp crayfish collectors and one in the general population. Overall cumulative incidence was therefore 3.2%: 8.7% in the exposed group and 0.5% in the non-exposed group. Relative risk was 16.2% (95% confidence interval: 2.1-127.4). The total cost of medical assistance and illness-related losses associated with leptospirosis was 1568€/case. CONCLUSIONS Leptospirosis in Isla Mayor is strongly associated with red swamp crayfish collecting. It's incidence here is much higher than that reported in studies published in other countries.
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Affiliation(s)
- María Carmen Gómez-Martín
- Unidad de Protección de la Salud, Distrito Sanitario Aljarafe-Sevilla Norte, Servicio Andaluz de Salud, Centro de Salud Ciudad Expo, Mairena del Aljarafe (Sevilla), España
| | - Luis Miguel Rodríguez-Benjumeda
- Unidad de Prevención, Promoción y Vigilancia de la Salud, Distrito Sanitario Aljarafe-Sevilla Norte, Servicio Andaluz de Salud, Centro de Salud Ciudad Expo, Mairena del Aljarafe (Sevilla), España
| | - María Carmen de Eguilior-Mestre
- Unidad de Gestión Clínica de Coria del Río, Distrito Sanitario Aljarafe-Sevilla Norte, Servicio Andaluz de Salud, Centro de Salud Blas Infante, Coria del Río (Sevilla), España
| | - María Carmen Lozano-Domínguez
- Unidad de Enfermedades Infecciosas, Microbiología Clínica y Medicina Preventiva, Hospital Universitario Virgen del Rocío, Servicio Andaluz de Salud, Sevilla, España
| | - Rafael Luque-Márquez
- Unidad de Enfermedades Infecciosas, Microbiología Clínica y Medicina Preventiva, Hospital Universitario Virgen del Rocío, Servicio Andaluz de Salud, Sevilla, España
| | - Francisco Jódar-Sánchez
- Departamento de Economía Aplicada (Estadística y Econometría), Facultad de Ciencias Económicas y Empresariales, Universidad de Málaga, Málaga, España
| | - Javier Aznar-Martín
- Unidad de Enfermedades Infecciosas, Microbiología Clínica y Medicina Preventiva, Hospital Universitario Virgen del Rocío, Servicio Andaluz de Salud, Sevilla, España; Instituto de Investigaciones Biomédicas de Sevilla, IBIS (Universidad de Sevilla, Hospital Universitario Virgen del Rocío, Junta de Andalucía, Consejo Superior de Investigaciones Científicas), Sevilla, España; Departamento de Microbiología, Facultad de Medicina, Universidad de Sevilla, Sevilla, España
| | | | - Luis Gabriel Luque-Romero
- Unidad de Investigación, Distrito Sanitario Aljarafe-Sevilla Norte, Servicio Andaluz de Salud, Sevilla, España; Departamento de Citología e Histología Normal y Patológica, Facultad de Medicina, Universidad de Sevilla, Sevilla, España.
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Richard E, Geslin J, Wurtzer S, Moulin L. Monitoring of Leptospira species diversity in freshwater bathing area and in rats in Paris, France. THE SCIENCE OF THE TOTAL ENVIRONMENT 2022; 833:155121. [PMID: 35398418 DOI: 10.1016/j.scitotenv.2022.155121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/12/2022] [Revised: 04/04/2022] [Accepted: 04/04/2022] [Indexed: 06/14/2023]
Abstract
Leptospirosis is a neglected zoonotic disease with a worldwide distribution caused by bacterial pathogenic Leptospira. Rodents are considered as the main reservoir of Leptospira and transmission usually occurs through exposure to urine-contaminated environment. However, interactions between environment, rodent reservoir and human leptospirosis remain poorly studied. Here, we evaluated the concentration of Leptospira in surface water and captured rats in the city of Paris (France) from 2018 to 2020 using an integrity qPCR (Quantitative Polymerase Chain Reaction). All environmental samples (n = 1031) were positive for saprophytic Leptospira but pathogenic Leptospira P1 group were only found in 40% (n = 363; 2018) to 0% (n = 264; 2020) of samples. In the same time, analysis of 200 brown rat corpses trapped in the city, showed about 15% of positivity for Leptospira but the different method used for rats conservation (based on presence or absence of conservative agent) showed important variations in the Leptospira prevalence. Metagenomic analysis, based on rrs gene sequencing, was also carried out to evaluate the distribution of Leptospira in samples. Results could indicate that some species of Leptospira are found in surface waters as well as rats, but further study is needed to accurately describe the nature of the link between these two reservoirs. Quantification of Leptospira and pathogenic species description circulating inside animal reservoir living in the vicinity of freshwater in urban areas, will be helpful to understand the eco-epidemiology of leptospirosis and to establish prevention and intervention strategies, especially in the context of organization of recreative activity events in these urban areas.
