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Leptospirosis and the maintenance host: a laboratory mouse model.

A laboratory mouse model was used to investigate the criteria that have been suggested as differentiating between a maintenance host and an accidental host for a particular leptospiral serovar. The comparative studies were conducted with serovars ballum, pomona, balcanica and hardjo. The relative pathological response, ratio of serological to bacteriological prevalence, level of serological response, age-susceptibility to infection and demonstration of artificial intraspecies transmission were found to be inadequate criteria with which to differentiate maintenance and accidental hosts for a particular serovar. The demonstration of natural intraspecies transmission was considered to be the definitive criterion for differentiating such hosts. In the light of the results obtained from the laboratory mouse model and the results obtained from field studies, a maintenance host may be defined as an animal which is capable of acting as a natural source of leptospiral infection for its own species. A maintenance population may be defined as a population of a species of animal which acts as a continuous reservoir of a serovar in a specific ecosystem.

Age Factors↗

May human leptospirosis develop as a chronic infection?

In connection with some rather uncommon cases, the authors asked themselves whether leptospirosis may also develop as a chronic infection. To answer this question, we took into consideration four of the most representative investigated cases encountered during the last 22 years. In conclusion, it appears that in some circumstances, human leptospirosis could present itself as a chronic disease.

Adult↗

Human leptospirosis infective serogroups and serotypes in Jamaica.

Of a total of 5,021 samples of sera tested in Jamaica between 1960-1978, 651 (12.9%) were positive in significant to microscopic agglutination for leptospirosis. There were 50 (5.9%) positive isolates of 845 cultures. Six serogroups and 13 serotypes of pathogenic leptospiral strains were identified. The serogroup icterohaemorrhagiae serovar icterohaemorrhagiae accounted for 57% of infections and the serogroup hebdomadis, serovar jules accounting for 31% of cases. Human leptospirosis is grossly under-reported in Jamaica and only systematic surveys and surveillance can define the true incidence of the public health problem of this disease.

Female↗

Diseases, parasites and survival of coyotes in south-central Georgia.

Serologic testing, radio-telemetry and post-mortem diagnostic evaluations were used to investigate survival and causes of mortality among 17 coyotes (Canis latrans) in south-central Georgia (USA). Prevalence of canine heartworm (Dirofilaria immitis) microfilariae was lower (P = 0.057) among fall-captured (22%) than among winter-captured (75%) coyotes. Prevalence of heartworm was higher among adults than juveniles in the fall, but no significant difference was detected between animals captured in winter. Antibodies were found against canine parvovirus (65%), canine parainfluenza virus (59%), infectious canine hepatitis virus (41%), and Toxoplasma gondii (18%). Antibodies were not found to Brucella canis, canine coronavirus, five serovars of Leptospira interrogans, or canine distemper virus. Seroprevalence of canine parvovirus was lower (P = 0.009) among fall-captured animals (33%) than winter-captured animals (100%). The Kaplan-Meier estimate of annual survival was 0.500 for all animals. Juvenile survival did not differ (P = 0.79) from adult survival, but male survival (S = 0.217) was lower (P = 0.11) than female survival (S = 0.804). Two of nine (22%) mortalities were human-caused, one was due to concurrent canine parvovirus and canine distemper virus infections, one animal died of trauma, two were considered natural mortalities of unknown cause, and no cause of death could be determined for the remaining three animals. Natural mortality may be significant for coyotes in south-central Georgia, although there was no apparent link between exposure to pathogens and the animals' subsequent fate in our small sample.

Animals↗

Human leptospirosis in Denmark 1970-1996: an epidemiological and clinical study.

Epidemiological and clinical aspects of 118 laboratory confirmed cases of human leptospirosis in Denmark from 1970 to 1996 were reviewed. Icterohaemorrhagiae (72%) and sejroe (20%) were the most frequent serovars. The incidence of leptospirosis was 0.09/100,000 inhabitants/y. 93% of the patients were 18-64 y old, 90% were men and 72% of the cases occurred from July to November. Occupational exposure was present in 63% (74/118) of the cases (41% fish farmers, 28%, farmers). Eight percent of the patients had travelled abroad, 7% had been exposed to sewers and 4%, had been exposed through recreational activities (fishing). Initial symptoms were generally non-specific. Weil's disease developed in 63%, of the patients, more often in patients infected with the serovar icterohaemorrhagiae (73%) compared to patients infected with serovars sejroe or saxkoebing (25%). The fatality rate was 7%, all due to icterohaemorrhagiae. Though a rare disease in Denmark, leptospirosis should be considered in certain risk groups as a possible diagnosis in patients with acute febrile illness.

