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Cardoso TL, de Freitas SB, Seixas Neto ACP, Balassiano IT, Hartwig DD. Advancing serologic diagnosis: assessing the efficacy of rErpY-like protein in human leptospirosis detection. Braz J Microbiol 2024:10.1007/s42770-024-01364-4. [PMID: 38805148 DOI: 10.1007/s42770-024-01364-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2024] [Accepted: 04/29/2024] [Indexed: 05/29/2024] Open
Abstract
Leptospirosis is a globally distributed infectious disease caused by pathogenic spirochetes of the Leptospira genus, often overlooked. It is estimated that the disease affects approximately one million people annually, resulting in more than 58,900 deaths. The gold standard for serodiagnosis of leptospirosis is the Microscopic Agglutination Test (MAT). However, the limitations of this technique necessitate the exploration of alternative diagnostic methods. In this study, we evaluated the ErpY-like recombinant protein (rErpY-like) in the development of a serologic diagnostic assay for human leptospirosis. Eighty-six human sera samples, characterized by MAT, underwent evaluation through indirect IgM-ELISA and IgG-ELISA. The sensitivity and specificity values obtained from IgM-ELISA were 60% and 76%, respectively, while those from IgG-ELISA were 96.4% and 100%, respectively. The use of the rErpY-like protein in both IgM-ELISA and IgG-ELISA proves to be a sensitive and specific method for antibody detection. This could potentially serve as a valuable alternative tool in the diagnosis of human leptospirosis.
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Affiliation(s)
- Thayná Laner Cardoso
- Laboratory of Bacteriology and Bioassays, Department of Microbiology and Parasitology, Institute of Biology, Federal University of Pelotas, Pelotas, RS, Brazil
| | - Stella Buchhorn de Freitas
- Laboratory of Bacteriology and Bioassays, Department of Microbiology and Parasitology, Institute of Biology, Federal University of Pelotas, Pelotas, RS, Brazil
| | - Amilton Clair Pinto Seixas Neto
- Laboratory of Bacteriology and Bioassays, Department of Microbiology and Parasitology, Institute of Biology, Federal University of Pelotas, Pelotas, RS, Brazil
| | - Ilana Teruszkin Balassiano
- Bacterial Zoonoses Laboratory, Leptospirosis National Reference Center/Leptospira Collection, WHO/PAHO Collaborating Center for Leptospirosis, Department of Bacteriology, Oswaldo Cruz Institute, FIOCRUZ, Rio de Janeiro, Brazil
| | - Daiane Drawanz Hartwig
- Laboratory of Bacteriology and Bioassays, Department of Microbiology and Parasitology, Institute of Biology, Federal University of Pelotas, Pelotas, RS, Brazil.
- Federal University of Pelotas, University Campus, Pelotas, RS, CEP 96010-900, Brazil.
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Man O, Kraay A, Thomas R, Trostle J, Lee GO, Robbins C, Morrison AC, Coloma J, Eisenberg JNS. Characterizing dengue transmission in rural areas: A systematic review. PLoS Negl Trop Dis 2023; 17:e0011333. [PMID: 37289678 PMCID: PMC10249895 DOI: 10.1371/journal.pntd.0011333] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/10/2023] Open
Abstract
Dengue has historically been considered an urban disease associated with dense human populations and the built environment. Recently, studies suggest increasing dengue virus (DENV) transmission in rural populations. It is unclear whether these reports reflect recent spread into rural areas or ongoing transmission that was previously unnoticed, and what mechanisms are driving this rural transmission. We conducted a systematic review to synthesize research on dengue in rural areas and apply this knowledge to summarize aspects of rurality used in current epidemiological studies of DENV transmission given changing and mixed environments. We described how authors defined rurality and how they defined mechanisms for rural dengue transmission. We systematically searched PubMed, Web of Science, and Embase for articles evaluating dengue prevalence or cumulative incidence in rural areas. A total of 106 articles published between 1958 and 2021 met our inclusion criteria. Overall, 56% (n = 22) of the 48 estimates that compared urban and rural settings reported rural dengue incidence as being as high or higher than in urban locations. In some rural areas, the force of infection appears to be increasing over time, as measured by increasing seroprevalence in children and thus likely decreasing age of first infection, suggesting that rural dengue transmission may be a relatively recent phenomenon. Authors characterized rural locations by many different factors, including population density and size, environmental and land use characteristics, and by comparing their context to urban areas. Hypothesized mechanisms for rural dengue transmission included travel, population size, urban infrastructure, vector and environmental factors, among other mechanisms. Strengthening our understanding of the relationship between rurality and dengue will require a more nuanced definition of rurality from the perspective of DENV transmission. Future studies should focus on characterizing details of study locations based on their environmental features, exposure histories, and movement dynamics to identify characteristics that may influence dengue transmission.
