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[Seroepidemiological study of human leptospirosis at Reunion Island].

In order to evaluate the prevalence of human leptospirosis in Reunion island and to identify possible risk factors, a study was realised on a representative population sample of 3.338 persons. The prevalence of leptospirosis, diagnosed by ELISA and confirmed by Micro Agglutination Test, was 1.1%. Male predominance and higher prevalence in rainy parts of the island, were confirmed. It has not been possible to display risk factors such as housing conditions or professional exercise. The serological repartition showed not only icterohaemorrhagiae serovar, but also canicola, panama and sejroe, especially in women. These results, compared with clinical studies (showing nearly exclusive male repartition, in agricultural workers, due to icterohaemorrhagiae serovar), confirm the double look of human leptospirosis in Reunion island: clinical leptospirosis, severe, concerning males, often countrymen, due to icterohaemorrhagiae serovar, and infraclinical leptospirosis, concerning principally females, which is a domestic illness, due to other serovars.

Adolescent↗

Characterization of leptospiral serovars by randomly amplified polymorphic DNA fingerprinting.

Randomly amplified polymorphic DNA (RAPD) fingerprinting of 14 laboratory strains of leptospiral serovars (serovars australis, autumnalis, ballum, bataviae, canicola, grippotyphosa, hardjoprajitno, hebdomadis, icterohaemorrhagiae, javanica, pomona, pyrogenes, panama, and tarassovi) was carried out by using a pair of primers. Each serovar had a unique and distinct fingerprint pattern. DNAs of other bacterial species, including Escherichia coli, Pasteurella multocida, Salmonella spp., Pseudomonas spp., and Klebsiella spp., did not show any amplification. RAPD fingerprinting was found to be a rapid and sensitive method for serovar identification when it was compared to DNA restriction enzyme analysis, which produced a larger number of bands that made it more difficult to compare serovars.

Base Sequence↗

[Involvement of the nervous system in leptospirosis. III. Immunologic reactions in the blood and cerebrospinal fluid].

From January 1st up to September 30th 1990, 77 patients with leptospirosis were admitted at the Infectious and Parasitic Diseases Service of the Hospital das Clínicas of the Universidade Federal de Pernambuco. The majority (64) were male patients, and average age was 28 years old. Serovars icterohaemorrhagic and canicola were the most frequent. CSF examination was performed in 67 (87.0%) patients and it was abnormal in 64 (95.52%). Micro-agglutination test for leptospirosis with live antigens was performed in CSF, as well as immunological tests for syphilis, cysticercosis and schistosomiasis for differential diagnosis. Concerning the serovar identification, results of microagglutination test for leptospirosis in CSF were significant considering the similitude of responses when compared to those found for blood samples.

Adolescent↗

[Evidence of dog as a reservoir for human leptospirosis: a serovar isolation, molecular characterization and its use in a serological survey].

Canine leptospirosis has been known as Stuttgart disease since 1898, and dogs are considered to be the second principal source of infection in man. The isolation of a pathogenic serovar from dog urine that was diagnosed clinically and laboratorial as having leptospirosis and its utilization to test serological samples of human and canine cases of leptospirosis, has demonstrated its importance to the ecosystem of the southern region of Brazil. The results of the serological microscopic agglutination test indicated that 100% of human serum samples from 12 patients from the serum bank of 2001 at the Center for Control of Zoonoses, that had titers between 25 and 3,200 with the canicola serovar, and 72% of 105 canine serum samples from the same serum bank, also reacted with the new isolate. The mean and median titers of the human serum samples tested with the battery of antigens recommended by WHO was 630 and 100 respectively, and when tested with the isolate it was 1,823 and 400. In the dog sera, the values were respectively 347 and 100 with the battery, and 1,088 and 200 with the isolate.

Agglutination Tests↗

A survey of leptospirological studies carried out on the Cape Verde Islands.

The authors subjected 611 human sera, 1295 sera of domestic and 211 sera of wild living animals from two islands of the Cape Verde archipelago to serological tests for leptospirosis. Among the human sera 7.2% reacted positively. Antibodies to L. bratislava of the serogroup Australis were most frequent (59.1% of all positive sera). Antibodies to L. icterohaemorrhagiae were found in 1.3% of the sera tested, to L. sejroe in 1.1%, to L. canicola in 0.7%, to L. pyrogenes in 0.3% and to L. pomona, L. bulgarica and L. grippotyphosa in 0.2% each. The existence of natural foci of leptospiroses could not be proved since tests of 211 wild-living mammals were all negative. The investigation of domestic animal sera showed a positivity of 3.1% with goats being positive most frequently (85% of all positive sera), followed by donkeys with 3.3% and cattle with 2.0%. Sera of dogs, sheep and pigs were all negative. The results indicate that anthropurgic foci exist on the Cape Verde Islands.