Adolescent↗

Sporadic urban leptospirosis.

BACKGROUND: Surprisingly, many inner-city residents have antibodies to Leptospira interrogans. The manner in which these persons acquire this organism in the absence of recognized occupational, recreational, or epidemic risk factors is not known. OBJECTIVE: To study the epidemiology of patients with leptospirosis who acquired L. interrogans in inner-city Baltimore, Maryland. DESIGN: Epidemiologic investigation. SETTING: Inner-city university hospital. PATIENTS: Three inner-city residents who developed leptospirosis. MEASUREMENTS: Trapping rats in alleys where the patients may have acquired L. interrogans; polymerase chain reaction (PCR) analysis of patients serum and cerebrospinal fluid specimens and rat tissues to determine the presence of leptospiral DNA; and serologic testing of serum from patients and rats by microagglutination assay to confirm L. interrogans infection. RESULTS: Three patients developed leptospirosis after probable percutaneous exposure to rat (Rattus norvegicus) urine in Baltimore alleys. A PCR assay detected L. interrogans DNA in samples of body fluid obtained from the first two patients at presentation (one in cerebrospinal fluid, the other in serum). Results of PCR done on serum drawn from the third patient after antibiotic therapy began were negative. A microagglutination test showed that all patients had high levels of antibodies to the L. interrogans serogroup icterohaemorrhagiae. In 19 of 21 rats that were trapped in the alleys where the patients had sustained lacerations before illness developed, kidney or brain tissues were positive by PCR for the presence of L. interrogans. CONCLUSIONS: A population was discovered to be at risk for acquiring L. interrogans: urban residents who are sporadically exposed to rat urine in the inner city. Inner-city rats often carry L. interrogans. Polymerase chain reaction can quickly establish the diagnosis of leptospirosis and is useful for epidemiologic study. An endemic substrate for the transmission of the organism is present in inner-city Baltimore. Leptospirosis may become increasingly recognized in deteriorating inner cities in which rat populations are expanding.

Adult↗

Serological survey for selected diseases in the endangered San Joaquin kit fox (Vulpes macrotis mutica).

Blood from endangered San Joaquin kit foxes (Vulpes macrotis mutica) inhabiting the Elk Hills Naval Petroleum Reserve, Kern County, and the Elkhorn Plain, San Luis Obispo County, California, was collected in 1981, 1982 and 1984 and sera were tested for antibodies against 10 selected pathogens. Proportions of kit fox sera containing antibodies against pathogens were: canine parvovirus, 100% in 1981-1982 and 67% in 1984; infectious canine hepatitis virus, 6% in 1981-1982 and 21% in 1984; canine distemper virus, none in 1981-1982 and 14% in 1984; Francisella tularensis, 8% in 1981-1982 and 31% in 1984; Brucella abortus, 8% in 1981-1982 and 3% in 1984; Brucella canis, 14% in 1981-1982 and none in 1984; Toxoplasma gondii, 6% in 1981-1982; Coccidioides immitis, 3% in 1981-1982; and Yersinia pestis and Leptospira interrogans serotypes canicola, grippotyphosa, hardjo, icterohaemorrhagiae, and pomona, none in 1981-1982. Although antibodies against selected pathogens were present, no clinical indications of disease were observed in these fox populations.

Animals↗

Infectious disease serologic survey in free-ranging Venezuelan anacondas (Eunectes murinus).

Reptiles can harbor pathogenic microorganisms asymptomatically and serve as potential reservoirs of infection for humans, domestic animals, and other reptiles. Infectious diseases are also problematic for free-ranging reptile populations and are an important consideration in reptile reintroduction and translocation projects. There have been limited serologic studies of free-ranging reptiles for evidence of exposure to potential pathogens. In the present study, serum or plasma samples from five male and five female free-ranging Venezuelan anacondas (Eunectes murinus) were screened for antibodies to eastern, western, and Venezuelan equine encephalitis viruses, vesicular stomatitis virus, ophidian paramyxovirus, 19 Leptospira interrogans serovars, and Cryptosporidium serpentes. Antibodies to these agents were not detected, or antibody titers were low and possibly nonspecific. These results for the limited number of anacondas surveyed suggest that they do not serve as significant reservoirs for these infectious agents at this location.

Animals↗

[Community-acquired pneumonia--current status of pathogen diagnosis].

