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PubMed2001

Role of the coypu (Myocastor coypus) in the epidemiology of leptospirosis in domestic animals and humans in France.

The coypu (Myocastor coypus), a rodent whose natural habitat is stagnant freshwater, has become a widespread pest in France within the last decade. This study investigated the prevalence of seropositivity and the renal carriage of leptospires in coypus in order to evaluate their role in terms of the risk of infection by Leptospira interrogans in domestic animals and humans. The study involved the application of serological and bacteriological methods to identify leptospires infection and/or carriage in 738 coypus trapped from 1996 to 1999 in six areas of France. Seroprevalence in samples ranged from 16.5 to 66%, and three field strains were isolated (two L. interrogans Icterohaemorrhagiae and one L. interrogans Sejroe). This first report on the isolation of leptospires from coypus in France emphasises the role of this animal in the epidemiology of leptospirosis.

Animals↗
PubMed1993

[A severe course of leptospirosis with acute kidney failure and extensive icterus (Weil disease)].

A 77-year-old man developed a fever up to 38.4 degrees C, with diarrhoea, acute renal failure (creatinine up to 8.7 mg/dl; urea up to 308 mg/dl) and marked jaundice (total bilirubin up to 24.3 mg/dl). In addition there was thrombocytopenia, conjunctivitis and epistaxis, as well as cerebral symptoms with somnolence and general slowing up. At first he was thought to have cholangitis resulting from previously diagnosed gall-stones, and he was therefore treated with ampicillin, 2 g two times daily, and metronidazole, 0.5 g two times daily. The fewer regressed, but the renal failure required haemodialysis and haemofiltration under strict fluid control. Endoscopy excluded obstructive jaundice, but a suspicion of inflammatory liver disease or possibly cirrhosis was raised in the differential diagnosis. Serology revealed an increased titre for Leptospira interrogans var. sejroe (1:200, later 1:1600). Liver biopsy finding was compatible with the diagnosis of leptospirosis. Because of the high inflammatory activity in the liver, 2 mega units of penicillin G were administered three times daily for six days. Gradually the renal functions and jaundice improved and, on discharge on the 36th day, the patient was again in generally good health, although creatinine and bilirubin values were still slightly elevated (1.7 mg/dl each).

Acute Kidney Injury↗
PubMed1982

Epidemiology of leptospirosis in dairy farm workers in the Manawatu. Part II. A case-control study of high and low risk farms.

Subsequent to a cross-sectional serological survey of Manawatu dairy farm workers, a case-control study was carried out to investigate the correlation between titres to leptospiral serovars in workers and those in cattle in their herds. A total of 52 herds was investigated, 25 of which were high risk where milkers had titres of 1:96 or greater, and 27 were case-controls where milkers had no detectable agglutinin titres at a minimum serum dilution of 1:24. The serological prevalence of titres to hardjo in cattle on high risk farms (76.5%) was significantly higher (P<0.05) than on the case-control farms (60.0%). The geometric mean titres of seropositive cattle on high risk farms were also significantly higher (P<0.01) than in the cattle from the case-control farms, especially in the younger cohorts. These findings suggest that there was active endemic hardjo infection in the two- to three-year-old cattle on the high risk farms. Titres to pomona were demonstrated in only 5.2% of the cattle from both types of farm. Workers with titres to pomona tended to be from farms on which stock, especially calves, were bought-in and pigs were kept. Conventional measures for protecting milkers from contact with infected urine appeared to be ineffective and it is concluded that prevention of leptospirosis in dairy farm workers can only be achieved by elimination of infection in the herd by vaccination of cattle.

Journal Article↗
PubMed1998

Observations of leptospirosis in farmed deer.