Animals↗

Canine viral vaccines at a turning point--a personal perspective.

The most important canine viral infections are distemper and CPV-2. Problems of variable CD vaccine safety and efficacy persist, but CD vaccines have greatly reduced the prevalence of disease and cases in vaccinated dogs are now rare. Canine hepatitis (ICH, CAV-1 infection) also has been controlled well by vaccines for more than 35 years and it is now rare; the sporadic cases seen in the 1990s have usually occurred in unvaccinated dogs. CAV-2 vaccines should, therefore, continue to be given since they have proved to be safe and effective, and prevent hepatitis as well as adenoviral tracheobronchitis. Failure to vaccinate would likely result in increase in cases of ICH, a serious disease, but never as significant as distemper and CPV infection. "Are we vaccinating too often?" The question is complex, but the dominant opinion is "yes" (Smith, 1995). The question cannot be responded to unequivocally, however, since manufacturers employ different strains that vary in their immunizing capacity and, probably, duration of immunity. This question was frequent with distemper in the 1960s. At that time, many veterinarians tested batches of the vaccine they used by providing pre- and postvaccinal sera to competent diagnostic laboratories. That practice appeared to benefit veterinarians and dogs, as well as the quality of vaccines. Unfortunately, many owners and some veterinarians seem to hold the view that infectious diseases such as parvovirus infection can be controlled by frequent vaccination alone. The common practice of dog breeders of vaccinating their animals several times each year is senseless. Revaccination for distemper and parvovirus infection is suggested at 1 year of age, but recommendations regarding the frequency of most vaccinations given after that time are unclear. Since most distemper and CPV-2 vaccines probably provide immunity that endures several years, vaccination at 3- to 5-year intervals, after the first year, seems a reasonable practice until more data on duration of immunity become available. "Are too many kinds of vaccines being promoted for dogs?" Distemper and parvovirus vaccines are essential; canine adenovirus vaccines are recommended since the few cases brought to our attention in recent years have been in unvaccinated dogs. Vaccination against respiratory infections is recommended for most dogs, especially those in kennels, or if they are to be boarded. Need has not been clearly established for coronavirus vaccines; Lyme disease vaccines (see below) are useful in preventing illness in areas where the disease exists, but are unnecessary elsewhere since dogs respond rapidly to appropriate antibiotics; current Leptospira bacterins are without benefit since they contain serovars that fail to protect in most areas (noted below). Lyme disease (LD) was not considered here, but newer recombinant (OspA) vaccines are now available that appear to be safe and effective for at least 1 year and they have not caused vaccine-induced postvaccinal lameness, which has been documented with certain whole-cell Lyme disease bacterins. Lyme disease vaccines should be restricted to dogs in, or entering, endemic areas where infested ticks reside. More than 85% of LD cases occur in the mid-Atlantic and Northeastern States, about 10% in six Midwestern states (Michigan, Minnesota, and Wisconsin), and a smaller percentage in restricted areas of northern California and the Pacific Northwest. Leptospirosis also was not discussed here, but vaccines are commonly reported as a cause of anaphylaxis and current vaccines do not contain the serovars prevalent in most regions. The vast majority of cases diagnosed at the New York State Diagnostic Lab at Cornell are grippotyphosa and pomona serovars and there have been no recent cases caused by canicola or icterohemorrhagiae serovars. Because leptospirosis is an important disease of dogs, there is an urgent need for more research and the development of safer vaccines that contain the prevalent

Animals↗

Leptospirosis in the Melut district--upper Nile province (south Sudan)--an overview.

