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PubMed2004

[Eleven cases of leptospirosis: clinical and microbiological features].

OBJECTIVE: The authors had for aim, to describe clinical and biological features of 11 cases of leptospirosis observed in Lorraine between 1996 and 2002, and to assess the interest of diagnostic methods. PATIENTS AND METHODS: A retrospective study was performed. The inclusion criteria was positive serological test for Leptospira. RESULTS: The contamination was mainly linked to water sports, during the summer holidays. The main symptom was fever, associated with moderate increase of aminotransferase serum level. Leptospira icterohaemorragiae was the most frequently identified serogroup. One 17-year-old male patient died after infection during water sports practice. CONCLUSION: Preventive measures should be considered for people exposed to Leptospira when practicing water sports.

Adolescent↗
PubMed2004

[Efficacy of Spirolept vaccine against human leptospirosis as estimated by passive protection of laboratory rodents].

OBJECTIVE: This study had for aim to assess the serological response induced by the Spirolept vaccine against human leptospirosis. METHOD: A serological follow-up was made on 31 patients at a risk of occupational exposure. The antibody titers of vaccinated patients were assessed by MAT and ELISA. In a second step, vaccinal protection was studied in vivo by checking the seroprotective effect of the human sera injected in an animal model (Meriones unguiculatus) naturally susceptible to the disease. The passive protection was studied by comparing the death rate on five batches of animals to which the bacterium was inoculated. Thus, four batches of animals were injected subcutaneously with a pooled sera of vaccinated people sampled at D0, D15, D135, and D320 after Spirolept vaccination. One control batch was given PBS. One day after injection, the latter batch was inoculated with the homologous strain Verdun of Leptospira interrogans ss icterohemorrhagiae (serogroup Icterohemorrhagiae) used to make the vaccine. RESULTS: The death rate was significantly decreased as soon as D15 after the first injection, even with pooled sera of vaccinated people negative for the MAT. COMMENTS: The Spirolept vaccine induces a protective response against icterohemorrhagiae, which can be transmitted to the animal model and thus is linked to a humoral response.

Adult↗
PubMed2004

Recombinant LipL32 antigen-based single serum dilution ELISA for detection of canine leptospirosis.

A recombinant antigen-based single serum dilution enzyme-linked immunosorbent assay (ELISA) was developed to measure the specific antibody activity in sera of dogs with leptospirosis. The recombinant antigen developed and used in the assay was specific for the pathogenic serovars of Leptospira. A linear relationship was found to exist between the predicted antibody titres at a single working dilution of 1:1000 and the corresponding observed serum titres as determined by the standard serial-dilution method. Regression analysis was used to determine a standard curve from which an equation can be derived that allows demonstration of the mentioned correlation. The equation was then used to convert the corrected absorbance readings of the single working dilution directly into the predicted ELISA antibody titres. The assay was proved to be sensitive, specific and accurate as compared to the standard microscopic agglutination test (MAT).

Agglutination Tests↗
PubMed1980

Leptospirin - an intradermic test for the diagnosis of leptospirosis.