AIMS: Slaughterhouse and on-farm surveys were undertaken to investigate some aspects of leptospirosis (Leptospira interrogans) in farmed deer in the lower North Island of New Zealand. METHODS: Blood samples and kidneys were collected at slaughter from 601 l-year and older red and red X Wapiti stags and 21 adult hinds from 53 farms (10 or 12 deer per farm). Serum samples were analysed for up to seven Leptospiral serovars. Gross and histological examinations of kidneys were undertaken. Kidneys from 202 deer were cultured for leptospires. A follow-up postal questionnaire (68% response) indicated one herd had been vaccinated prior to the survey. Serological analyses were also carried out on serum bank samples from a previous on-farm survey involving male and female weaner, yearling and adult red deer from 16 commercial deer farms in March and November. RESULTS: Serological reactions at titres > or = 96 to serovar hardjo were present in 73.6%, pomona in 41.5%, copenhageni in 11.3% and tarassovi in 15.1% of farms from the slaughterhouse survey. Antibodies to serovars australis, ballam and balanica were present in three, one and four of six herds studied, respectively. Titre prevalence to hardjo was higher than that of pomona and other serovars within farms. Cultures for Leptospira were positive in 10 stags from six lines with similar prevalence across age groups. Histological examination showed many gross lesions were associated with mild interstitial cellular infiltration characteristic of subclinical Leptospiral infections. Some sections from culture-positive kidneys contained spirochetes in renal tubules. The on-farm survey showed a 10-30% within-herd prevalence of pomona and hardjo titres in 56% of 3-month-old deer herds, but by 11 months of age, 100% of herds were titre-positive with high prevalences to one or both serovars. Concurrently, herds of 1-year-old and adult deer on the same farms were all seropositive. CONCLUSION: This study has shown that Leptospiral infections are common in farmed deer in the survey area.

Journal Article↗
PubMed2002

A brief review on the laboratory diagnosis of leptospirosis.

Leptospirosis is a ubiquitous zoonotic disease that may be maintained in either wild or domesticated animal species. These bacteria have been classified into serovars based on their antigenic characteristics and, more recently, into species based on genomic studies. They produce both chronic and acute infections. Chronic infections of serovars in the host species to which they have become adapted can result in long term shedding, providing a source of acute infection for other species. As clinical presentation can vary greatly, diagnosis often depends on laboratory methods. In addition to diagnostic testing, herd health monitoring and screening for international trade purposes are performed at veterinary laboratories. The test method selected varies depending on the samples available and the purpose of testing. An increasing variety of laboratory methods are being described for detection of bacteria and antibodies. In addition to classical methods such as culture, dark-field, microscopy and the microscopic agglutination test (MAT), a variety of polymerase chain reaction (PCR), indirect enzyme-linked immunosorbent assay (ELISA), competitive ELISA and other rapid serological tests have been described. This review describes the advantages and limitations of these assays together with other factors that may affect results and their interpretation, such as species variation, vaccination and antibiotic administration.

Journal Article↗
PubMed1990

Skeletal and cardiac muscle involvement in severe, late leptospirosis.

Information is lacking on the prevalence and severity of cardiac and striated muscle injury in late leptospirosis, and it is unclear whether patients with one type of myositis are at increased risk of developing another. Therefore, 38 patients with severe, late Weil's disease were evaluated for heart and skeletal muscle involvement: 37% had myositis and 39% had abnormal electrocardiograms (ECGs). First-degree atrioventricular heart block and changes suggestive of acute pericarditis were the most common ECG findings. Two patients had transient pericardial friction rubs, but neither pericardial effusion, shock, nor congestive heart failure occurred. Cardiac involvement was not associated with skeletal muscle injury (P = .35), although both manifestations were correlated with severity of disease. Thus, ECG changes and myositis were prominent features of late Weil's disease but cardiac morbidity was not.

Acute Disease↗
PubMed1986

A monoclonal antibody reacting with a determinant on leptospiral lipopolysaccharide protects guinea pigs against leptospirosis.

An IgA monoclonal antibody (MUM/F1-1/copenhageni) was produced from a mouse immunised with Leptospira interrogans serovar copenhageni. The antibody showed partial serogroup specificity by agglutination and by reaction in enzyme immunoassay, and opsonised homologous leptospires for phagocytosis by cultured mouse macrophages. Immunodiffusion and Western-blotting experiments indicated that MUM/F1-1/copenhageni reacted with a carbohydrate determinant in the leptospiral lipopolysaccharide. Daily administration of purified MUM/F1-1/copenhageni IgA before and after challenge with 2 X 10(8) virulent homologous leptospires passively protected newborn guinea pigs against lethal leptospirosis.

Animals↗
PubMed1996

Leptospirosis - An Emerging Pathogen in Travel Medicine: A Review of its Clinical Manifestations and Management.

