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PubMed2000

[Report on a leptospirosis outbreak in the city of Santa Fe, Argentina, March-April 1998].

In March-April 1998 in a neighborhood in the city of Santa Fe, Argentina, there was an outbreak of an acute disease characterized by fever, headaches, and intense myalgias. This article presents the studies surrounding this outbreak and the attempts to identify the source and the mode of transmission. The epidemiological, serological, and clinical findings indicated that the causative agent was Leptospira interrogans. As a screening test, macroscopic agglutination with heat-resistant antigen was applied, followed by the ELISA test, and, as a confirmatory test, microscopic agglutination for 10 serotypes of L. interrogans. The study covered 32 persons, 8 dogs, and 8 water samples. Among the 32 persons, 12 cases were confirmed, 2 were suspicious, and 18 were negative. Six dogs were found to be infected, and motile spirochetes were found in the water samples. The human sera reacted with the ballum, canicola, icterohaemorrhagiae, and pyrogenes serotypes; the canine sera reacted with the ballum, canicola, and pomona serotypes. The coagglutination found in all the confirmed cases indicates that they were acute cases of leptospirosis, but it was impossible to identify the causal serotype. Except for the index case, the disease was not recognized clinically. Several facts suggest that the outbreak was caused by rain that had flooded the study area. The results of this study emphasize the need for active surveillance of leptospirosis when there are floods and other natural disasters.

Animals↗
PubMed1985

Tick-borne Borrelia infection in Sweden.

Spirochetes were cultivated from 17% of 114 Ixodes ricinus ticks in the Stockholm area. Three strains of these spirochetes were selected for studies by electron microscopy. These three strains had definite morphological similarities to spirochetes of the genus Borrelia, as judged by the number of flagella, absence of cytoplasmic tubules, and dimensions. The three strains were not identical, but seemed to consist of two different kinds of cells, one with eight and one with eleven flagella. The three strains were also shown to react with a monoclonal antibody that reacts with Lyme disease spirochetes (Borrelia burgdorferi), but not with strains of other Borreliae, Treponemes, or Leptospiras. These results indicate the possibility of transmission of Borrelia spirochetes from ticks to humans in Sweden. The antibody response to one of the spirochetal strains isolated from Swedish I. ricinus was studied in 37 patients with the typical clinical picture of erythema chronicum migrans (ECM), in 45 patients with chronic meningitis (CMe) cured by high-dose intravenous penicillin, in 298 patients with post-infectious arthritis, and in controls. The antibody response was estimated by indirect immunofluorescence assay (IFA) enzyme-linked immunosorbent assay (ELISA). The antibody levels differed significantly between patients with CMe and healthy individuals (p less than 0.001), both with respect to serum antibody levels and CSF-antibody levels. The antibody levels also differed significantly between patients with ECM and healthy controls as measured by ELISA (p less than 0.05), whereas the difference was not significant as measured by IFA. Five of 298 patients with post-infectious arthritis had higher titers than any of the controls, and two of these five patients had titers higher than any patient with CMe or ECM. These results indicate spirochetal aetiology of ECM, and in some patents with CMe or postinfectious arthritis. As a diagnostic test for ECM, both IFA and ELISA were of limited value, since only 5/37 (14%) ECM patients were positive by IFA, and 14/37 (38%) by ELISA. Regarding patients with CMe, 23/45 (51%) were seropositive by IFA and 30/45 (67%) by ELISA. However, measurement of CSF-antibodies were found to be a more sensitive method than measurement of serum antibodies both by IFA and ELISA, since 38/45 (84%) CMe patients were positive by IFA, and 41/45 (91%) by ELISA. In addition, estimation of CSF antibodies was also found to be a more specific method than estimation of serum antibodies.(ABSTRACT TRUNCATED AT 400 WORDS)

Animals↗
PubMed2006

Thrombocytopenia in the experimental leptospirosis of guinea pig is not related to disseminated intravascular coagulation.