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Affiliation(s)
- Elise Richard
- Eau de Paris, DRDQE, 33 Avenue Jean Jaurès, 94200 Ivry-Sur-Seine, France; Institut Pasteur, Unité Biologie des Spirochètes, 28 rue du docteur Roux, 75724 Paris, France
| | - Jacques Geslin
- Eau de Paris, DRDQE, 33 Avenue Jean Jaurès, 94200 Ivry-Sur-Seine, France
| | - Sébastien Wurtzer
- Eau de Paris, DRDQE, 33 Avenue Jean Jaurès, 94200 Ivry-Sur-Seine, France
| | - Laurent Moulin
- Eau de Paris, DRDQE, 33 Avenue Jean Jaurès, 94200 Ivry-Sur-Seine, France.
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Soupé-Gilbert ME, Oedin M, Kainiu M, Girault D, Figuet O, Brescia F, Goarant C. Original Leptospira spp. in island native terrestrial mammals: a case study in Pteropus spp. bats of New Caledonia. Transbound Emerg Dis 2022; 69:e2852-e2862. [PMID: 35730517 DOI: 10.1111/tbed.14635] [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: 03/15/2022] [Revised: 05/18/2022] [Accepted: 06/17/2022] [Indexed: 11/26/2022]
Abstract
Leptospirosis is a bacterial zoonosis that occurs in tropical and subtropical regions worldwide. Chiroptera are known to be a formidable reservoir of zoonotic pathogens, including leptospires. The epidemiology of leptospirosis in bats in the Pacific Islands is poorly known, both in terms of prevalence and in terms of the bacterial strains involved. A strong host specificity between leptospiral strains and their mammalian reservoir is recognized. This phenomenon has notably been studied recently in bat communities, providing strong evidence of coevolution. In New Caledonia, a biodiversity hotspot where leptospirosis is endemic and enzootic, Chiroptera are the only indigenous terrestrial mammals. In this study, we aimed to investigate leptospires associated with three flying fox species in New Caledonia. Kidneys and urine samples of Pteropus spp. from captures and seizures were analyzed. Among 254 flying foxes analyzed, 24 harboured pathogenic leptospires corresponding to an observed prevalence of 9.45% with 15.8% on the Main Island and 4.3% on Loyalty Islands. The analysis of the rrs gene, lfb1, MLST sequences evidenced 4 distinct clusters of undescribed strains, likely corresponding to undescribed species. All four strains belong to the Group I of pathogenic Leptospira spp., which includes Leptospira interrogans, Leptospira noguchii and Leptospira kirschneri. We detected pathogenic leptospires in all 3 Pteropus spp. studied (including 2 endemic species) with no evidence of host specificity in two co-roosting species. For a better understanding of Leptospira-host coevolution, notably to genetically characterize and evaluate the virulence of these original bat-associated leptospires, it is essential to improve isolation techniques. Flying foxes are traditionally hunted and eaten in New Caledonia, a massive cause of bat-human interactions. Our results should encourage vigilance during these contacts to limit the spillover risk of these pathogens to humans. This article is protected by copyright. All rights reserved.
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Affiliation(s)
| | - Malik Oedin
- Institut Agronomique Néo-Calédonien (IAC), Equipe ARBOREAL (AgricultuRe BiOdiveRsité Et vALorisation) BP
| | - Malia Kainiu
- Institut Pasteur in New Caledonia, Leptospirosis Research and Expertise Unit
| | - Dominique Girault
- Institut Pasteur in New Caledonia, Leptospirosis Research and Expertise Unit
| | - Orane Figuet
- Institut Pasteur in New Caledonia, Leptospirosis Research and Expertise Unit
| | - Fabrice Brescia
- Institut Agronomique Néo-Calédonien (IAC), Equipe ARBOREAL (AgricultuRe BiOdiveRsité Et vALorisation) BP
| | - Cyrille Goarant
- Institut Pasteur in New Caledonia, Leptospirosis Research and Expertise Unit
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Sapna K, Ashaiba A, Kumar TR, Shashidhar V, Arun A, Prasad KS. Evaluation of anti-LipL32 carbon nanotube immunofluorescence probe (carbo-lip) and comparison with MAT, IgM ELISA, IgM spot test and culture for early detection of leptospirosis at local hospital. J Microbiol Methods 2022; 195:106448. [DOI: 10.1016/j.mimet.2022.106448] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2022] [Revised: 03/04/2022] [Accepted: 03/08/2022] [Indexed: 11/28/2022]
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Gupta N, Wilson W, Ravindra P, Joylin S, Bhat R, Saravu K. Clinical profile, management and outcome of patients with leptospirosis during the times of COVID-19 pandemic: A prospective study from a tertiary care centre in South India. LE INFEZIONI IN MEDICINA 2022; 29:393-401. [PMID: 35146344 DOI: 10.53854/liim-2903-10] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/17/2021] [Accepted: 06/28/2021] [Indexed: 12/26/2022]
Abstract