Leptospirosis is a zoonosis caused by a spirochete, Leptospira interrogans. The disease has a wide range of clinical manifestations, ranging from a mild febrile illness to classic Weil's disease, which presents with jaundice, myalgia, acute renal failure, and tissue hemorrhage. Transmission usually occurs from contact with infected water surfaces. Recently, recreational activities such as hiking, swimming in lakes, biking through infected water, and hunting have been associated with the acquisition of this disease. This review describes the epidemiology, clinical manifestations, diagnostic methods, management, and prevention of this disease.

Journal Article↗
PubMed1986

Penicillins, cephalosporins, and tetracyclines in treatment of hamsters with fatal leptospirosis.

A predictable 6- to 7-day course of a fatal Leptospira interrogans serovar bataviae infection in experimentally infected mature 110- to 150-g hamsters was used to evaluate the therapeutic efficacy of conventionally used and newer antibiotics. Active drugs were ampicillin, bacampicillin, cyclacillin, piperacillin, mezlocillin, doxycycline, chlortetracycline, cefotaxime, and moxalactam. Cephalexin, cefadroxil, cefamandole, and cefoperazone showed little or no activity in preliminary studies. In delayed treatment studies, all nine active drugs prevented death of hamsters even when treatment was delayed until 1 to 2.5 days before expected time of death. Leptospires in kidneys of surviving animals could be demonstrated in one or more hamsters treated with doxycycline, chlortetracycline, cyclacillin, and piperacillin, but in none of the animals treated with ampicillin, bacampicillin, mezlocillin, cefotaxime, and moxalactam. The potential usefulness of newer penicillins and cephalosporins, as well as ampicillin, chlortetracycline, and doxycycline, for treatment of severe leptospirosis is reported.

Animals↗
PubMed1987

Serodiagnosis of human leptospirosis by counterimmunoelectrophoresis.

The counterimmunoelectrophoresis (CIE) technique employing a soluble extract antigen was found useful in screening human sera for antileptospiral antibodies to multiple leptospiral serovars. The CIE test results with sera from patients with suspected cases of leptospirosis and sera from a control group compared favorably (97.9%) with those obtained by the microscopic agglutination test using a battery of live leptospiral antigens. CIE is easy to perform, is highly sensitive, uses an antigen which is very stable at room temperature, and permits the screening of many sera in a short period of time. The CIE technique appears to be ideally suited to a small laboratory where facilities may be too limited for examining sera by the microscopic agglutination test.

Agglutination Tests↗
PubMed1991

Serological follow-up of patients involved in a localized outbreak of leptospirosis.

Eighteen patients involved in a localized outbreak of leptospirosis were subjected to a serological follow-up study over a 5-year period. Four distinct sets of sera from all patients and a fifth sample obtained from 10 of them were examined by the microscopic agglutination test (MAT) for demonstration of leptospiral antibodies. The test was carried out by using live leptospires from reference strains of 17 Leptospira interrogans serovars known to occur in Italy. In all cases, the highest titers of agglutinins were recorded against one or more of the three Australis group serovars tested (australis, bratislava, and lora). The highest antibody levels were reached soon after the acute phase of infection in some patients but only after some months in others. Titers then tended to recede with varying rapidity, but titers against the Australis group serovars were still detectable in some patients after 5 years. Coagglutinins against serovars of other serogroups were detected, generally at low levels, in the early sets of sera of most patients, but tended to disappear in the late-set sera. Specific immunoglobulin M (IgM) and IgG against the three Australis group serovars were determined in most serum samples from 16 patients by solid-phase enzyme immunoassay (EIA). In general, EIA titers were considerably lower than MAT titers, but there was a certain patient-to-patient variability in both the IgM/IgG ratio and the evolution and persistence of the two immunoglobulin classes. Since all the evidence indicated that the initial outbreak from a single source, the observed patient-to-patient variability in the progress of both MAT and EIA titers appeared to be attributable to factors inherent in the individual patients. Cross agglutination absorption tests, aimed at retrospectively determining to which of the Australis group serovars the outbreak-specific infecting strain belonged, were performed with six serum samples from different patients. Most absorbed sera seemed to originate from an australis or lora infection, but it was not possible to discriminate conclusively between the two serovars.

Adult↗
PubMed1981

Diffusion in gel-enzyme-linked immunosorbent assay-a new serological test for leptospirosis.