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Affiliation(s)
- Olivia Man
- Department of Epidemiology, University of Michigan, Ann Arbor, Michigan, United States of America
| | - Alicia Kraay
- Department of Kinesiology and Community Health, University of Illinois, Urbana, Illinois, United States of America
- Institution for Genomic Biology, University of Illinois, Urbana, Illinois, United States of America
| | - Ruth Thomas
- Department of Epidemiology, University of Michigan, Ann Arbor, Michigan, United States of America
| | - James Trostle
- Department of Anthropology, Trinity College, Hartford, Connecticut, United States of America
| | - Gwenyth O. Lee
- Rutgers Global Health Institute, Rutgers, The State University of New Jersey, New Brunswick, New Jersey, United States of America
- Rutgers Department of Biostatistics and Epidemiology, School of Public Health, Rutgers, The State University of New Jersey, New Brunswick, New Jersey, United States of America
| | - Charlotte Robbins
- Department of Anthropology, Trinity College, Hartford, Connecticut, United States of America
| | - Amy C. Morrison
- Department of Pathology, Microbiology, and Immunology, School of Veterinary Medicine, University of California, Davis, Davis, California, United States of America
| | - Josefina Coloma
- Division of Infectious Diseases and Vaccinology, School of Public Health, University of California, Berkeley, Berkeley, California, United States of America
| | - Joseph N. S. Eisenberg
- Department of Epidemiology, University of Michigan, Ann Arbor, Michigan, United States of America
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Akaba Y, Kudo Y, Ket V, Ket V, Rin E, Masuzawa T. Identification of Leptospira Species in Environmental Soil of Urban Settlements in Cambodia. Vector Borne Zoonotic Dis 2023; 23:291-297. [PMID: 36927062 DOI: 10.1089/vbz.2022.0052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/18/2023] Open
Abstract
Background: Leptospirosis represents a major public health threat in Cambodia. To help establish preventive strategies for leptospirosis, we isolated and identified Leptospira from soil collected in Phnom Penh and its neighboring province during the dry and rainy seasons. Materials and Methods: Soil samples were collected from 15 sites in the Phnom Penh metropolitan area and Kandal Province in 2019 and 2020. A total of 120 soil samples were collected and analyzed after culturing. Cultured isolates were identified at the species level using 16S rRNA and gyrB gene sequencing analysis. Results: The positive culture rate for Leptospira was significantly higher for samples collected during the rainy season (31 out of 60 samples, 51.7%) than during the dry season (19 out of 60 samples; p < 0.05, chi-squared test). In terms of sampling area, 10 (35.7%) and 13 (46.9%) soil samples from Phnom Penh and 9 (28.1%) and 18 (56.3%) soil samples from Kandal Province were culture-positive when collected during the dry and rainy seasons, respectively. Three isolates from the Kandal samples collected during the dry season were categorized as pathogenic clade type P1 according to 16S rRNA and gyrB sequence analyses. In addition, samples collected during the rainy season from Phnom Penh and Kandal Province (three each) were categorized as clade type P1. The samples with isolates in clade type P1 were collected from riverbanks during both the dry and rainy seasons and from a hospital garden during the rainy season. Conclusions: This is the first report on the isolation of clade P1 Leptospira species in environmental soil samples from Cambodia. Environmental soil appears to be a reservoir for Leptospira in the capital city and surrounding areas of Cambodia. This study contributes to the understanding of Leptospira species distribution in Asian countries.
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Affiliation(s)
- Yuka Akaba
- Department of Clinical Laboratory, International University of Health and Welfare Narita Hospital, Chiba Prefecture, Japan
| | - Yoshiko Kudo
- International Exchange Center, Showa University, Tokyo, Japan
| | - Vansith Ket
- Samaki Medical Laboratory, Phnom Penh, Cambodia
| | - Vansen Ket
- Samaki Medical Laboratory, Phnom Penh, Cambodia
| | - En Rin
- Samaki Medical Laboratory, Phnom Penh, Cambodia
| | - Toshiyuki Masuzawa
- Faculty of Pharmaceutical Sciences, Chiba Institute of Science, Chiba Prefecture, Japan
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Katz H, Schelotto F, Bakker D, Castro-Ramos M, Gutiérrez-Expósito D, Panzera Y, Pérez R, Franco-Trecu V, Hernández E, Menéndez C, Meny P. Survey of selected pathogens in free-ranging pinnipeds in Uruguay. DISEASES OF AQUATIC ORGANISMS 2022; 150:69-83. [PMID: 35833546 DOI: 10.3354/dao03676] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Marine mammals, regarded as sentinels of aquatic ecosystem health, are exposed to different pathogens and parasites under natural conditions. We surveyed live South American fur seals Arctocephalus australis and South American sea lions Otaria flavescens in Uruguay for Leptospira spp., canine distemper virus (CDV), Mycobacterium spp., Toxoplasma gondii, and Neospora caninum. Samples were collected from 2007 to 2013. The seroprevalence of Leptospira spp. was 37.6% positive, 50.9% negative, and 11.5% suspect for A. australis (n = 61) while for O. flavescens (n = 12) it was 67% positive, 25% negative, and 8% suspect. CDV RNA was not detected in any of the analyzed samples. Most animals tested seropositive to tuberculosis antigens by WiZo ELISA (A. australis: 29/30; O. flavescens: 20/20); reactivity varied with a novel ELISA test (antigens MPB70, MPB83, ESAT6 and MPB59). Seroprevalence against N. caninum and T. gondii was 6.7 and 13.3% positive for O. flavescens and 0 and 2.2% positive for A. australis respectively. To evaluate possible sources of infection for pinnipeds, wild rats Rattus rattus and semi-feral cats Felis catus were also tested for Leptospira spp. and T. gondii respectively. Water samples tested for Leptospira revealed saprofitic L. bioflexa. Pathogenic Leptospira were detected in the kidneys of 2 rats, and cats tested positive for T. gondii (100%). These results represent a substantial contribution to the study of the health status of wild pinnipeds in Uruguay.