BACKGROUND: Thrombocytopenia is commonly observed in severe leptospirosis. However, previous studies on coagulation alterations during leptospirosis resulted in inconsistent conclusions. Some findings showed that the prominent levels of thrombocytopenia observed in severe leptospirosis did not reflect the occurrence of disseminated intravascular coagulation (DIC) syndrome, while the others reached the conclusion that the hemorrhages observed in leptospirosis were due to DIC. The aim of this study is to elucidate whether DIC is an important feature of leptospirosis. METHODS: The leptospirosis model of guinea pig was established by intraperitoneal inoculation of Leptospira interrogans strain Lai. Hematoxylin and eosin (HE) staining, electron microscopy and immunohistochemistry staining were used to detect the pathologic changes. Platelet thrombus or fibrin thrombus was detected by HE, Martius Scarlet Blue (MSB) staining and electron microscopy. Hemostatic molecular markers such as 11-dehydrogenate thromboxane B2 (11-DH-TXB2), thrombomodulin (TM), thrombin-antithrombin III complex (TAT), D-Dimer and fibrin (ogen) degradation products (FDPs) in the plasma were examined by quantitative enzyme-linked immunosorbent assay (ELISA) to evaluate the hematological coagulative alterations in leptospirosis models. RESULTS: Pulmonary hemorrhage appeared in the model guinea pig 24 hours after leptospires intraperitoneal inoculation, progressing to a peak at 96 hours after the infection. Leptospires were detected 24 hours post-inoculation in the liver, 48 hours in the lung and 72 hours in the kidney by immunohistochemistry staining. Spiral form of the bacteria was initially observed in the liver, lung and kidney suggestive of intact leptospires, granular form of leptospires was seen as the severity increased. Platelet aggregation in hepatic sinusoid as well as phagocytosis of erythrocytes and platelets by Kupffer cells were both observed. Neither platelet thrombus nor fibrin thrombus was found in the liver, lung or kidney via morphological observation. Thrombocytopenia was observed in all infected guinea pigs of our experimental leptospirosis study. Analysis of hematologic molecular markers showed that 11-DH-TXB2 and TM in the plasma were elevated significantly. TAT that reflects the thrombin activation had a trend of decline after infection. Although D-dimer and FDPs increased statistically, the increasing may not bear clinical significance. CONCLUSION: Pathologic and hematological studies for experimental leptospirosis of guinea pig indicated that the thrombocytopenia found in guinea pigs did not correlate with the occurrence of DIC. The platelet aggregation and Kupffer cells phagocytosis might be the potential causes of thrombocytopenia in severe leptospirosis.

Animals↗
PubMed2001

[Integrated disease control in dairy herds. A case study from the veterinarians' viewpoint].

Integrated control of bovine virus diarrhoea virus, bovine herpesvirus-1, Leptospira interrogans serovar hardjo subtype hardjobovis, Mycobacterium avium subsp. paratuberculosis, and Salmonella dublin in dairy herds may provide economic benefits superior to those obtained by sequential disease control, because, among other things, it allows optimization of voluntary culling. However, in practice there are no adequate instruments to establish priorities in voluntary culling. Therefore, in this study the priorities in decision-making for voluntary culling of infected cattle, as indicated by more than 300 cattle veterinarians, were analysed. Based on our results and supplementary considerations, the priorities for voluntary culling in the Netherlands can be ranked as: 1st. cull S. dublin carriers, 2nd. cull persistently infected BVDV carriers, 3rd. cull paratuberculosis faecal culture positive cattle and their last offspring, 4th. cull, in paratuberculosis infected herds, paratuberculosis ELISA positive cattle and their last offspring and cull, in low prevalence herds, BHV1 gE-positive cattle, and 5th. cull leptospirosis seropositive cattle. Since this ranking was based on one case study only, other priorities may prevail in other herds.

Animals↗
PubMed1999

Microbiological safety of drinking water: United States and global perspectives.

Waterborne disease statistics only begin to estimate the global burden of infectious diseases from contaminated drinking water. Diarrheal disease is dramatically underreported and etiologies seldom diagnosed. This review examines available data on waterborne disease incidence both in the United States and globally together with its limitations. The waterborne route of transmission is examined for bacterial, protozoal, and viral pathogens that either are frequently associated with drinking water (e.g., Shigella spp.), or for which there is strong evidence implicating the waterborne route of transmission (e.g., Leptospira spp.). In addition, crucial areas of research are discussed, including risks from selection of treatment-resistant pathogens, importance of environmental reservoirs, and new methodologies for pathogen-specific monitoring. To accurately assess risks from waterborne disease, it is necessary to understand pathogen distribution and survival strategies within water distribution systems and to apply methodologies that can detect not only the presence, but also the viability and infectivity of the pathogen.