Leptospirosis is a rodent-borne acute febrile illness, classically seen after heavy rainfall and floods. This study aimed to describe the clinical profile, management strategies and outcome of patients with leptospirosis amidst the Coronavirus disease-2019 outbreak. A prospective study of adult patients with undifferentiated fever (5-15 days) was conducted in South India between October 2020 and February 2021. The demographic, clinical details, laboratory details, treatment and outcome of leptospirosis positive (based on serology) and negative patients were compared. A chisquare test was used for qualitative variables, while an independent t-test or Mann Whitney U test was used for continuous variables. Of the 206 patients with suspected acute febrile illness, a total of 63 patients were diagnosed with leptospirosis based on serology results. The median sequential organ failure assessment score was higher in those with leptospirosis (p<0.001). Myalgia, abdominal pain, jaundice, decreased urine output, myocarditis, and dialysis requirement were more common in patients with leptospirosis. Leucocytosis and raised procalcitonin/C-reactive protein were more common in patients with leptospirosis. The duration of stay and antibiotic consumption was higher in patients with leptospirosis. Acute febrile illness such as leptospirosis should be suspected in tropical areas with significant risk factors. The presence of conjunctival suffusion, hepatic and renal dysfunction should warrant a serology test for leptospirosis.
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Affiliation(s)
- Nitin Gupta
- Department of Infectious Diseases, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, Karnataka, India.,Manipal Center for Infectious Diseases, Prasanna School of Public Health, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - William Wilson
- Department of Emergency Medicine, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Prithvishree Ravindra
- Department of Emergency Medicine, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Sowmya Joylin
- Department of Infectious Diseases, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Rachana Bhat
- Department of Emergency Medicine, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Kavitha Saravu
- Department of Infectious Diseases, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, Karnataka, India.,Manipal Center for Infectious Diseases, Prasanna School of Public Health, Manipal Academy of Higher Education, Manipal, Karnataka, India
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Kakita T, Okano S, Kyan H, Miyahira M, Taira K, Kitashoji E, Koizumi N. Laboratory diagnostic, epidemiological, and clinical characteristics of human leptospirosis in Okinawa Prefecture, Japan, 2003-2020. PLoS Negl Trop Dis 2021; 15:e0009993. [PMID: 34905535 PMCID: PMC8670671 DOI: 10.1371/journal.pntd.0009993] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2021] [Accepted: 11/12/2021] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Leptospirosis is considered an endemic disease among agricultural workers in Okinawa Prefecture, which is the southernmost part of Japan and has a subtropical climate, but data on the current status and trend of this disease are scarce. METHODOLOGY/PRINCIPAL FINDINGS We conducted a retrospective study of clinically suspected leptospirosis patients whose sample and information were sent to the Okinawa Prefectural Institute of Health and Environment from November 2003 to December 2020. Laboratory diagnosis was established using culture, nested polymerase chain reaction (PCR), and/or microscopic agglutination test (MAT) with blood, cerebrospinal fluid, and/or urine samples. Statistical analyses were performed to compare the epidemiological information, clinical features, and sensitivities of diagnostic methods among laboratory-confirmed cases. Serogroups and the species of Leptospira isolates were determined by MAT using 13 antisera and flaB sequencing. A total of 531 clinically suspected patients were recruited, among whom 246 (46.3%) were laboratory confirmed to have leptospirosis. Among the confirmed cases, patients aged 20-29 years (22.4%) and male patients (85.7%) were the most common. The most common estimated sources of infection were recreation (44.5%) and labor (27.8%) in rivers. Approximately half of the isolates were of the L. interrogans serogroup Hebdomadis. The main clinical symptoms were fever (97.1%), myalgia (56.3%), and conjunctival hyperemia (52.2%). Headache occurred significantly more often in patients with Hebdomadis serogroup infections than those with other serogroup infections. The sensitivities of culture and PCR exceeded 65% during the first 6 days, while the sensitivity of MAT surpassed that of culture and PCR in the second week after onset. PCR using blood samples was a preferable method for the early diagnosis of leptospirosis. CONCLUSIONS/SIGNIFICANCE The results of this study will support clinicians in the diagnosis and treatment of undifferentiated febrile patients in Okinawa Prefecture as well as patients returning from Okinawa Prefecture.