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Affiliation(s)
- H Katz
- Facultad de Veterinaria, Universidad de la República (UdelaR), 11600 Montevideo, Uruguay
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Comparison of the Serion IgM ELISA and Microscopic Agglutination Test for diagnosis of Leptospira spp. infections in sera from different geographical origins and estimation of Leptospira seroprevalence in the Wiwa indigenous population from Colombia. PLoS Negl Trop Dis 2022; 16:e0009876. [PMID: 35666764 PMCID: PMC9223614 DOI: 10.1371/journal.pntd.0009876] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Revised: 06/23/2022] [Accepted: 04/22/2022] [Indexed: 11/23/2022] Open
Abstract
Leptospirosis is among the most important zoonotic diseases in (sub-)tropical countries. The research objective was to evaluate the accuracy of the Serion IgM ELISA EST125M against the Microscopic Agglutination Test (MAT = imperfect reference test); to assess its ability to diagnose acute leptospirosis infections and to detect previous exposure to leptospires in an endemic setting. In addition, to estimate the overall Leptospira spp. seroprevalence in the Wiwa indigenous population in North-East Colombia. We analysed serum samples from confirmed leptospirosis patients from the Netherlands (N = 14), blood donor sera from Switzerland (N = 20), and sera from a cross-sectional study in Colombia (N = 321). All leptospirosis ELISA-positive, and a random of negative samples from Colombia were tested by the MAT for confirmation. The ELISA performed with a sensitivity of 100% (95% CI 77% - 100%) and a specificity of 100% (95% CI 83% - 100%) based on MAT confirmed Leptospira spp. positive and negative samples. In the cross-sectional study in Colombia, the ELISA performed with a sensitivity of 100% (95% CI 2–100%) and a specificity of 21% (95% CI 15–28%). Assuming a 5% Leptospira spp. seroprevalence in this population, the positive predictive value was 6% and the negative predictive value 100%. The Leptospira spp. seroprevalence in the Wiwas tested by the ELISA was 39%; however, by MAT only 0.3%. The ELISA is suitable to diagnose leptospirosis in acutely ill patients in Europe several days after onset of disease. For cross-sectional studies it is not recommended due to its low specificity. Despite the evidence of a high leptospirosis prevalence in other study areas and populations in Colombia, the Wiwa do not seem to be highly exposed to Leptospira spp.. Nevertheless, leptospirosis should be considered and tested in patients presenting with febrile illness. Leptospirosis is among the most important zoonotic diseases in (sub-)tropical countries. The correct diagnosis of leptospirosis is very important to take a medical or public health decision. Therefore, we tested a serological test (ELISA) for its ability to correctly diagnose a negative sample as truly negative and a positive sample as truly positive. We tested the ELISA with European acute leptospirosis confirmed positive and negative samples and compared results with another serological test (microscopic agglutination test), which is the recognized reference test. Further, the ELISA was assessed for its ability to detect previous exposure to leptospires in serum samples from the indigenous Wiwa population from Colombia, where leptospirosis is expected to be endemic. The ELISA performed very well with sera from patients with acute leptospirosis, however had difficulties to diagnose negative samples as truly negative in the Colombian field samples; hence unexposed persons were falsely diagnosed to be positive. Therefore, we recommend using the ELISA to detect acute leptospirosis several days after onset of illness in a non-endemic environment, but are not convinced of its usefulness to screen a population for previous Leptospira spp. exposure.
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Acute kidney injury in leptospirosis: A country-level report. Travel Med Infect Dis 2022; 49:102359. [PMID: 35660008 DOI: 10.1016/j.tmaid.2022.102359] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2022] [Revised: 05/13/2022] [Accepted: 05/16/2022] [Indexed: 02/08/2023]
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Douchet L, Goarant C, Mangeas M, Menkes C, Hinjoy S, Herbreteau V. Unraveling the invisible leptospirosis in mainland Southeast Asia and its fate under climate change. THE SCIENCE OF THE TOTAL ENVIRONMENT 2022; 832:155018. [PMID: 35390383 DOI: 10.1016/j.scitotenv.2022.155018] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Revised: 03/16/2022] [Accepted: 03/30/2022] [Indexed: 10/18/2022]
Abstract
Leptospirosis is a neglected waterborne zoonosis of growing concern in tropical and low-income regions. Endemic in Southeast Asia, its distribution and environmental factors such as climate controlling its dynamics remain poorly documented. In this paper, we investigate for the first time the current and future leptospirosis burden at a local scale in mainland Southeast Asia. We adjusted machine-learning models on incidence reports from the Thai surveillance system to identify environmental determinants of leptospirosis. The explanatory variables tested in our models included climate, topographic, land cover and soil variables. The model performing the best in cross-validation was used to estimate the current incidence regionally in Thailand, Myanmar, Cambodia, Vietnam and Laos. It then allowed to predict the spatial distribution of leptospirosis future burden from 2021 to 2100 based on an ensemble of CMIP6 climate model projections and 4 Shared Socio-economics Pathways ranging from the most optimistic to the no-climate policy outcomes (SSP1-2.6, SSP2-4.5, SSP3-7.0 and SSP5-8.5). Leptospirosis incidence was best estimated by 10 environmental variables: four landscape-, four rainfall-, two temperature-related variables. Of all tested scenario, the worst-case scenario of climate change (SSP5-8.5) surprisingly appeared as the best-case scenario for the future of leptospirosis since it would induce a significant global decline in disease incidence in Southeast Asia mainly driven by the increasing temperatures. These global patterns are however contrasted regionally with some regions showing increased incidence in the future. Our work highlights climate and the environment as major drivers of leptospirosis incidence in Southeast Asia. Applying our model to regions where leptospirosis is not routinely monitored suggests an overlooked burden in the region. As our model focuses on leptospirosis responses to environmental drivers only, some other factors, such as poverty, lifestyle or behavioral changes, could further influence these estimated future patterns.
