International Journal of Environmental Research and Public Health

Editorial

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Open AccessEditorial

Leptospirosis: A Silent Epidemic Disease

by Maria Cristina Schneider, Michel Jancloes, Daniel F. Buss, Sylvain Aldighieri, Eric Bertherat, Patricia Najera, Deise I. Galan, Kara Durski and Marcos A. Espinal

Int. J. Environ. Res. Public Health 2013, 10(12), 7229-7234; https://doi.org/10.3390/ijerph10127229 - 16 Dec 2013

Cited by 70 | Viewed by 11836

Abstract

This special issue of International Journal of Environmental Research and Public Health is dedicated to leptospirosis, an endemic zoonotic disease that is a cause of many acute undifferentiated fevers, especially in tropical countries [1,2]. While it can be debated whether leptospirosis is an [...] Read more.

This special issue of International Journal of Environmental Research and Public Health is dedicated to leptospirosis, an endemic zoonotic disease that is a cause of many acute undifferentiated fevers, especially in tropical countries [1,2]. While it can be debated whether leptospirosis is an emerging disease, it is evident that it is becoming an emerging public health problem. It is recognized as a disease of epidemic potential that has a significant health impact in many parts of the world. [...] Full article

(This article belongs to the Special Issue Leptospirosis in the Animal—Human-Ecosystem Interface)

Research

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910 KiB

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Geographical Scale Effects on the Analysis of Leptospirosis Determinants

by Renata Gracie, Christovam Barcellos, Mônica Magalhães, Reinaldo Souza-Santos and Paulo Rubens Guimarães Barrocas

Int. J. Environ. Res. Public Health 2014, 11(10), 10366-10383; https://doi.org/10.3390/ijerph111010366 - 10 Oct 2014

Cited by 36 | Viewed by 8626

Abstract

Leptospirosis displays a great diversity of routes of exposure, reservoirs, etiologic agents, and clinical symptoms. It occurs almost worldwide but its pattern of transmission varies depending where it happens. Climate change may increase the number of cases, especially in developing countries, like Brazil. [...] Read more.

Leptospirosis displays a great diversity of routes of exposure, reservoirs, etiologic agents, and clinical symptoms. It occurs almost worldwide but its pattern of transmission varies depending where it happens. Climate change may increase the number of cases, especially in developing countries, like Brazil. Spatial analysis studies of leptospirosis have highlighted the importance of socioeconomic and environmental context. Hence, the choice of the geographical scale and unit of analysis used in the studies is pivotal, because it restricts the indicators available for the analysis and may bias the results. In this study, we evaluated which environmental and socioeconomic factors, typically used to characterize the risks of leptospirosis transmission, are more relevant at different geographical scales (i.e., regional, municipal, and local). Geographic Information Systems were used for data analysis. Correlations between leptospirosis incidence and several socioeconomic and environmental indicators were calculated at different geographical scales. At the regional scale, the strongest correlations were observed between leptospirosis incidence and the amount of people living in slums, or the percent of the area densely urbanized. At the municipal scale, there were no significant correlations. At the local level, the percent of the area prone to flooding best correlated with leptospirosis incidence. Full article

(This article belongs to the Special Issue Leptospirosis in the Animal—Human-Ecosystem Interface)

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Human Leptospirosis Trends: Northeast Thailand, 2001–2012

by Wilawan Thipmontree, Yupin Suputtamongkol, Wiwit Tantibhedhyangkul, Chuanpit Suttinont, Ekkarat Wongswat and Saowaluk Silpasakorn

Int. J. Environ. Res. Public Health 2014, 11(8), 8542-8551; https://doi.org/10.3390/ijerph110808542 - 20 Aug 2014

Cited by 23 | Viewed by 6357

Abstract

The objective of this study was to determine the changing trend of leptospirosis over time in Thailand using two prospective hospital-based studies conducted amongst adult patients with acute undifferentiated fever (AUFI) admitted to Maharat Nakhon Ratchasima Hospital, Nakhon Ratchasima Province, Thailand between July [...] Read more.