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Affiliation(s)
- Tetsuya Kakita
- Department of Biological Sciences, Okinawa Prefectural Institute of Health and Environment, Uruma, Okinawa, Japan
| | - Sho Okano
- Department of Biological Sciences, Okinawa Prefectural Institute of Health and Environment, Uruma, Okinawa, Japan
| | - Hisako Kyan
- Department of Biological Sciences, Okinawa Prefectural Institute of Health and Environment, Uruma, Okinawa, Japan
| | - Masato Miyahira
- Department of Biological Sciences, Okinawa Prefectural Institute of Health and Environment, Uruma, Okinawa, Japan
| | - Katsuya Taira
- Department of Biological Sciences, Okinawa Prefectural Institute of Health and Environment, Uruma, Okinawa, Japan
| | - Emi Kitashoji
- Department of Clinical Medicine, Institute of Tropical Medicine, Nagasaki University, Nagasaki, Nagasaki, Japan
| | - Nobuo Koizumi
- Department of Bacteriology I, National Institute of Infectious Disease, Shinjuku, Tokyo, Japan
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Kembhavi RS, Velhal GD, Shah AK. Epidemiological determinants of leptospirosis in rural and urban districts of Maharashtra, India. J Family Med Prim Care 2021; 10:3361-3367. [PMID: 34760758 PMCID: PMC8565121 DOI: 10.4103/jfmpc.jfmpc_674_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2021] [Revised: 07/02/2021] [Accepted: 07/10/2021] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND Leptospirosis is emerging as one of the growing public health problems in many parts of India. It can occur in both rural and urban areas with varied risk factors. This study was taken up in three districts of Maharashtra namely-Mumbai, Ratnagiri, and Sindhudurg to understand the determinants of leptospirosis in both the urban and rural areas and look for differences if any. MATERIALS AND METHODS This cross-sectional study was carried out during the year 2017. A pretested validated questionnaire was used to collect data. Field observations were made. Eighty-seven cases from Sindhudurg and 14 from Ratnagiri and 307 cases from Mumbai were included in the study. RESULTS A total of 408 cases were included in the study. A total of 63 (62.4%) were males and 38 (37.6%) were females. Most cases belonged to the 20-35 year age group (37%). In rural areas, 32.7% of them visited government facilities first, whereas, in the urban areas, it was 73.9% (P = 0.006). Headache, myalgia, and prostration were more common in cases from rural areas (P = <0.05). Skin rash was found to be associated with urban cases of leptospirosis. The presence of rodents, cattle sheds, pets, and working in paddy fields were common environmental risks in rural areas, and using water for recreational activities were common in urban areas (P < 0.001). CONCLUSIONS Context-specific risk factors were found significantly associated with the cases. No important difference was found in the epidemiology of leptospirosis in the urban and rural areas except the source of infection.
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Affiliation(s)
- Ravindra S. Kembhavi
- Department of Community Medicine, Seth G. S. Medical College and KEM Hospital, Parel, Mumbai, Maharashtra, India
| | - Gajanan D. Velhal
- Department of Community Medicine, Seth G. S. Medical College and KEM Hospital, Parel, Mumbai, Maharashtra, India
| | - Anuradha K. Shah
- Department of Community Medicine, Seth G. S. Medical College and KEM Hospital, Parel, Mumbai, Maharashtra, India
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Is the Rattus norvegicus Population Playing a Role in the Transmission of Zoonotic Diseases to Children? A Pilot Study in Tehran, Iran. ARCHIVES OF PEDIATRIC INFECTIOUS DISEASES 2021. [DOI: 10.5812/pedinfect.113203] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
Background: Due to frequent exposure to surface water and contact with animals, children represent a group susceptible to zoonotic diseases. Objectives: The present study aims to determine the presence and prevalence of the main zoonotic agents in R. norvegicus populations in Tehran, Iran. Methods: In the present study, 100 R. norvegicus were captured within a time span of one year from five districts of Tehran, Iran. Fecal and blood samples were collected from rodents and serum was recovered after centrifugation. The presence of specific IgG antibodies against Leptospira spp. and Rabies virus was detected using a commercial qualitative rat ELISA kit. A conventional PCR assay was employed to detect the presence of Vibrio vulnificus in the commensal R. norvegicus population. Results: In general, 80% (n = 80/100) and 20% (n = 20/100) of rats were males and females, respectively. The results of the ELSA assay showed that of the 100 R. norvegicus captured in Tehran, 7% (n = 7/100) and 1% (n = 1/100) were positive for Leptospira spp. and Rabies virus, respectively. Leptospira spp. revealed the highest frequency (20%; 4/20) among R. norvegicus collected from the eastern part of Tehran. Rabies virus was detected only from the southern (5%; 1/20) part of Tehran. Results of the PCR method showed that the percentage of the rats tested positive for V. vulnificus was 5%. Overall, the surveyed zoonotic microorganisms had the highest (n = 5/20; 25%) and lowest (n = 1/20; 5%) frequency rates in the eastern and northern parts of Tehran, respectively. Conclusions: The results accentuate the necessity of implementing rodent control programs and regular disinfection as well as avoiding contact with rodent populations in urban environments.
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