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Affiliation(s)
- Léa Douchet
- ENTROPIE, IRD, Univ Reunion, CNRS, IFREMER, Univ Nouvelle Calédonie, 101 Promenade Roger Laroque, Nouméa 98800, New Caledonia; ESPACE-DEV, IRD, Univ Montpellier, Univ. Antilles, Univ Guyane, Univ Réunion, 5 Preah Monivong Blvd, Phnom Penh 12201, Cambodia.
| | - Cyrille Goarant
- Institut Pasteur in New Caledonia, Institut Pasteur International Network, Leptospirosis Research and Expertise Unit, 9 Ave Paul Doumer, Nouméa 98800, New Caledonia
| | - Morgan Mangeas
- ENTROPIE, IRD, Univ Reunion, CNRS, IFREMER, Univ Nouvelle Calédonie, 101 Promenade Roger Laroque, Nouméa 98800, New Caledonia
| | - Christophe Menkes
- ENTROPIE, IRD, Univ Reunion, CNRS, IFREMER, Univ Nouvelle Calédonie, 101 Promenade Roger Laroque, Nouméa 98800, New Caledonia
| | - Soawapak Hinjoy
- Office of International Cooperation, Department of Disease Control, Ministry of Public Health, 88/21 Tiwanon Road, Thaladkwan, Muang, Nonthaburi 11000, Thailand
| | - Vincent Herbreteau
- ESPACE-DEV, IRD, Univ Montpellier, Univ. Antilles, Univ Guyane, Univ Réunion, 5 Preah Monivong Blvd, Phnom Penh 12201, Cambodia
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Meny P, Iglesias T, Menéndez C, Quintero J, Ríos C, Ashfield N, Ferreira O, Mosca V, De Brun L, Ortiz G, De Vries I, Varela G, Schelotto F. Seroprevalence of anti-Leptospira antibodies in equines and associated workers-Isolation of Leptospira interrogans serogroup Canicola from equine urine. Zoonoses Public Health 2022; 69:526-536. [PMID: 35347868 DOI: 10.1111/zph.12942] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2021] [Revised: 01/21/2022] [Accepted: 03/14/2022] [Indexed: 11/30/2022]
Abstract
To investigate seroprevalence of anti-Leptospira antibodies in equines and associated workers in Uruguay, 891 equine and 150 human sera were drawn; 212 equine urine samples were also taken for culture. Environmental conditions and equine raising or managing practices were recorded in all 72 visited establishments; epidemiological information was obtained from each worker. Microscopic agglutination technique (MAT) was performed with 10 Leptospira strains for equines and 18 for human sera, that were also studied with IgM indirect immunofluorescence (IgM-IIF). Equine titres ≥100 were considered positive, and human sera titres ≥200 suggested probable recent or past infection. Urines were cultured in Ellinghausen-McCullough-Johnson-Harris (EMJH) media; local identification of one obtained isolate with lipL32 PCR, Multiple Locus Variable number tandem repeat Analysis and partial rrs gene sequencing, were completed at Institut Pasteur, Paris. Estimated reactivity was 61.3% for equines, which was higher than the studied bovine national levels (21%) and mainly observed with Icterohaemorrhagiae serogroup (40.3%), Sejroe, Canicola, Pomona or Ballum. Aged animals from slaughterhouses and cattle farms were the most frequently positive. Multiple regression analysis confirmed a significant association between seropositivity and equine age. Only one positive culture could be fully studied, and confirmed to be Leptospira interrogans serogroup Canicola; it was added to the MAT antigen panel and revealed fairly frequent reaction with equine and human sera. Three workers (2%) showed titres = 200 with Icterohaemorrhagiae or Canicola serogroups, without recent clinical manifestations. Their attended equines reacted with the same serogroups, suggesting common source infections or infection transmitted by equines. Three other humans yielded titres = 100, and none of the 150 showed an IgM-IIF-positive result. Equines seem not to be an important origin of regional human leptospirosis, except perhaps during acute animal infection. More culture work is required to study intensity and lapses of leptospiruria, as well as to further identify circulating strains.
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Affiliation(s)
- Paulina Meny
- Bacteriology and Virology Department, Hygiene Institute, Medicine Faculty, Universidad de la República, Montevideo, Uruguay
| | - Tamara Iglesias
- Bacteriology and Virology Department, Hygiene Institute, Medicine Faculty, Universidad de la República, Montevideo, Uruguay
| | - Clara Menéndez
- Bacteriology and Virology Department, Hygiene Institute, Medicine Faculty, Universidad de la República, Montevideo, Uruguay
| | - Jair Quintero
- Bacteriology and Virology Department, Hygiene Institute, Medicine Faculty, Universidad de la República, Montevideo, Uruguay
| | - Cristina Ríos
- Veterinary Faculty, Universidad de la República, Montevideo, Uruguay
| | - Natalia Ashfield
- Bacteriology and Virology Department, Hygiene Institute, Medicine Faculty, Universidad de la República, Montevideo, Uruguay
| | - Oscar Ferreira
- Veterinary Faculty, Universidad de la República, Montevideo, Uruguay
| | - Virginia Mosca
- Veterinary Faculty, Universidad de la República, Montevideo, Uruguay
| | - Laureana De Brun
- Veterinary Faculty, Universidad de la República, Montevideo, Uruguay
| | - Gabriela Ortiz
- Veterinary Faculty, Universidad de la República, Montevideo, Uruguay
| | - Isabel De Vries
- Veterinary Faculty, Universidad de la República, Montevideo, Uruguay
| | - Gustavo Varela
- Bacteriology and Virology Department, Hygiene Institute, Medicine Faculty, Universidad de la República, Montevideo, Uruguay
| | - Felipe Schelotto
- Bacteriology and Virology Department, Hygiene Institute, Medicine Faculty, Universidad de la República, Montevideo, Uruguay
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Discovering disease-causing pathogens in resource-scarce Southeast Asia using a global metagenomic pathogen monitoring system. Proc Natl Acad Sci U S A 2022; 119:e2115285119. [PMID: 35238677 PMCID: PMC8931249 DOI: 10.1073/pnas.2115285119] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
SignificanceMetagenomic pathogen sequencing offers an unbiased approach to characterizing febrile illness. In resource-scarce settings with high biodiversity, it is critical to identify disease-causing pathogens in order to understand burden and to prioritize efforts for control. Here, metagenomic next-generation sequencing (mNGS) characterization of the pathogen landscape in Cambodia revealed diverse vector-borne and zoonotic pathogens irrespective of age and gender as risk factors. Identification of key pathogens led to changes in national program surveillance. This study is a "real world" example of the use of mNGS surveillance of febrile individuals, executed in-country, to identify outbreaks of vector-borne, zoonotic, and other emerging pathogens in a resource-scarce setting.