The objective of this study was to determine the changing trend of leptospirosis over time in Thailand using two prospective hospital-based studies conducted amongst adult patients with acute undifferentiated fever (AUFI) admitted to Maharat Nakhon Ratchasima Hospital, Nakhon Ratchasima Province, Thailand between July 2001 to December 2002 and between July 2011 to December 2012. During the first period, leptospirosis (98 patients, 40%) and scrub typhus (59 patients, 24.1%) were the two major causes of AUFI. In the second period, scrub typhus (137 patients, 28.3%) was found to be more common than leptospirosis (61 patients, 12.7%). Amongst patients with leptospirosis, the proportion of male patients and the median age were similar. Leptospira interrogans serogroup Autumnalis was the major infecting serogroup in both study periods. The case fatality rate of leptospirosis was significantly higher in 2011–2012 as compared with the case fatality rate in 2001–2002 (19.7% vs. 6.3%, p < 0.001). In summary, we found that number of leptospirosis cases had decreased over time. This trend is similar to reportable data for leptospirosis complied from passive surveillance by the Ministry of Public Health, Thailand. However, the case fatality rate of severe leptospirosis has increased. Severe lung hemorrhage associated with leptospirosis remained the major cause of death. Full article

(This article belongs to the Special Issue Leptospirosis in the Animal—Human-Ecosystem Interface)

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Open AccessArticle

Socioeconomic Factors and Vulnerability to Outbreaks of Leptospirosis in Nicaragua

by Jorge Bacallao, Maria Cristina Schneider, Patricia Najera, Sylvain Aldighieri, Aida Soto, Wilmer Marquiño, Carlos Sáenz, Eduardo Jiménez, Gilberto Moreno, Octavio Chávez, Deise I. Galan and Marcos A. Espinal

Int. J. Environ. Res. Public Health 2014, 11(8), 8301-8318; https://doi.org/10.3390/ijerph110808301 - 15 Aug 2014

Cited by 21 | Viewed by 9164

Abstract

Leptospirosis is an epidemic-prone zoonotic disease that occurs worldwide, with more than 500,000 human cases reported annually. It is influenced by environmental and socioeconomic factors that affect the occurrence of outbreaks and the incidence of the disease. Critical areas and potential drivers for [...] Read more.

Leptospirosis is an epidemic-prone zoonotic disease that occurs worldwide, with more than 500,000 human cases reported annually. It is influenced by environmental and socioeconomic factors that affect the occurrence of outbreaks and the incidence of the disease. Critical areas and potential drivers for leptospirosis outbreaks have been identified in Nicaragua, where several conditions converge and create an appropriate scenario for the development of leptospirosis. The objectives of this study were to explore possible socioeconomic variables related to leptospirosis critical areas and to construct and validate a vulnerability index based on municipal socioeconomic indicators. Municipalities with lower socioeconomic status (greater unsatisfied basic needs for quality of the household and for sanitary services, and higher extreme poverty and illiteracy rates) were identified with the highest leptospirosis rates. The municipalities with highest local vulnerability index should be the priority for intervention. A distinction between risk given by environmental factors and vulnerability to risk given by socioeconomic conditions was shown as important, which also applies to the “causes of outbreaks” and “causes of cases”. Full article

(This article belongs to the Special Issue Leptospirosis in the Animal—Human-Ecosystem Interface)

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Open AccessCommunication

Molecular Detection of Leptospiral DNA in Environmental Water on St. Kitts

by Julienne Rawlins, Alexandra Portanova, Ilana Zuckerman, Amanda Loftis, Pietro Ceccato, Arve Lee Willingham and Ashutosh Verma

Int. J. Environ. Res. Public Health 2014, 11(8), 7953-7960; https://doi.org/10.3390/ijerph110807953 - 7 Aug 2014

Cited by 31 | Viewed by 6826

Abstract

Leptospirosis is an important waterborne zoonotic disease caused by pathogenic Leptospira. The pathogen is maintained in a population due to chronic colonization and shedding from renal tubules of domestic and wild animals. Humans and other animals become infected when they come in [...] Read more.