IN the State of Bahia (Brazil) the leptospirin produced in Germany for experimental use by the Institute for Veterinary Medicine, Federal Health Office, Berlin, was administered to humans and animals in order to diagnose leptospirosis in collaboration with this Institute. The results were compared with the microscopic agglutination reaction. The total number of test persons or animals was 268; this group included 81 human patients. 60 heads of cattle, 50 goats, 40 pigs, 25 horses, and 12 dogs. All were tested serologically and simultaneously the intracutaneous test was carried out. This test was positive when the erythema formed had a diameter of more than 9 mm. The evaluation took place 8 to 10 h and 24 h after the injection of leptospirin. 1. 52 humans reacted serologically; out of this group 44 were positive in the leptospirin test. The allergy test was also negative in the 29 serologically negative patients. 2. Out of the 21 heads of cattle with a positive agglutination test 7 reacted to leptospirin whereas 39 animals which did not react serologically were also negative in the skin test. 3. Although 10 goats out of 50 reacted serologically, all were negative in the intracutaneous test. 4. 9 out of 40 pigs reacted serologically; however, 8 reacted only to apathogenic leptospires (L.patoc, L.rufino, L.andamana). Out of these 9 animals 4 were positive in the intracutaneous test; among them the pig which reacted serologically to L.autumnalis. Out of 31 serologically negative pigs 2 were allergologically positive. 5. Out of 21 serologically positive horses 15 exhibited an erythema which was considered positive in the skin test. 4 serologically negative animals also were negative in the intracutaneous test. 6. Out of 6 serologically positive dogs, 4 reacted to leptospirin. 6 that had reacted serologically were all negative in the intracutaneous test. A comparison of the serological and allergological findings judged by the serological standard showed that out of all cases tested, 0.7% had at the same time a serologically negative and allergologically positive reaction and 16.8% had a serologically positive and allergologically negative reaction. In some cases, the administration of leptospirin caused the formation of antibodies which could only be detected in low dilutions and usually disappeared after 6-8 weeks. In humans, pigs, and horses the leptospirin also showed positive reactions which serologically could be attributed only to biflexa leptospires. Serotypes not contained in the leptospirin were accounted for to a varying degree in the individual animal species. These reactions and the results of other studies carried out in pig stocks have been the basis for studies performed at the Institute for Veterinary Medicine. These studies are expected to contribute to an improvement of the sensitivity of the leptospirin.

Agglutination Tests↗
PubMed1994

[Epidemiological, clinical, biological and developmental aspects of leptospirosis: apropos of 30 cases in Aquitaine].

We have studied retrospectively 30 cases of leptospirosis observed in Aquitaine (South West France) from 1980 till 1992. This review was made in three internal and a nephrology department in Bordeaux hospital. Most cases occurred by indirect contact with infected animals or by occupational exposures. Onset was brutal with fever often associated with painful syndrome and sometimes conjunctival suffusion. Jaundice (70%), acute renal failure (67%), meningitis (50%) and hemorrhagic signs (50%) were among the major visceral manifestations. Diagnosis was always confirmed by micro-agglutination test. Leptospira ictero-hemorrhage was the predominant serogroup found. The outcome was favorable in 22 patients; reversible complications were seen in six cases (five acute renal failure with hemodialysis myocarditis and pulmonary edema in two hemodialysed patients, polyradiculoneuritis). Two patients died (acute respiratory failure and meningo-encephalitis with diffuse hemorrhagic syndrome). The characteristic of our series is the high frequency of hepatorenal syndrome due to the importance of our nephrologist recruitment. Furthermore our study confirm the vital prognostic characters of the pulmonary, renal, hemorrhagic and neurologic complications. No absolute relationship was found between the clinical and laboratory findings and the serotype of leptospira. Penicillin remains the treatment of choice and should be started as soon as possible the avoid the life threatening visceral complications.

Adolescent↗
PubMed2000

Randomized controlled trial of doxycycline prophylaxis against leptospirosis in an endemic area.

Leptospirosis occurs as seasonal outbreaks, lasting for about 3 weeks during October-November in North Andaman. A randomized controlled trial was undertaken to assess the efficacy of doxycycline prophylaxis in the prevention of infection and clinical disease due to leptospires during the outbreak period. A sample population of 782 persons, randomized into two groups was given doxycycline 200 mg/week and a placebo. The microscopic agglutination test was done on blood samples collected on day zero, after 6 weeks and after 12 weeks. Infection rates and attack rates of clinical illness were calculated in the two groups based on the serological results. Statistically there was no difference in the infection rates among the two groups. However, a statistically significant difference was observed in the clinical disease attack rates (3.11 vs. 6.82%) between study group and control group. The results of the study indicate that doxycycline prophylaxis does not prevent leptospiral infection in an endemic area, but has a significant protective effect in reducing the morbidity and mortality during outbreaks.