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Koizumi N, Morita M, Pheng V, Wann C, Masuoka H, Higa Y, Wada T, Hirayama K, Ohnishi M, Miura K. Rat trade and leptospirosis: Molecular epidemiology of Leptospira species in rats exported from Cambodia to Vietnam. Transbound Emerg Dis 2021; 69:1641-1648. [PMID: 33735490 DOI: 10.1111/tbed.14077] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2021] [Revised: 03/09/2021] [Accepted: 03/15/2021] [Indexed: 01/12/2023]
Abstract
Rats are an important maintenance host of Leptospira spp., the causative agents of leptospirosis, a zoonotic disease with worldwide distribution. Rats are traded as food in the Mekong Delta, where Cambodia exports tons of rats to Vietnam. Handling wild rats is a potential health risk, but the information on Leptospira spp. carried by rats traded in the region remains limited. In this study, we investigated the carriage of Leptospira spp. in rats exported from Cambodia to Vietnam using bacterial culture, nested PCR and DNA sequencing. Isolates were then assessed using serological analysis and whole-genome sequencing (WGS), and Leptospira DNA detected in rat kidney tissues was also analysed by multilocus sequence typing (MLST). Seventy-two rats (2 Bandicota indica, 57 Rattus argentiventer, 11 R. losea, 1 R. norvegicus and 1 R. rattus) were subjected to bacterial culture, and three L. borgpetersenii serogroup Javanica isolates were obtained from R. argentiventer (5.3%). WGS revealed that although Cambodian isolates were genetically related to L. borgpetersenii serogroup Javanica strains widely distributed in East and South-East Asian countries, they formed a different cluster from other strains. In addition to the three L. borgpetersenii sequences, the flaB sequence of L. interrogans was detected in 18 R. argentiventer and 7 R. losea kidney tissue samples (38.9%) using nested PCR followed by DNA sequencing. The L. interrogans flaB-positive samples were further analysed by MLST, revealing that seven housekeeping genes (glmU, pntA, sucA, tpiA, pfkB, mreA and caiB) contained novel sequences with distinct lineages from other sequence types. This study revealed a high prevalence of Leptospira spp. among rats exported from Cambodia to Vietnam, indicating a potential risk to people engaging in rat trade and demonstrating that a fastidious L. interrogans strain circulates among Cambodian rats.
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Affiliation(s)
- Nobuo Koizumi
- Department of Bacteriology I, National Institute of Infectious Diseases, Tokyo, Japan
| | - Masatomo Morita
- Department of Bacteriology I, National Institute of Infectious Diseases, Tokyo, Japan
| | - Vutha Pheng
- Prek Leap National Institute of Agriculture, Phnom Penh, Cambodia
| | - Chinda Wann
- Prek Leap National Institute of Agriculture, Phnom Penh, Cambodia
| | - Hiroaki Masuoka
- Department of Veterinary Medical Sciences, Graduate School of Agricultural and Life Sciences, The University of Tokyo, Tokyo, Japan
| | - Yukiko Higa
- Department of Medical Entomology, National Institute of Infectious Diseases, Tokyo, Japan
| | - Takayuki Wada
- Graduate School of Human Life Science, Osaka City University, Osaka, Japan
| | - Kazuhiro Hirayama
- Department of Veterinary Medical Sciences, Graduate School of Agricultural and Life Sciences, The University of Tokyo, Tokyo, Japan
| | - Makoto Ohnishi
- Department of Bacteriology I, National Institute of Infectious Diseases, Tokyo, Japan
| | - Kozue Miura
- Department of Veterinary Medical Sciences, Graduate School of Agricultural and Life Sciences, The University of Tokyo, Tokyo, Japan
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Dreyfus A, Ruf MT, Mayer-Scholl A, Zitzl T, Loosli N, Bier NS, Hiereth S, Ulrich S, Poppert S, Straubinger RK, Stenos J, Tshokey T. Exposure to Leptospira spp. and Associated Risk Factors in the Human, Cattle and Dog Populations in Bhutan. Pathogens 2021; 10:pathogens10030308. [PMID: 33800914 PMCID: PMC8000015 DOI: 10.3390/pathogens10030308] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Revised: 02/22/2021] [Accepted: 02/23/2021] [Indexed: 12/30/2022] Open
Abstract
Leptospirosis is a neglected worldwide zoonotic bacterial disease with a high prevalence in subtropical and tropical countries. The prevalence of Leptospira spp. in humans, cattle and dogs is unknown in Bhutan. Therefore, we sought to find out whether humans, cattle or dogs had been infected in the past with leptospires by measuring antibodies in the serum. We therefore collected blood from 864 humans ≥13 years of age, 130 bovines and 84 dogs from different rural and urban areas in Bhutan and tested the serum for antibodies specific for leptospires with a screening of enzyme-linked immunosorbent assays (ELISA) and a confirmatory microscopic agglutination test (MAT). In humans, 17.6% were seropositive by ELISA and 1.6% by MAT. The seropositivity was stronger in bovines (36.9%) and dogs (47.6%). "Having had a fever recently" (OR 5.2, p = 0.004), "working for the military" (OR 26.6, p = 0.028) and "being unemployed" (OR 12.9, p = 0.041) (reference category = housemaker) were statistically significantly associated with seropositivity when controlled for the effects of other risk factors. However, due to the small number of positive test results, the findings on risk factors should be interpreted with caution. Based on the serogroups found in the three species, dogs could be a source of infection for humans, or dogs and humans are exposed to the same environmental risk factors Clinical leptospirosis in humans and domestic animals should be investigated by testing blood and urine for the presence of leptospires by molecular methods (qPCR).