Bacterial Infections↗
PubMed1993

Comparative pathogenicity study of Leptospira interrogans serovar pomona strains.

The comparative pathogenicity study of two Leptospira interrogans serovar pomona strains isolated from pig herds of different epizootiological status is reported. Using monoclonal antibodies (Mabs), the isolates were identified as Leptospira interrogans serovar pomona. The results obtained for the reference strain of L. pomona were identical with those of the two isolates, with the exception of monoclonal serum designated 61-7, which gave a 1:30 titre with the reference strain. In a pig herd comprising 1,000 sows, strain XVIII caused abortion in 300 animals. In the hamster pathogenicity test, this strain killed the hamsters on postinoculation (PI) days 5 or 6. The pathogen was reisolated from their organs. Strain XV did not cause abortion in a herd of 600 sows; it only elicited seroconversion in a proportion of the animals (26 out of 274 blood samples were positive, corresponding to a seropositivity rate of 9.5%). This strain did not kill the hamsters and could be demonstrated from their organs neither by isolation nor by histological examination. The blood serum of two pregnant sows infected with strain XVIII contained high titres of antibodies (1:1,600 and 1:3,200) already on PI day 10. The first urine sample of these animals, taken on PI day 10, also contained large numbers of leptospires. The pathogen was reisolated from urine samples taken at 10-day intervals and from the kidneys of the slaughtered sows. One of the two infected sows delivered four non-viable and a viable piglet. From the kidneys of the non-viable piglets, leptospires were demonstrated by histological examination. In contrast, none of the four pregnant sows inoculated with strain XV aborted. The sows did not produce antibodies detectable by the microscopic agglutination test (MAT). The pathogen could not be isolated from urine samples and from kidney samples taken from the sows at slaughter. Histological demonstration of leptospires from the sows' kidneys also failed.

Animals↗
PubMed1985

ELISA for the detection of specific IgM and IgG in human leptospirosis.

ELISA was used to detect specific IgM and IgG in sera from humans with current or past leptospirosis. A serological pattern of a high IgM titre (greater than or equal to 1280), or moderately increased IgM (160-640) in conjunction with a low IgG titre (less than or equal to 20), with serovar copenhageni antigen was characteristic for approximately two-thirds of the sera from serovar icterohaemorrhagiae patients obtained in the first two months of the disease. The antigen was the supernatant of a heated and centrifuged culture of leptospires. Antigens were prepared from serovars copenhageni, grippotyphosa, hardjo and patoc. Sera from patients with icterohaemorrhagiae, grippotyphosa and hardjo infections showed cross-reactivity when different antigens were used. In past infections the IgG titres were clearly higher with the homologous antigen. ELISA for IgM and IgG allows the rapid diagnosis of acute leptospirosis.

Agglutination Tests↗
PubMed1989

A farming systems study of abortion in dairy cattle on the Atherton Tableland. 2. The pattern of infectious diseases.

The role of infectious agents on dairy farms on the Atherton Tableland in tropical north Queensland was studied as part of a comprehensive investigation into the causes of bovine abortion. The prevalence of antibody in serums collected from 7 herds whose annual abortion rates ranged from 3% to 21% were as follows: Leptospira hardjo 49.9% (426/853), L. pomona 0.4% (3/851), bovine virus diarrhoea (BVD) 33.7% (35/104). Infectious bovine rhinotracheitis virus (IBR) 11.5% (12/105), Akabane virus 92.2% (95/103), Aino virus 62.1% (64/103), Chlamydia psittaci 3.1% (37/1004), Brucella abortus 0% (0/851), and Toxoplasma gondii 0% (0/105). Testing of serums against a wide range of leptospiral serotypes indicated that reactions occurring in the Hebdomadis and Sejroe serogroups were probably cross reactions with L. hardjo. Infection with L. hardjo and Akabane virus occurred prior to first mating and contact with Aino virus occurred during first pregnancy. Infection with BVD and IBR viruses was sporadic. The pathology and microbiology of 32 aborted foetuses from 24 Tableland herds (10 from the group of 19 farms under more intense study) were performed. Lesions associated with a Sarcocystis-like agent were present in 6, leptospires in 1, suspected toxic hepatosis in 2 and purulent bronchopneumonia (Staphylococcus aureus) in 1 foetus. No diagnoses were made in the remaining 22 foetuses (69%). Evidence for a common infectious cause of abortion in the population was inconclusive.