A new serological test, diffusion in gel-enzyme-linked immunosorbent assay (DIG-ELISA) was developed and compared with the microscopic agglutination test (MAT) for the serological diagnosis of leptospirosis. The results suggest that DIG-ELISA is a viable alternative to the MAT because of its simplicity, sensitivity, versatility and potential for standardisation.

Agglutination Tests↗
PubMed1983

Cotton-wool spots as a sign in leptospirosis (Weil's disease).

A 44-year-old black male presented with fever, myalgia and weakness. He had elevated blood urea nitrogen, creatine phosphokinase and serum glutamic-oxaloacetic transaminase. During the first 6 days of this undiagnosed illness azotemia increased, a pericardial friction rub occurred, and hematuria was present. On the 7th day bilateral subconjunctival hemorrhages, anterior uveitis, and peripapillary cotton-wool spots were noted. This combination of findings suggested leptospirosis, which was subsequently confirmed by specific antibody titers. Therapeutic response was achieved with high-dose systemic steroids.

Adult↗
PubMedDate not supplied

Decreased erythrocyte osmotic fragility during canine leptospirosis.

Erythrocyte osmotic fragility (EOF) was carried out in nineteen dogs naturally infected by Leptospira interrogans serovar icterohaemorrhagiae/copenhagi. A decreased EOF was observed, suggesting a modification of erythrocyte components secondary to disturbances that occur during canine leptospirosis, such as renal damage and hepatic disease.

Animals↗
PubMedDate not supplied

Dot-ELISA-IgM in saliva for the diagnosis of human leptospirosis using polyester fabric-resin as support (preliminary report).

In order to improve the diagnosis of human leptospirosis, we standardized the dot-ELISA for the search of specific IgM antibodies in saliva. Saliva and serum samples were collected simultaneously from 20 patients with the icterohemorrhagic form of the disease, from 10 patients with other pathologies and from 5 negative controls. Leptospires of serovars icterohaemorrhagiae, canicola, hebdomadis, brasiliensis and cynopteri grown in EMJH medium and mixed together in equal volumes, were used as antigen at individual protein concentration of 0.2 micrograms/microliters. In the solid phase of the test we used polyester fabric impregnated with N-methylolacrylamide resin. The antigen volume for each test was 1 microliter, the saliva volume was 8 microliters, and the volume of peroxidase-labelled anti-human IgM conjugate was 30 microliters. A visual reading was taken after development in freshly prepared chromogen solution. In contrast to the classic nitrocellulose membrane support, the fabric support is easy to obtain and to handle. Saliva can be collected directly onto the support, a fact that facilitates the method and reduces the expenses and risks related to blood processing.

Antibodies, Anti-Idiotypic↗
PubMedDate not supplied

Leptospirosis severity may be associated with the intensity of humoral immune response.

Leptospirosis severity may be increasing, with pulmonary involvement becoming more frequent. Does this increase result from an intense immune response to leptospire? Notice that renal failure, thrombocytopenia and pulmonary complications are found during the immune phase. Thirty-five hospitalized patients with Weil's disease had 5 blood samples drawn, from the 15th day to the 12th month of symptoms, for ELISA-IgM, -IgG and -IgA specific antibody detection. According their 1st IgG titer, the patients were divided into: group 1 (n = 13) titer > 1:400 (positive) and group 2 (n = 22) titer < or =1:400 (negative). Early IgG antibodies in group 1 showed high avidity which may indicate reinfection. Group 1 was older, had worse pulmonary and renal function, and fever for a longer period than group 2. Throughout the study, IgG and IgA titers remained higher in group 1. In conclusion, the severity of Weil's disease may be associated with the intensity of the humoral immune response to leptospire.

Adolescent↗
PubMed1999

Leptospirosis in Portugal: epidemiology from 1991 to 1997.

The term leptospirosis describes a group of diseases caused by members of the order Spirochaetales, mainly the species Leptospira interrogans. Infection can be asymptomatic but disease of differing severity and clinical features (often suggestive of menin

Journal Article↗
PubMed1978

Leptospirosis in zoo workers associated with bears.

Leptospirosis due to Leptospira interrogans serovar icterohaemorrhagiae was diagnosed in two zoo animal keepers. The implicated source of infection was bear cubs that had microscopic agglutination antibody titers to leptospires of the Icterohaemorrhagiae serogroup.

Adult↗