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Affiliation(s)
- Anou Dreyfus
- Department of Medicine, Swiss Tropical and Public Health Institute, 4055 Basel, Switzerland; (M.-T.R.); (N.L.); (S.P.)
- Medical Faculty, University of Basel, 4055 Basel, Switzerland
- Epidemiology and Clinical Research Unit, Institut Pasteur Madagascar, Antananarivo 101, Madagascar
- Correspondence:
| | - Marie-Thérèse Ruf
- Department of Medicine, Swiss Tropical and Public Health Institute, 4055 Basel, Switzerland; (M.-T.R.); (N.L.); (S.P.)
- Medical Faculty, University of Basel, 4055 Basel, Switzerland
| | - Anne Mayer-Scholl
- Department of Biological Safety, German Federal Institute for Risk Assessment, 10589 Berlin, Germany; (A.M.-S.); (N.S.B.)
| | - Theresa Zitzl
- Institute of Hygiene and Infectious Diseases of Animals, Justus Liebig University, 35392 Giessen, Germany;
- Chair for Bacteriology and Mycology, Institute for Infectious Diseases and Zoonoses, Faculty of Veterinary Medicine, Ludwig-Maximilians University Munich, 80539 Munich, Germany; (S.H.); (S.U.); or (R.K.S.)
| | - Nadine Loosli
- Department of Medicine, Swiss Tropical and Public Health Institute, 4055 Basel, Switzerland; (M.-T.R.); (N.L.); (S.P.)
- Medical Faculty, University of Basel, 4055 Basel, Switzerland
| | - Nadja Seyhan Bier
- Department of Biological Safety, German Federal Institute for Risk Assessment, 10589 Berlin, Germany; (A.M.-S.); (N.S.B.)
| | - Stephanie Hiereth
- Chair for Bacteriology and Mycology, Institute for Infectious Diseases and Zoonoses, Faculty of Veterinary Medicine, Ludwig-Maximilians University Munich, 80539 Munich, Germany; (S.H.); (S.U.); or (R.K.S.)
| | - Sebastian Ulrich
- Chair for Bacteriology and Mycology, Institute for Infectious Diseases and Zoonoses, Faculty of Veterinary Medicine, Ludwig-Maximilians University Munich, 80539 Munich, Germany; (S.H.); (S.U.); or (R.K.S.)
| | - Sven Poppert
- Department of Medicine, Swiss Tropical and Public Health Institute, 4055 Basel, Switzerland; (M.-T.R.); (N.L.); (S.P.)
- Medical Faculty, University of Basel, 4055 Basel, Switzerland
| | - Reinhard K. Straubinger
- Chair for Bacteriology and Mycology, Institute for Infectious Diseases and Zoonoses, Faculty of Veterinary Medicine, Ludwig-Maximilians University Munich, 80539 Munich, Germany; (S.H.); (S.U.); or (R.K.S.)
| | - John Stenos
- Australian Rickettsial Reference Laboratory, University Hospital Geelong, Geelong, VIC 3220, Australia;
| | - Tshokey Tshokey
- Department of Pathology and Laboratory Medicine, Jigme Dorji Wangchuck National Referral Hospital, Thimphu 11001, Bhutan;
- Faculty of Postgraduate Medicine, Khesar Gyalpo University of Medical Sciences of Bhutan, Thimphu 11001, Bhutan
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Sandhu RS, Ismail HB, Ja’afar MHB, Rampal S. The Predictive Factors for Severe Leptospirosis Cases in Kedah. Trop Med Infect Dis 2020; 5:tropicalmed5020079. [PMID: 32422911 PMCID: PMC7344897 DOI: 10.3390/tropicalmed5020079] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2020] [Revised: 05/08/2020] [Accepted: 05/12/2020] [Indexed: 12/18/2022] Open
Abstract
Over the past decade, increased awareness about leptospirosis disease in developing and industrialized countries has resulted in increased numbers of leptospirosis cases being reported worldwide. About 5% to 15% of leptospirosis patients end up with severe forms of the disease. Complication due to leptospirosis requires monitoring, specific treatments, and intensive care admission, thus increasing the cost of treating severe leptospirosis cases. Currently, we have data on incident and mortality rates, but we do not have data on the number of patients with severe form of leptospirosis or how many patients have complications, and whether or not these complications were resolved. Therefore, we carried out this study to determine the predictive factors for severe leptospirosis cases in Kedah. We conducted a cross-sectional study. The data of patients diagnosed with leptospirosis were obtained from the surveillance unit, Kedah Health Department, through the e-notification system. These data were then sorted according to the hospitals where the patients were admitted. The patients’ medical records were collected, and their information was obtained using a checklist. A total of 456 confirmed leptospirosis cases were included in the study, with 199 patients classified as severe cases and 257 patients as mild cases, based on the Malaysian leptospirosis guidelines. Most patients were male (71.5%) with a mean SD age of 36.62 ± 20.75 years. The predictive factors for severe leptospirosis include abnormal lung sounds (OR: 3.07 [CI 1.58–6.00]), hepatomegaly (OR: 7.14 [1.10–45.98]), hypotension (OR: 2.16 [1.08–4.34]), leukocytosis (OR: 2.12 [1.37–3.29]), low hematocrit (OR: 2.33 [1.43–3.81]), and increased alanine aminotransferase (SGPT ALT) (OR: 2.12 [1.36–3.30]). In conclusion, knowing these predictive factors will help clinicians identify severe leptospirosis cases earlier and develop their treatment plans accordingly, to reduce the complications and death from severe leptospirosis.