Leptospirosis is an important waterborne zoonotic disease caused by pathogenic Leptospira. The pathogen is maintained in a population due to chronic colonization and shedding from renal tubules of domestic and wild animals. Humans and other animals become infected when they come in contact with urine from infected animals, either directly or through urine-contaminated surface water. In this study, we screened environmental water on the island of St. Kitts by using a TaqMan based real time quantitative polymerase chain reaction (qPCR) targeting a pathogen specific leptospiral gene, lipl32. Our results indicate that around one-fifth of tested water sources have detectable leptospiral DNA. Full article

(This article belongs to the Special Issue Leptospirosis in the Animal—Human-Ecosystem Interface)

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Open AccessArticle

Leptospira spp. in Rodents and Shrews in Germany

by Anne Mayer-Scholl, Jens Andre Hammerl, Sabrina Schmidt, Rainer G. Ulrich, Martin Pfeffer, Dietlinde Woll, Holger C. Scholz, Astrid Thomas and Karsten Nöckler

Int. J. Environ. Res. Public Health 2014, 11(8), 7562-7574; https://doi.org/10.3390/ijerph110807562 - 24 Jul 2014

Cited by 55 | Viewed by 11582

Abstract

Leptospirosis is an acute, febrile disease occurring in humans and animals worldwide. Leptospira spp. are usually transmitted through direct or indirect contact with the urine of infected reservoir animals. Among wildlife species, rodents act as the most important reservoir for both human and [...] Read more.

Leptospirosis is an acute, febrile disease occurring in humans and animals worldwide. Leptospira spp. are usually transmitted through direct or indirect contact with the urine of infected reservoir animals. Among wildlife species, rodents act as the most important reservoir for both human and animal infection. To gain a better understanding of the occurrence and distribution of pathogenic leptospires in rodent and shrew populations in Germany, kidney specimens of 2973 animals from 11 of the 16 federal states were examined by PCR. Rodent species captured included five murine species (family Muridae), six vole species (family Cricetidae) and six shrew species (family Soricidae). The most abundantly trapped animals were representatives of the rodent species Apodemus flavicollis, Clethrionomys glareolus and Microtus agrestis. Leptospiral DNA was amplified in 10% of all animals originating from eight of the 11 federal states. The highest carrier rate was found in Microtus spp. (13%), followed by Apodemus spp. (11%) and Clethrionomys spp. (6%). The most common Leptospira genomospecies determined by duplex PCR was L. kirschneri, followed by L. interrogans and L. borgpetersenii; all identified by single locus sequence typing (SLST). Representatives of the shrew species were also carriers of Leptospira spp. In 20% of Crocidura spp. and 6% of the Sorex spp. leptospiral DNA was detected. Here, only the pathogenic genomospecies L. kirschneri was identified. Full article

(This article belongs to the Special Issue Leptospirosis in the Animal—Human-Ecosystem Interface)

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Increasing Incidence of Canine Leptospirosis in Switzerland

by Andrea Major, Ariane Schweighauser and Thierry Francey

Int. J. Environ. Res. Public Health 2014, 11(7), 7242-7260; https://doi.org/10.3390/ijerph110707242 - 16 Jul 2014

Cited by 86 | Viewed by 11635

Abstract

A marked increase in canine leptospirosis was observed in Switzerland over 10 years with a peak incidence of 28.1 diagnosed cases/100,000 dogs/year in the most affected canton. With 95% affected dogs living at altitudes <800 m, the disease presented a seasonal pattern associated [...] Read more.