Abortion, Veterinary↗
PubMed1982

Evaluation of a hardjo-pomona vaccine to prevent leptospiruria in cattle exposed to a natural challenge with Leptospira interrogans serovar hardjo.

The efficacy of a vaccine against Leptospira interrogans serovar pomona and Leptospira interrogans serovar hardjo was evaluated in a group of dairy heifers that were serologically negative at the time of vaccination and later subjected to natural challenge with L. interogans serovar hardjo. Thirty-nine heifers were vaccinated twice, at a one-month interval, with a commercially prepared bivalent vaccine, while 43 unvaccinated heifers were used as controls. After vaccination, microscopic agglutination (MA) titres of serums to L. interrogans serovar hardjo ranged from 32 to 512, and those to L. interrogans serovar pomona ranged from 32 to 2048. Titres resulting from vaccination were short-lived and after the first vaccination the serums of 95% of vaccinated heifers did not react in the MA test by 24 weeks. The first indication of infection in the heifers was noted at week 6, and by week 16, elevated MA titres (greater than or equal to 128) to L. interrogans serovar hardjo had occurred in 62% of unvaccinated heifers and had increased to 85% by week 24. At week 18, 18% of the vaccinated heifers and 56% of the unvaccinated heifers had leptospiruria (p less than 0.01); after 22 weeks, 13% of the vaccinated heifers and 58% of the unvaccinated heifers showed evidence of leptospiruria (p less than 0.01).

Agglutination Tests↗
PubMed1996

[Weil's disease and necrotizing herpes pneumonia as the cause of death of a 39-year-old sewage drain worker].

Acute leptospirosis in Europe (Weil's disease) is a rare and in more than 90% of the cases undiagnosed febrile, self-limited disease. We report the case of a 39-year-old sewerage worker, who was admitted to our hospital with fever, jaundice, pain in his calves and acute renal failure. Serology revealed elevated antibody titers against Leptospira canicola, L. icterhaemorrhagica and L. sejroe. The patient developed disseminated intravascular coagulation (DIC) with diffuse gastrointestinal bleeding due to thrombocytopenia. The ECG showed atrial fibrillation with irregularly irregular rhythm. Cardiac arrest developed, most likely due to hypoxia, with a drop in the blood pressure. Despite immediate resuscitation efforts the patient developed severe hypoxic brain damage and died a few days later. Autopsy disclosed histologic signs of a generalized leptospiral infection, signs of shock and within the lungs a necrotizing herpes simplex virus pneumonia causing the death of the patient. The virus pneumonia most probably was caused by retrograde canalicular dissemination of oral secretions since herpetic tracheitis and esophagitis were found and herpetic lesions were readily identified on the lips and tongue. A medical opinion asked for by the professional association having liability for occupational safety and insurance was given, the disease being recognized as an occupational disease.

Adult↗
PubMed1982

A survey of leptospirosis in febrile patients mainly from hospitals and clinics in Trinidad.

Acute and convalescent sera were obtained from 202 febrile patients, most of whom were admitted to or attended hospitals or clinics in northern Trinidad during the 12 months from mid-February 1977 to mid-February 1978. Laboratory tests confirmed that 10 of the patients were suffering from current leptospirosis while another 54 had serological evidence of previous leptospiral infections. Antibodies to strains of the Icterohaemorrhagiae serogroup were most commonly found, followed by those to the Hebdomadis and Autumnalis serogroups. Isolates were obtained from the blood of two and the urine of three of the 10 current cases. Four of these strains were identified as belonging to copenhageni serovar of the Icterohaemorrhagiae serogroup and one to serovar brasiliensis of the Bataviae serogroup. Seven of the patients suffering from leptospirosis were males, all rural dwellers, and all except one under 20 years of age. Two of the three female patients were over 60 years old and were urban dwellers. It was not possible to identify the sources of infection with certainty, although dogs may have been responsible for three of the Icterohaemorrhagiae and one of the Canicola infections. Of the 192 patients who were not currently infected, serological evidence of previous infection was obtained in 31 (40%) males and 23 (21%) females and was most common among farmers and rural workers.