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Affiliation(s)
- Rakesh Singh Sandhu
- Department of Community Health, Universiti Kebangsaan Malaysia, Kuala Lumpur 56000, Malaysia; (H.B.I.); (M.H.B.J.)
- Sik District Health Office, Ministry of Health Malaysia, Sik Kedah 08200, Malaysia
- Correspondence:
| | - Halim Bin Ismail
- Department of Community Health, Universiti Kebangsaan Malaysia, Kuala Lumpur 56000, Malaysia; (H.B.I.); (M.H.B.J.)
| | - Mohd Hasni Bin Ja’afar
- Department of Community Health, Universiti Kebangsaan Malaysia, Kuala Lumpur 56000, Malaysia; (H.B.I.); (M.H.B.J.)
| | - Sanjay Rampal
- Centre for Epidemiology and Evidence-Based Practice, Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur 56000, Malaysia;
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Tarantola A, Goarant C. Leptospirosis in French Historical Medical Literature: Weil's Disease or Kelsch's Disease? Am J Trop Med Hyg 2019; 99:1366-1368. [PMID: 30298813 DOI: 10.4269/ajtmh.18-0629] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
Early names for leptospirosis often indicate occupational or environmental exposure. Leptospirosis is hard to identify in the tropical setting because of co-circulating diseases. This is not the case in the temperate setting, such as Europe, where the few historical differential diagnoses were malaria, typhoid, and viral hepatitis. Leptospirosis presumably caused community epidemics in Europe before 1900 and military epidemiologists carefully documented outbreaks in "constrained settings." Achille Kelsch (1841-1911) synthesized available military data and epidemiological perspectives to define "epidemic jaundice" as a nosological continuum, caused by an infectious agent found in muds and water. He viewed Weil's disease as being only one form of that now well-identified disease continuum. The causative pathogen and epidemiological determinants were identified years later. The role of soils and muds as intermediate reservoirs, as suggested by Kelsch, deserves further investigation.
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Affiliation(s)
| | - Cyrille Goarant
- Institut Pasteur de Nouvelle-Calédonie, Nouméa, New Caledonia
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14
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Meny P, Menéndez C, Ashfield N, Quintero J, Rios C, Iglesias T, Schelotto F, Varela G. Seroprevalence of leptospirosis in human groups at risk due to environmental, labor or social conditions. Rev Argent Microbiol 2019; 51:324-333. [PMID: 30979517 DOI: 10.1016/j.ram.2019.01.005] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2018] [Accepted: 01/08/2019] [Indexed: 12/30/2022] Open
Abstract
Leptospirosis is important in Uruguay due to the economic loss caused by the diseases of production animals, mainly bovines, and also due to frequent human infection. We decided to study anti-Leptospira antibodies in the sera of dairy workers, rice laborers, veterinarians, suburban slum dwellers and garbage recyclers. Our aims were to estimate the seroprevalence of infection by Leptospira spp. in these people at risk, the relative importance of the known risk factors associated with infection, and the impact of human infections in each setting. Groups at risk were identified and 35 visits to their locations were made, conducting field surveys and exchange talks for information and education. Simple epidemiological questionnaires were administered and sera samples were taken from 308 persons. The microagglutination Technique (MAT) and the IgM Indirect Immunofluorescence (IIF) assay were employed to detect antibodies. Environmental water samples, canine and equine sera were also examined. More than 45% of human sera were reactive and the studied groups were confirmed to be widely exposed to infection. Female sera were frequently reactive, though most illnesses occur in men, and the most severe cases in elderly males; the emergence and evolution of the disease may strongly depend on the host condition and functions. Animal contact and unsafe water usage were the main identified risk factors to be considered in prevention. Fifty per cent of the studied horses showed a positive MAT reaction. The underdiagnosis of the illness and its long-term symptoms require further study, as well as greater health and social attention efforts.
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Affiliation(s)
- Paulina Meny
- Bacteriology and Virology Department, Institute of Hygiene, Medicine Faculty, Universidad de la República, Uruguay
| | - Clara Menéndez
- Bacteriology and Virology Department, Institute of Hygiene, Medicine Faculty, Universidad de la República, Uruguay
| | - Natalia Ashfield
- Bacteriology and Virology Department, Institute of Hygiene, Medicine Faculty, Universidad de la República, Uruguay
| | - Jair Quintero
- Bacteriology and Virology Department, Institute of Hygiene, Medicine Faculty, Universidad de la República, Uruguay
| | - Cristina Rios
- Veterinary Public Health area, Veterinary Faculty, Universidad de la República, Uruguay
| | - Tamara Iglesias
- Bacteriology and Virology Department, Institute of Hygiene, Medicine Faculty, Universidad de la República, Uruguay
| | - Felipe Schelotto
- Bacteriology and Virology Department, Institute of Hygiene, Medicine Faculty, Universidad de la República, Uruguay.