A marked increase in canine leptospirosis was observed in Switzerland over 10 years with a peak incidence of 28.1 diagnosed cases/100,000 dogs/year in the most affected canton. With 95% affected dogs living at altitudes <800 m, the disease presented a seasonal pattern associated with temperature (r² 0.73) and rainfall (r² 0.39), >90% cases being diagnosed between May and October. The increasing yearly incidence however was only weakly correlated with climatic data including number of summer (r² 0.25) or rainy days (r² 0.38). Serovars Australis and Bratislava showed the highest seropositivity rates with 70.5% and 69.1%, respectively. Main clinical manifestations included renal (99.6%), pulmonary (76.7%), hepatic (26.0%), and hemorrhagic syndromes (18.2%), leading to a high mortality rate (43.3%). Similar to the human disease, liver involvement had the strongest association with negative outcome (OR 16.3). Based on these data, canine leptospirosis presents similar features and severity as the human infection for which it therefore can be considered a model. Its re-emergence in a temperate country with very high incidence rates in canines should thus be viewed as a warning and emphasize the need for increased awareness in other species. Full article

(This article belongs to the Special Issue Leptospirosis in the Animal—Human-Ecosystem Interface)

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Leptospira Contamination in Household and Environmental Water in Rural Communities in Southern Chile

by Claudia Muñoz-Zanzi, Meghan R. Mason, Carolina Encina, Angel Astroza and Alex Romero

Int. J. Environ. Res. Public Health 2014, 11(7), 6666-6680; https://doi.org/10.3390/ijerph110706666 - 26 Jun 2014

Cited by 74 | Viewed by 9767

Abstract

Leptospirosis is a zoonosis of global distribution that affects tropical and temperate areas. Under suitable conditions, Leptospira can survive in water and soil and contribute to human and animal infections. The objective of this study was to describe the presence of pathogenic Leptospira [...] Read more.

Leptospirosis is a zoonosis of global distribution that affects tropical and temperate areas. Under suitable conditions, Leptospira can survive in water and soil and contribute to human and animal infections. The objective of this study was to describe the presence of pathogenic Leptospira in peri-domestic water samples from rural households in southern Chile. Water samples, including puddles, containers, animal troughs, rivers, canals, and drinking water were collected from 236 households and tested for Leptospira using a PCR assay targeting the lipL32 gene. Evidence of Leptospira presence was detected in all sample types; overall, 13.5% (77/570) samples tested positive. A total of 10/22 (45.5%) open containers, 12/83 (14.5%) animal drinking sources, 9/47 (19.1%) human drinking sources, and 36/306 (19.3%) puddles tested positive. Lower income (OR = 4.35, p = 0.003), increased temperature (OR = 1.23, p < 0.001), and presence of dogs (OR = 15.9, p = 0.022) were positively associated with positive puddles. Increased number of rodent signs was associated with positive puddles in the household (OR = 3.22); however, only in the lower income households. There was no association between PCR positive rodents and puddles at the household level. Results revealed the ubiquity of Leptospira in the household environment and highlight the need to develop formal approaches for systematic monitoring. Full article

(This article belongs to the Special Issue Leptospirosis in the Animal—Human-Ecosystem Interface)

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Open AccessCommunication

Though not Reservoirs, Dogs might Transmit Leptospira in New Caledonia

by Noellie Gay, Marie-Estelle Soupé-Gilbert and Cyrille Goarant

Int. J. Environ. Res. Public Health 2014, 11(4), 4316-4325; https://doi.org/10.3390/ijerph110404316 - 17 Apr 2014

Cited by 50 | Viewed by 8013

Abstract

Leptospira has been a major public health concern in New Caledonia for decades. However, few multidisciplinary studies addressing the zoonotic pattern of this disease were conducted so far. Here, pig, deer and dog samples were collected. Analyses were performed using molecular detection and [...] Read more.