Adolescent↗
PubMed1989

Etiologic studies on late-term swine abortions.

One hundred thirty-eight swine abortions were studied in detail in an effort to identify an etiologic agent. A viral agent was implicated in 7 cases. Bacteria were isolated in less than half of the examined cases: however, in 61% of the cases, motile, filamentous organisms were observed in tissues and fluids. Although swine sera from farms experiencing reproductive problems had a high reactor rate to Leptospira bratislava antigen, electron microscopy of the observed organism revealed a wall-free prokaryote morphologically typical of the class Mollicutes.

Abortion, Veterinary↗
PubMed1995

Evaluation of the polymerase chain reaction for early diagnosis of leptospirosis.

Early diagnosis of leptospirosis is important because severe leptospiral infection can run a fulminant course. The polymerase chain reaction (PCR) was evaluated for the detection of leptospires in clinical samples from patients with acute leptospiral infection. Blood and urine samples from 71 patients with leptospirosis were examined by PCR, culture or serology. Samples from 44 (62%) patients with the diagnosis of leptospirosis were positive by PCR as compared to 34 (48%) by culture. The presence of leptospires was demonstrated by PCR in 13 patients before the development of antibodies, as well as in two patients who were seronegative during their illness and at autopsy. Samples from 16 patients without leptospirosis were seronegative and culture negative, and also negative by PCR. We conclude that PCR is a rapid, sensitive and specific means of diagnosing leptospiral infection, especially during the first few days of the disease.

Acute Disease↗
PubMed1982

Bovine leptospirosis: microbiological and serological findings in normal fetuses removed from the uteri after slaughter.

Leptospires were demonstrated by a combination of the direct fluorescent antibody technique and culture in six (4.6 per cent) of 130 fetuses from apparently normal uteri collected at an abattoir. Fetal ages ranged from the fifth to the seventh months. In addition, leptospires were isolated from the oviducts of two uteri whose fetuses were not infected. All the strains isolated were similar antigenically to serovar hardjo. Leptospiral antibodies were not detected in any of the fetuses.

Animals↗
PubMedDate not supplied

[Natural foci of leptospirosis on the territory of Moscow in 1995 - 2004].

The results of ten-year observations of the natural foci of leptospirosis on the territory of Moscow are presented. Information on the foci, the main species of small mammals (the reservours of the infection), the etiological structure of leptospires, circulating among rodents and insectivores, is given.

Animals↗
PubMed1984

Infection by leptospires of the Pomona serogroup in cattle and pigs in south west England.

Leptospires belonging to the Pomona serogroup were isolated from calves involved in two outbreaks of acute haemolytic disease which were characterised by jaundice, haemoglobinuria and high death rates. Retrospective case studies in which serological evidence of Pomona serogroup infection was found are also presented. Serovar pomona is the leptospire of the Pomona serogroup most commonly incriminated in clinical disease in domestic species, but the organisms isolated in this study were antigenically different to pomona and may represent a new serovar. The limited information available on the epidemiology of sporadic infection with leptospires of the Pomona serogroup in domestic species in the south west of England supports the contention that a serovar other than pomona is involved.

Animals↗
PubMed1973

Comparative tests with formolized and irradiated vaccines against leptospirosis.

The effectiveness of gamma-irradiated antileptospirosis vaccines and of vaccines killed with formol was compared in guineapigs. Irradiated vaccines proved no more effective than formolized vaccines in preventing either death or persistent kidney infection. Anti-pomona vaccines gave little protection against serotype icterohaemorrhagiae, and there was no significant difference between irradiated and formolized preparations. Vaccine prepared from a virulent strain showed little advantage over vaccine prepared from weak strains.

Animals↗