| | - Gustavo Varela
- Bacteriology and Virology Department, Institute of Hygiene, Medicine Faculty, Universidad de la República, Uruguay
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15
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Meny P, Menéndez C, Quintero J, Hernández E, Ríos C, Balassiano IT, Trindade CNDR, Vital-Brazil JM, Ramos TMV, Ashfield N, Feble C, Avila E, Schelotto F, Varela G. Characterization of Leptospira isolates from humans and the environment in Uruguay. Rev Inst Med Trop Sao Paulo 2017; 59:e79. [PMID: 29267587 PMCID: PMC5738764 DOI: 10.1590/s1678-9946201759079] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2017] [Accepted: 09/12/2017] [Indexed: 01/30/2023] Open
Abstract
Laboratory diagnosis of human leptospirosis usually relies on indirect methods exploring specific immune response. Isolation and identification of the involved strains are cumbersome, but can provide biological resources for pathogenic studies and relevant information for guiding prevention and control measures. The aim of the research we are hereby reporting was the characterization of Leptospira isolates obtained from humans and the environment in Uruguay. Blood cultures were performed from early samples of 302 Uruguayan patients, mainly rural workers, and from 36 water samples taken from their living or working environments. Eight human isolates and seven environmental isolates were obtained and analyzed by end point Polymerase Chain Reaction (PCR), Multilocus Variable Number of Tandem Repeat Analysis (MLVA) and other molecular methods. Human isolates corresponded to several serogroups and serovars of Leptospira interrogans and Leptospira kirschneri species, probably reflecting the infection with similar involved Leptospira species and serovars of an extended animal reservoir in rural settings of the country, mostly dedicated to meat and dairy production. Culture-positive patients were older than usually affected workers, and presented signs and symptoms of severe illness. A high organic and circulating bacterial burden may explain an easier positive result from these workers’ samples. Environmental isolates were mainly identified as Leptospira biflexa strains, with a single L. meyeri isolate of uncertain significance.
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Affiliation(s)
| | | | | | | | | | - Ilana Teruszkin Balassiano
- Instituto Osvaldo Cruz, Centro de Referência Nacional para Leptospirose, WHO Collaborating Center for Leptospirosis, Laboratório de Zoonoses Bacterianas, Rio de Janeiro, Rio de Janeiro, Brazil
| | - Camilla Nunes Dos Reis Trindade
- Instituto Osvaldo Cruz, Centro de Referência Nacional para Leptospirose, WHO Collaborating Center for Leptospirosis, Laboratório de Zoonoses Bacterianas, Rio de Janeiro, Rio de Janeiro, Brazil
| | - Juliana Magalhães Vital-Brazil
- Instituto Osvaldo Cruz, Centro de Referência Nacional para Leptospirose, WHO Collaborating Center for Leptospirosis, Laboratório de Zoonoses Bacterianas, Rio de Janeiro, Rio de Janeiro, Brazil
| | - Tatiane Mendes Varela Ramos
- Instituto Osvaldo Cruz, Centro de Referência Nacional para Leptospirose, WHO Collaborating Center for Leptospirosis, Laboratório de Zoonoses Bacterianas, Rio de Janeiro, Rio de Janeiro, Brazil
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16
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Ledien J, Sorn S, Hem S, Huy R, Buchy P, Tarantola A, Cappelle J. Assessing the performance of remotely-sensed flooding indicators and their potential contribution to early warning for leptospirosis in Cambodia. PLoS One 2017; 12:e0181044. [PMID: 28704461 PMCID: PMC5509259 DOI: 10.1371/journal.pone.0181044] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2016] [Accepted: 06/26/2017] [Indexed: 12/27/2022] Open
Abstract
Remote sensing can contribute to early warning for diseases with environmental drivers, such as flooding for leptospirosis. In this study we assessed whether and which remotely-sensed flooding indicator could be used in Cambodia to study any disease for which flooding has already been identified as an important driver, using leptospirosis as a case study. The performance of six potential flooding indicators was assessed by ground truthing. The Modified Normalized Difference Water Index (MNDWI) was used to estimate the Risk Ratio (RR) of being infected by leptospirosis when exposed to floods it detected, in particular during the rainy season. Chi-square tests were also calculated. Another variable—the time elapsed since the first flooding of the year—was created using MNDWI values and was also included as explanatory variable in a generalized linear model (GLM) and in a boosted regression tree model (BRT) of leptospirosis infections, along with other explanatory variables. Interestingly, MNDWI thresholds for both detecting water and predicting the risk of leptospirosis seroconversion were independently evaluated at -0.3. Value of MNDWI greater than -0.3 was significantly related to leptospirosis infection (RR = 1.61 [1.10–1.52]; χ2 = 5.64, p-value = 0.02, especially during the rainy season (RR = 2.03 [1.25–3.28]; χ2 = 8.15, p-value = 0.004). Time since the first flooding of the year was a significant risk factor in our GLM model (p-value = 0.042). These results suggest that MNDWI may be useful as a risk indicator in an early warning remote sensing tool for flood-driven diseases like leptospirosis in South East Asia.
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Affiliation(s)
- Julia Ledien
- Epidemiology and Public Health Unit, Institut Pasteur du Cambodge, Phnom Penh, Cambodia
- * E-mail:
| | - Sopheak Sorn
- Epidemiology and Public Health Unit, Institut Pasteur du Cambodge, Phnom Penh, Cambodia
| | - Sopheak Hem
- Medical Biology Unit, Institut Pasteur du Cambodge, Phnom Penh, Cambodia
| | - Rekol Huy
- Centre National de Malariologie (CNM), Phnom Penh, Cambodia
| | | | - Arnaud Tarantola
- Epidemiology and Public Health Unit, Institut Pasteur du Cambodge, Phnom Penh, Cambodia
- Epidemiology unit, Institut Pasteur de Nouvelle-Calédonie, 11 rue Paul Doumer, Nouméa, New Caledonia
| | - Julien Cappelle
- Epidemiology and Public Health Unit, Institut Pasteur du Cambodge, Phnom Penh, Cambodia
- CIRAD-ES, UPR AGIRs, Montpellier, France
- UMR EPIA, INRA, VetAgro Sup, Univ Lyon, Marcy-l'étoile, France
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