Leptospira has been a major public health concern in New Caledonia for decades. However, few multidisciplinary studies addressing the zoonotic pattern of this disease were conducted so far. Here, pig, deer and dog samples were collected. Analyses were performed using molecular detection and genotyping. Serological analyses were also performed for dogs. Our results suggest that deer are a reservoir of L. borgpetersenii Hardjobovis and pigs a reservoir of L. interrogans Pomona. Interestingly, 4.4% of dogs were renal carriers of Leptospira. In dog populations, MAT results confirmed the circulation of the same Leptospira serogroups involved in human cases. Even if not reservoirs, dogs might be of significance in human contamination by making an epidemiological link between wild or feral reservoirs and humans. Dogs could bring pathogens back home, shedding Leptospira via their urine and in turn increasing the risk of human contamination. We propose to consider dog as a vector, particularly in rural areas where seroprevalence is significantly higher than urban areas. Our results highlight the importance of animal health in improving leptospirosis prevention in a One Health approach. Full article

(This article belongs to the Special Issue Leptospirosis in the Animal—Human-Ecosystem Interface)

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Open AccessArticle

Social Cost of Leptospirosis Cases Attributed to the 2011 Disaster Striking Nova Friburgo, Brazil

by Carlos Pereira, Martha Barata and Aline Trigo

Int. J. Environ. Res. Public Health 2014, 11(4), 4140-4157; https://doi.org/10.3390/ijerph110404140 - 15 Apr 2014

Cited by 9 | Viewed by 7160

Abstract

The aim of this study was to estimate the social cost of the leptospirosis cases that were attributed to the natural disaster of January 2011 in Nova Friburgo (State of Rio de Janeiro, Brazil) through a partial economic assessment. This study utilized secondary [...] Read more.

The aim of this study was to estimate the social cost of the leptospirosis cases that were attributed to the natural disaster of January 2011 in Nova Friburgo (State of Rio de Janeiro, Brazil) through a partial economic assessment. This study utilized secondary data supplied by the Municipal Health Foundation of Nova Friburgo. Income scenarios based on the national and state minimum wages and on average income of the local population were employed. The total social cost of leptospirosis cases attributed to the 2011 disaster may range between US$21,500 and US$66,000 for the lower income scenario and between US$23,900 and US$100,800 for that of higher income. Empirical therapy represented a total avoided cost of US$14,800, in addition to a reduction in lethality. An estimated 31 deaths were avoided among confirmed cases of the disease, and no deaths resulted from the leptospirosis cases attributed to the natural disaster. There has been a significant post-disaster rise in leptospirosis incidence in the municipality, which illustrates the potential for increased cases—and hence costs—of this illness following natural disasters, which justifies the adoption of preventive measures in environmental health. Full article

(This article belongs to the Special Issue Leptospirosis in the Animal—Human-Ecosystem Interface)

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Discovery of a Leptospirosis Cluster Amidst a Pneumonic Plague Outbreak in a Miners’ Camp in the Democratic Republic of the Congo

by Eric Bertherat, Melissa J. Mueller, Jean-Christophe Shako and Mathieu Picardeau

Int. J. Environ. Res. Public Health 2014, 11(2), 1824-1833; https://doi.org/10.3390/ijerph110201824 - 7 Feb 2014

Cited by 19 | Viewed by 6488

Abstract

Conditions in the Democratic Republic of the Congo provide an ideal environment for leptospirosis and plague, both of which can cause severe pulmonary manifestations. In December 2004, an outbreak of lethal pneumonia occurred in a local mining camp, affecting 130 persons and killing [...] Read more.