Procedures for the microbiological diagnosis of acute community-acquired pneumonia are based on the expected pathogens. Although a great variety of microorganisms are able to cause community-acquired pneumonia only a few pathogens play an important role in daily practice. The most important investigations are blood cultures and sputum cultures to detect bacteria like pneumococci, Haemophilus influenzae and Staphylococcus aureus as well as antibody tests for Mycoplasma pneumonia and Chlamydia pneumonia. According to anamnesis and clinic presentation tests such as for Legionella or viruses have to be added. Sometimes also rare pathogens have to be considered such as Coxiella burnetii, Leptospira, Hantaviruses, cryptococci or Chlamydia psittaci. The standard procedure for diagnosis of tuberculosis is the microscopical examination and the standardized culture in liquid and on solid media. Amplification methods such as PCR are also useful for a rapid diagnosis. However, the application of amplification procedures alone without culture is not recommended.

Bacteriological Techniques↗

Bovine leptospirosis: infection by the Hebdomadis serogroup and mastitis.

An outbreak of mastitis involving approximately 70 out of 140 cows over a two-month period is described. Common mastitis pathogens were not incriminated. Leptospires belonging to the Hebdomadis serogroup were isolated from the milk of three out of five cows and the blood of two of those cows.

Animals↗

Serological survey for diseases in free-ranging coyotes (Canis latrans) in Yellowstone National Park, Wyoming.

From October 1989 to June 1993, we captured and sampled 110 coyotes (Canis latrans) for various diseases in Yellowstone National Park, Wyoming (USA). Prevalence of antibodies against canine parvovirus (CPV) was 100% for adults (> 24 months old), 100% for yearlings (12 to 24 months old), and 100% for old pups (4 to 12 months old); 0% of the young pups (< 3 months old) had antibodies against CPV. Presence of antibodies against canine distemper virus (CDV) was associated with the age of the coyote, with 88%, 54%, 23%, and 0% prevalence among adults, yearlings, old pups, and young pups, respectively. Prevalence of CDV antibodies declined over time from 100% in 1989 to 33% in 1992. The prevalence of canine infectious hepatitis (ICH) virus antibodies was 97%, 82%, 54%, and 33%, for adults, yearlings, old pups, and young pups, respectively. The percentage of coyotes with ICH virus antibodies also declined over time from a high of 100% in 1989 to 31% in 1992, and 42% in 1993. Prevalence of antibodies against Yersinia pestis was 86%, 33%, 80%, and 7%, for adults, yearlings, old pups, and young pups, respectively, and changed over time from 57% in 1991 to 0% in 1993. The prevalence of antibodies against Francisella tularensis was 21%, 17%, 10%, and 20%, for adults, yearlings, old pups, and young pups, respectively. No coyotes had serologic evidence of exposure to brucellosis, either Brucella abortus or Brucella canis. No coyotes were seropositive to Leptospira interrogans (serovars canicola, hardjo, and icterohemorrhagiae). Prevalence of antibodies against L. interrogans serovar pomona was 7%, 0%, 0%, and 9%, for adults, yearlings, old pups, and young pups, respectively. Antibodies against L. interrogans serovar grippotyphosa were present in 17% of adults and 0% of yearlings, old pups, and young pups. Many infectious canine pathogens (CPV, CDV, ICH virus) are prevalent in coyotes in Yellowstone National Park, with CPV influencing coyote pup survival during the first 3 months of life; eight of 21 transmitted pups died of CPV infection in 1992. The potential impact of these canine pathogens on wolves (C. lupus) reintroduced to Yellowstone National Park remains to be documented.

Adenoviruses, Canine↗

Detection and ecology of leptospirosis in Iowa wildlife.

To gain additional information on the extent of leptospirosis in wildlife following a human outbreak in Iowa, wild mammals and lower forms of life were collected. Isolation, darkfield microscopic, serologic and pathologic procedures were used to identify past or present evidence of leptospiral infection. Leptospires were isolated from 7 of 75 (9%) mammals. Serotype grippotyphosa was isolated from three raccoons (procyon lotor) and one Western Harvest Mouse (Reithrodontomys megalotis). Serotype ballum was isolated from three opossums (Didelphis marsupialis). Leptospires, unidentified to date, were isolated from frog (Rana pipiens) kidneys. Other positive serologic and pathologic tests gave evidence of infection or previous infection. Utilization of Darkfield microscopic and silver staining techniques did not detect all cases of leptospiral infection. Macroscopic and microscopic serologic methods failed to identify evidence of leptospirosis in all mammals from which leptospires were isolated. Pathologic lesions could only be considered presumptive evidence for leptospirosis. These findings indicate that detection of leptospirosis in wildlife cannot be limited to a single diagnostic test. A combination of diagnostic procedures and clinical evaluation is necessary. Although serotype pomona was implicated as the predominant infecting leptospire in the human cases and domestic animals and was isolated from water at a swimming site, only serotypes grippotyphosa, ballum and ICF (frog isolate) were isolated from wild mammals and lower forms of life in the same vicinity.