The authors examined 195 domestic animals for leptospirosis serologically in Sudan (170 cattle, 7 sheep and 18 goats) and 771 wild animals (36 species) with 13 serovars from 13 serogroups. 54% of domestic animals namely, 108 cattle and 1 sheep were positive in titer levels of 1:400 and higher. Cattle sera with the serovars of the serogroup Icterohaemorrhagiae were 2.4% positive with Cynopteri 2.4%, Autumnalis 3.5%, Australis 1.2%, Pomona 2.9%, Grippotyphosa 2.9%, Hebdonadis 17.1%, Bataviae 9.4% and Tarassovi 50.6%. Only one Numida meleagris of the 54 wild birds (14 species) was positive in low titer level of 1:100 with L. canicola. Seventy (9.8%) of the 717 wild mammals (22 species) examined were positive namely with the serovars of the serogroups Icterohaemorrhagiae 3.4%, Javanica 3.0%, Pomona 2.0%, Grippotyphosa 0.7%, Hebdomadis 0.4%, Ballum, Australis, Pyrogenes, Bataviae each 0.3% and Cynopteri 0.1%, whereby sera from 7 animals reacted simultaneously with the serovars of two serogroups. With regard to the species, positive reactions were found in Erinaceus albiventris, Eidolon helbum, Cercopithecus aethiops, Genetta spec., Canis adustus et aurus, Felis silvestris, Leptailurus serval, Arvicanthis niloticus, Mastomys spec., Mus spec., Gazella spec., Tragelaphus spec. The positivity in rodents was very low - 1.2%.

Animals↗

Evaluation of the immune response of cattle to leptospiral bacterins.

Cattle were vaccinated against leptospirosis with 3 bacterin preparations: (a) trivalent (serotypes grippotyphosa, pomona, and hardjo) whole cell bacterin; (b) bivalent pomona and hardjo whole cell bacterin; and (c) pentavalent (canicola, grippotyphosa, icterohaemorrhagiae, pomona, and hardjo) cell wall bacterin. Microscopic agglutinating antibody responses in cattle given the last-named bacterin were higher than those in cattle vaccinated with the 2 whole cell bacterins (trivalent and bivalent). However, microscopic agglutinating antibody responses occurred in all vaccinated cattle after they were given a challenge inoculation of serotype hardjo. Leptospires were isolated from 2 of 4 challenge controls (i.e., not given any bacterin), but none of the 15 vaccinated cattle given any one of the bacterins and then challenge inoculated with hardjo became culturally positive. It was concluded that the 3 multivalent bacterins were protective against experimental challenge inoculation of hardjo.

Animals↗

Results of leptospirosis examinations of human sera from El Salvador.

The authors examined 984 human sera for leptospirosis with the serovars from 15 serogroups serologically in 15 localities of El Salvador. In 17.5% of the sera the following reactions were found with serovars of 13 serogroups: Australis 6.8%, Pomona 5.5%, Grippotyphosa 3.2%, Icterohaemorrhagiae and Tarassovi each 2.1%, Javanica, Canicola, Pyrogenes, Cynopteri, Autumnalis, Sejroe, Hebdomadis, Bataviae, Shermani, between 0.2%-1.4%. Men showed a 18.5% and women 17.0% positive reaction. Positivity increases with an increase in age, an increase was shown from 11.5% in the group of up to 10 years, to 40.4% in the group of 51 to 60 years, in the last age group of over 60 years a decrease was shown of 34.7%. In 8 localities we were able to compare the serological positivity of the population, the highest percentages were found in Fey Esperanza 35.1%, San Jose de la Montana 31.6% and Domus Maria 27.8%, the lowest in Credisa 6.4% and Ametepec 7.6%.

Adolescent↗

[Characterication of reference strains of L. interrogans in China by ISSP-PCR].

The gene polymorphism of the DNAs extracted from reference strains of L. interrogans in China was characterized by LSSP-PCR primered by G1 or G2, which were a pair of specific primers for L. interrogans. The fingerprinting produced by LSSP-PCR showed that serovar lai, serovar canicola, serovar pyrogens, serovar autumnalis, serovar australis, serovar linhai, serovar wolffi and serovar haemolytic have similar patterns, but serovar hebdomadis, serovar javanica, serovar ballum, serovar pomona, serovar spaidjin, serovar tarassov and serovar manahao I have different profiles. This result agreed with the classification of genetic species by Yasuda. The utilization of LSSP-PCR banding patterns in the identification of leptospries in blood samples also gained encouraging results. Compared with the routine methods in genetic species classification, LSSP-PCR has the advantages of rapidity, simplicity and low-cost. It appears to be a promising tool in studying such slowly growing bacteria as leptospires. Further exploration of LSSP-PCR in classification and identification of Leptospires is worthwhile.