Adolescent↗
PubMed1974

Characterization of the antibodies detected by the microscopic agglutination test for bovine leptospirosis.

The nature of the antibodies detectable by the microscopic agglutination test for bovine leptospirosis was examined. Density gradient ultracentrifugation, gel filtration and disulphide-bond-reduction experiments indicated that antileptospiral agglutinating activity was present in both IgM and IgG immunoglobulin fractions. This was confirmed by selective precipitation of specific antibody classes and ion-exchange chromatography.

Agglutination Tests↗
PubMed1985

The risk of leptospirosis in United Kingdom fish farm workers. Results from a 1981 serological survey.

Less than one per cent of serum samples taken from 257 fish farmers in 1981 had agglutinating antibodies to strains of Leptospira interrogans of serogroup Icterohaemorrhagiae at a titre of 30 or greater. Compared with the results from other serological surveys, this agglutinating antibody prevalence suggests that fish farming does not have a high occupational risk for leptospirosis. Between 1961 and 1981 the incidence in fish farmers was about 33 per 100000 person years at risk. During the same period the incidence in the general adult male population was 0.137 per 100000 person years at risk, so that fish farming had a moderately increased risk of Icterohaemorrhagiae serogroup infection (relative risk = 243). No one particular risk factor within fish farming could be reliably identified and therefore recommendations to reduce the risk can only be general.

Adult↗
PubMed1994

Seroprevalence of leptospirosis in a rural flood prone district of Bangladesh.

Leptospirosis is a worldwide zoonotic disease. In the present investigation, a total of 89 human sera from a flood prone district of Bangladesh was screened by a one-point microscapsule agglutination test (MCAT). MCAT-positive and -doubtful sera were further tested by microscopic agglutination test (MAT) against 16 reference serovars of Leptospira interrogans, and the antibody titres determined. In MCAT, 34 sera were positive and 22 were doubtful. Among those positive and doubtful sera, 33 and 20, respectively were tested by MAT. Thirty-four out of 53 MCAT-screened samples were MAT-positive. The titres ranged from 20 to 1600 with antibodies to serovars copenhageni, australis, cynopteri and icterohaemorrhagiae being the most prevalent. Eleven MCAT-positive samples failed to react with any strains used by MAT, suggesting the presence of new or untested serovars. Among the MAT-positive samples, the presence of antibody against two or more serovars was more common than that of a single serovar. The present study suggests that rural people in Bangladesh are at high risk to leptospiral infection.

Agglutination Tests↗
PubMed1991

Further evaluation of one-point microcapsule agglutination test for diagnosis of leptospirosis.

A total of 100 serum samples including 22 acute phase sera and 39 paired sera collected from clinically diagnosed cases of leptospirosis in Ming-shan County, Sichuan Province, China were examined by the one-point microcapsule agglutination test (MCAT), which was developed in Japan, and by conventional microscopic agglutination tests (MAT). The one-point MCAT is more reactive to IgM antibody than MAT and is superior in detecting antibodies in the early stages of the disease.

Acute Disease↗
PubMed2004

Leptospirosis among schoolchildren of the Andaman & Nicobar Islands, India: low levels of morbidity and mortality among pre-exposed children during an epidemic.

Leptospirosis is an important public health problem in the Andaman Islands. The disease is being increasingly reported among children and adolescents in recent times. An attempt was made to find out the level of exposure to leptospires, to estimate the incidence of infection and to identity the risk factors for acquiring infection among children. A sample of 1544 schoolchildren was selected. Presence of anti-leptospiral antibodies was tested using the microscopic agglutination test (MAT). Students were interviewed for behavioural factors. In total, 341 (221 seronegative and 120 seropositive) students were followed up clinically and serologically during a subsequent outbreak. An overall seropositivity rate of 23.6% (95% CI 21.54-25.81) was observed. Infection rate was 33.5% among seronegatives whereas re-infection rate was 16.7% among seropositives during the outbreak that occurred 1 month after the first sample collection. Morbidity and mortality were found to be higher among seronegative individuals than seropositives. More than 90% of leptospiral infections were found to be subclinical or unnoticed. The high level of exposure among the children results in high infection rates and because they have less previous exposure than adults, they do not have sufficient protection to resist clinical illness during outbreaks.