Animals↗

Immunity to leptospirosis: renal changes in vaccinated cattle given challenge inoculum.

Resistance to renal leptospirosis was demonstrated in cattle vaccinated with Leptospira interrogans serotype pomona bacterin. Fewer vaccinated cattle given challenge inoculum of virulent serotype pomona leptospires 12 months after vaccination had kidneys with gross focal lesions in the cortex than did nonvaccinated controls. Histopathologic changes characteristically associated with renal leptospirosis occurred less frequently and renal tissue damage was less severe in vaccinated cattle than in nonvaccinated controls. The isolation of serotype pomona from only 1 of 29 vaccinated cattle, compared to 7 isolations from 11 nonvaccinated cattle, at 26 days after challenge inoculum was given, indicated that mild renal infection occurred only infrequently in vaccinated cattle. It appeared that challenge inoculation of vaccinated cattle with virulent serotype pomona leptospires stimulated an accelerated secondary immune response in which immunity limited the multiplication of leptospires in the kidney.

Animals↗

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↗

Dairy herd health management.

Estrual cows are more likely to be recognized if penned with other open cows. Cycling cows fresh less than 100 days, without signs of heat or a follicle but with good uterine tone and signs of ovarian activity, are closely observed for heat 15-20 days after examination. Those fresh at least 150 days are given prostaglandin. Lugol's iodine solution is infused into the uterus of cows without signs of ovarian activity but with normal uterine tone. Cows with retained fetal membranes are given an intrauterine infusion of oxytetracycline with the membranes being removed only if it will not damage the uterus. Oxytetracycline or chlorhexidine solution is infused into the uterus of cows with a purulent vulvar discharge 2 or more weeks postpartum. Prostaglandins may benefit cows not showing signs of heat by 21 days postpartum. Procaine penicillin G solution is infused if the uterus is abnormal at 60 days postpartum. Heifers are vaccinated against brucellosis, blackleg, leptospirosis, IBR-PI3 and BVD at 4-11 months of age, with an optional Vibrio vaccination if a bull is used in the herd. Cows are given IBR-PI3, BVD and Leptospira vaccines a few days post-partum, with a Leptospira booster at pregnancy examination. Cows with Streptococcus mastitis in late lactation may best be treated by drying off. Control of coliform mastitis necessitates a clean barn and milking parlor environment. Staphylococcus mastitis may require segregation of affected cows and installation of a low-line milker to prevent spread.

Anestrus↗

Serosurvey of selected viral and bacterial diseases in wild swine from Oklahoma.

Blood samples collected from 120 wild swine (Sus scrofa) in thirteen Oklahoma (USA) counties during 1996 were tested for antibodies against six viral and two bacterial diseases. No antibodies to swine brucellosis, pseudorabies, transmissible gastroenteritis, and vesicular stomatitis were detected. Antibody titers to one or more leptospiral serovars were found in 44% of the samples, the two most frequent serovars being Leptospira interrogans serovars bratislava (29%) and pomona (27%). Antibody against porcine parvovirus and swine influenza virus was detected in 17% and 11% of the swine, respectively. Two samples (2%) were positive for antibody to the recently emerged porcine reproductive and respiratory syndrome virus.

Agglutination Tests↗

[The self-maintenance of natural foci of leptospirosis].

The specificity of infection of individual species of small mammals with definite serogroups of leptospires has been shown. The intensity of the epizootic process has been found to depend on the number of animals in the population. The mechanisms of the self-regulation of the epizootic process in natural foci are explained.

Animals↗

[An anademy of ictero-hemorrhagic leptospirosis in a military group in Algeria (author's transl].

Seven cases of L.I.H. are noted simultaneously in a military group in the suburbs of Algier. It is an anademic by contamination at the same point, without interhuman infection. Only two of these cases have clinical symptoms to permit diagnosis of the others by research of specific antibodies (Immunodiagnosis). Anicteric forms are very frequent. This explains probably failure of diagnosis when epidemiological conditions are realized. This unawareness of leptospiroses is unfortunately a general phenomenon in the world.

Adult↗