DNA, Bacterial↗

Comparison of polymerase chain reaction assay, bacteriologic culture, and serologic testing in assessment of prevalence of urinary shedding of leptospires in dogs.

OBJECTIVE: To compare results of polymerase chain reaction (PCR) testing of urine samples, serologic testing, and bacteriologic culture of urine to determine prevalence of urinary shedding of leptospires in dogs. DESIGN: Serial case study. ANIMALS: 500 dogs evaluated serially without regard to health status. PROCEDURE: Urine samples were examined via PCR assay and bacteriologic culture for leptospires. Blood samples were analyzed for antibodies against serovars canicola, bratislava, pomona, icterohemorrhagiae, grippotyphosa, and hardjo. RESULTS: Titers > or = 1:100 against at least 1 serovar were detected in 104 (20.8%) dogs, and titers > or = 1:400 were detected in 41 (8.2%) dogs. High titers were detected most commonly to serovar grippotyphosa, followed by icterohemorrhagiae, canicola, pomona, bratislava, and hardjo. High titers to > 1 serovar were detected in 14 dogs. A positive PCR assay result was obtained in 41 (8.2%) dogs, only 9 of which had a titer > or = 1:100. Leptospires were not cultured from the urine of any dog. Only 4 dogs had clinical leptospirosis. Overall disease prevalence was 0.8% for the 6-month evaluation period. Compared with PCR assay, serologic testing for predicting shedding had a sensitivity of 22%, specificity of 79%, positive predictive value of 9%, and negative predictive value of 92%. CONCLUSIONS AND CLINICAL RELEVANCE: Irrespective of health status, 8.2% of dogs were shedding pathogenic leptospires. Serologic testing was a poor predictor of urinary shedding. Clinically normal dogs that shed leptospires may pose a zoonotic risk to their owners.

Animals↗

Can antibody responses in cattle vaccinated with a multivalent leptospiral bacterin interfere with serologic diagnosis of disease?

A commercially available leptospiral bacterin containing 5 serovars (canicola, grippotyphosa, hardjo, icterohemorrhagiae, pomona) was used per label directions to vaccinate 45 steers and bulls. In animals in which the prevaccination sera were negative for microscopic agglutinating antibody, the increase and decrease of titers were similar among all serovars. A serologic response was stimulated by a single dose and enhanced by the 2nd dose. Most titers peaked at 2 weeks and then fell rapidly by 15 weeks after the 2nd dose. Thirty-four animals with prevaccinal titers to serovar hardjo responded with high microscopic agglutinating titers for a sustained period. Of these cattle, 31 still had titers between 200 and 400 by 29 weeks after the 2nd dose. These results were interpreted as representing an anamnestic response initiated by the bacterin to a sensitization that had followed natural exposure.

Agglutination Tests↗

A review of leptospirosis in Malaysia.

This paper reviews the literature on leptospirosis in Malaysia from its first description in 1928 until the present day. Most of the early reports were on investigations of leptospirosis in wildlife and man and up-to-date, thirty-seven leptospiral serovars from thirteen serogroups have been bacteriologically identified. The thirteen serogroups are: Australis, Autumnalis Bataviae, Canicola, Celledoni, Grippotyphosa, Hebdomadis, Icterohaemorrhagiae, Javanica, Pomona, Pyrogenes, Sejroe and Tarassovi. Rats have been ascribed as the principal maintenance host of leptospires in Malaysia. However, serovars from the Pomona, Pyrogenes and Sejroe serogroups have yet to be isolated from rats. It is considered that the majority of leptospirosis cases in man were due to association of man with an environment where rats were plentiful. Recent investigations on domestic animals disclosed a high prevalence of infection in cattle and pigs and they were suspected as being the maintenance host for serovar hardjo and pomona respectively. There is ample scope for research in leptospirosis, particularly in the epidemiology and control of the disease in domestic animals. The strategy to control the infection in domestic animals and man in Malaysia is bound to be different from that of the temperate countries, basically due to the presence of a large number of leptospiral serovars in wildlife, further confounded by geographical and financial constraints.

Animals↗

Use of fluorescent amplified fragment length polymorphism for molecular epidemiology of leptospirosis in India.