Adolescent↗
PubMed2001

Latex based, rapid and easy assay for human leptospirosis in a single test format.

Leptospirosis is an often severe disease which requires prompt treatment. Laboratory testing is required to reach a valid diagnosis. An agglutination assay for the detection of Leptospira-specific antibodies consisting of individually wrapped agglutination cards containing a stable, dried detection reagent is evaluated. The assay is simply performed by suspending the dried reagent with a drop of serum. The result is obtained within 30 s. The sensitivity of the assay varied with the stage of the disease and was 72.3% for samples collected during the first 10 days of the illness and 88.2% for samples collected at a later stage. The specificity was 93.9% and 89.8%, respectively. These characteristics make the test ideal for use in areas where the disease is common and where laboratory support is not routinely available.

Antibodies, Bacterial↗
PubMed1979

Pseudospirochetes, a cause of erroneous diagnoses of leptospirosis.

Motile filaments of varying lengths and thicknesses were observed by darkfield microscopy in a blood culture of a specimen from a patient who had fever of unknown origin. Similar structures were also seen in cultures inoculated with donor blood from healthy controls. Since the movement and configuration of the structures were not characteristic for spirochetes, the morphologic features were further examined by electron microscopy. The filaments observed were identical in appearance to pseudospirochetes described more than 50 years ago. The authors' observations indicate that they are derived from erythrocytes. Because of possible confusion of these pseudospirochetes with living organisms, the diagnosis of leptospirosis by darkfield microscopy should be confirmed by cultural or serologic tests.

Adult↗
PubMedDate not supplied

The Jarisch-Herxheimer reaction in leptospirosis: possible pathogenesis and review.

The importance of treating leptospirosis with penicillin is emphasized by two case reports and a review documenting the occurrence of the Jarisch-Herxheimer reaction (JHR) in patients with this bacterial infection. The JHR is significant both as a cause of morbidity and mortality and as an indication of the therapeutic efficacy of penicillin. The possible etiology of the JHR is discussed, and comparisons with the changes occurring in septic shock are made; a study of either condition facilitates the understanding of the other. Tumor necrosis factor is hypothesized to play a key role in both. Current treatment of the JHR consists of general clinical support. Specific measures such as oxpentifylline therapy may play a role in the future.

Adult↗
PubMed1978

Leptospirosis: a common-source outbreak due to leptospires of the grippotyphosa serogroup.

In the period August 1-10, 1975, seven cases of leptospirosis occurred in residents of Stewart County, Tennessee. Based on serologic evidence, the infection was caused by leptospires of the Grippotyphosa serogroup. Epidemiologic study showed that the patients apparently acquired their infection while swimming in Cub Creek, a small local stream. Stagnation of the stream resulting from subnormal rainfall may have contributed to the timing of the outbreak. The source of leptospiral contamination for the stream could not be determined.

Adolescent↗
PubMed1987

A waterborne outbreak of leptospirosis.

During the period from July 10-26, 1984, 33 cases of serologically confirmed leptospirosis occurred in a small town in central Italy. The fatality rate, including the deaths of two unconfirmed cases, was 8.6% (3 of 35). Based on serologic evidence, the infection was caused by leptospires of the serogroup Australis. Epidemiologic study showed that the patients contracted the infection by drinking water from a fountain. The source of leptospiral contamination was probably a hedgehog trapped in a reservoir of water not in use but still connected to the water system of the fountain.

Adult↗