Nineteen isolates of leptospires recovered from patients during three epidemics that occurred at different places and different times in the Andaman Islands and eight isolates from sporadic cases were characterized using serological and molecular genetic techniques. Group sera and monoclonal antibodies were used for antigenic characterization, whereas fluorescent amplified fragment length polymorphism (FAFLP) was used for genotyping. Of the 27 isolates, 19 were identified as belonging to serogroup Grippotyphosa, 3 belonged to serogroup Australis, 2 belonged to serogroup Icterohaemorrhagiae, and 1 each belonged to serogroups Hebdomadis, Canicola, and Sejroe. Analysis of FAFLP data grouped these 27 isolates into two main clusters of genotypes. One of the clusters, populated by 19 isolates, included 16 outbreak isolates. Seven of these 19 isolates belonged to serovar Ratnapura, 10 belonged to serovar Valbuzzi, and 1 each belonged to serovar Grippotyphosa and serovar Saxkoebing. Of the 27 patients from whom isolates were obtained, 9 had severe illness, and 6 of these 9 patients had pulmonary involvement, 1 had pulmonary and hepatorenal involvement, and the remaining 2 had hepatorenal involvement alone. Two patients out of the nine severe cases died subsequently. The isolates from sporadic cases showed great genetic diversity and were also diverse antigenically. Perhaps the strains belonging to a dominant genotype (the outbreak-associated cluster) possessed epidemic potential and higher virulence with a greater predilection to cause pulmonary complications than strains belonging to other genetic backgrounds.

Base Sequence↗

[Importance of the microbiological confirmation in an outbreak of human leptospirosis in the city of Villa Clara].

A multidisciplinary group was created to confirm the existance of human leptospirosis in the province of Villa Clara where by the end of June, 1977, there was a considerable increase of febrile cases with symptoms and signs consistent with diseases such as hemorrhagic dengue and human leptospirosis. The National Laboratory of Reference of Leptospires from "Pedro Kouri" Institute, organized a set of direct and indirect diagnostic techniques as a working strategy that would serve to confirm this health problem. As a final result, it was observed that the Ballum, Pomona, Canicola and icterohaemorrhagiae serogroups showed the highest percentage of appearance among the studied cases. A total of 7 cases had active infection, since they were positives by the passive hemoagglutination method. The four severe cases studied by passive hemoagglutination and microagglutination were positive. Sera from the 3 patients with febrile syndrome of unknown ethiology were negative by these 2 techniques. The 3 samples obtained from the autopsy of a dead were positive by direct exam in dark field and staining of immunoperoxidase. The monosera of the dead subjects were highly reactive by passive hemagglutination (titers from 1-10 and up to 1-640). 2 hemocultures were typified as Ballum; 2 urines and 1 hemoculture were positive by polymerase chain reaction. In this way, a fast answer was given to the health public authorities from the Viceministry of Hygiene and Epidemiology of Cuba on confirming microbiologically the existance of the disease. lt was sugggested to administer the Cuban vax SPIRAL vaccine in the affected area.

Cuba↗

Clinical observation and treatment of leptospirosis.

The epidemiological and clinical observations of 240 patients with Weil's disease and 10 patients with canicola fever, and these observations in two epidemics of canicola fever, are presented. Early diagnosis is most important for the prognosis of patients with the severe form of leptospirosis. It depends on the clinical features, clinical laboratory findings, and the epidemiological situation. The most characteristic clinical signs for early diagnosis were febrile illness of sudden onset, severe general malaise, muscular pain, and conjunctival congestion. Proteinuria, leukocytosis with neutrophilia, and raised erythrocyte sedimentation rate were the most indicative clinical laboratory findings for early diagnosis. Although jaundice and hemorrhage are the most important signs of the severe form of leptospirosis, Weil's disease, these are rarely useful in early diagnosis. Of a variety of antibiotics used, penicillins and cephems had the lowest minimal inhibitory concentration against leptospires. However, it became apparent from basic studies in vitro and in vivo that streptomycin showed the best bactericidal action against leptospires and that it was the most effective anti-leptospiral antibiotic. Gentamicin, tobramycin, and isepamicin are also effective as alternatives to streptomycin. Although penicillins, cephems, tetracyclines, and macrolides are also effective for the treatment of leptospirosis, when these antibiotics with inadequate bactericidal activity are used for the treatment of the disease, long-term therapy with sufficiently large doses may be required from an early stage of the disease until the appearance of antibodies.

Animals↗