Conditions in the Democratic Republic of the Congo provide an ideal environment for leptospirosis and plague, both of which can cause severe pulmonary manifestations. In December 2004, an outbreak of lethal pneumonia occurred in a local mining camp, affecting 130 persons and killing 57 of them. Clinical signs, fast disease spread, and initial laboratory investigations suggested pneumonic plague. While leptospirosis had not recently been described in the region, it was considered as a differential diagnosis. Anti-Leptospira antibodies were detected by microscopic agglutination test (MAT). A confirmed case of leptospirosis was defined as having consistent clinical signs and any one of the following: seroconversion or four-fold increase in MAT titre for paired serum samples, or a MAT titre ≥ 1:400 for acute-phase serum samples. Twenty-nine of the 54 patients or convalescents tested for leptospirosis were seropositive. Two cases showed a confirmed infection for both plague and leptospirosis. While evidence supports the plague nature of this outbreak, the results suggest that some of the suspected plague cases might be due to leptospirosis. In any case, this diagnosis will have to be evoked in the future if a similar outbreak occurs in this region of Africa. Full article

(This article belongs to the Special Issue Leptospirosis in the Animal—Human-Ecosystem Interface)

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Sero-Prevalence and Risk Factors for Leptospirosis in Abattoir Workers in New Zealand

by Anou Dreyfus, Jackie Benschop, Julie Collins-Emerson, Peter Wilson, Michael G. Baker and Cord Heuer

Int. J. Environ. Res. Public Health 2014, 11(2), 1756-1775; https://doi.org/10.3390/ijerph110201756 - 5 Feb 2014

Cited by 48 | Viewed by 9549

Abstract

Leptospirosis is an important occupational disease in New Zealand. The objectives of this study were to determine risk factors for sero-prevalence of leptospiral antibodies in abattoir workers. Sera were collected from 567 abattoir workers and tested by microscopic agglutination for Leptospira interrogans sv. [...] Read more.

Leptospirosis is an important occupational disease in New Zealand. The objectives of this study were to determine risk factors for sero-prevalence of leptospiral antibodies in abattoir workers. Sera were collected from 567 abattoir workers and tested by microscopic agglutination for Leptospira interrogans sv. Pomona and Leptospira borgpetersenii sv. Hardjobovis. Association between prevalence and risk factors were determined by species specific multivariable analysis. Eleven percent of workers had antibodies against Hardjobovis or/and Pomona. Workers from the four sheep abattoirs had an average sero-prevalence of 10%–31%, from the two deer abattoirs 17%–19% and the two beef abattoirs 5%. The strongest risk factor for sero-positivity in sheep and deer abattoirs was work position. In sheep abattoirs, prevalence was highest at stunning and hide removal, followed by removal of the bladder and kidneys. Wearing personal protective equipment such as gloves and facemasks did not appear to protect against infection. Home slaughtering, farming or hunting were not significantly associated with sero-prevalence. There is substantial risk of exposure to leptospires in sheep and deer abattoirs in New Zealand and a persisting, but lower risk, in beef abattoirs. Interventions, such as animal vaccination, appear necessary to control leptospirosis as an occupational disease in New Zealand. Full article

(This article belongs to the Special Issue Leptospirosis in the Animal—Human-Ecosystem Interface)

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Human Leptospirosis on Reunion Island: Past and Current Burden

by Frédéric Pagès, Dominique Polycarpe, Jean-Sébastien Dehecq, Mathieu Picardeau, Nadège Caillère, Marie-Christine Jaffar-Bandjee, Alain Michault and Laurent Filleul

Int. J. Environ. Res. Public Health 2014, 11(1), 968-982; https://doi.org/10.3390/ijerph110100968 - 10 Jan 2014

Cited by 26 | Viewed by 8839

Abstract

Since 1953, leptospirosis has been recognized as a public health problem on Reunion Island. In 2004, was implemented a specific surveillance system that included systematic reporting and the realization of environmental investigations around hospitalized cases. Here, we present the synthesis of historical data [...] Read more.

Since 1953, leptospirosis has been recognized as a public health problem on Reunion Island. In 2004, was implemented a specific surveillance system that included systematic reporting and the realization of environmental investigations around hospitalized cases. Here, we present the synthesis of historical data and the assessment of 9 years of leptospirosis surveillance. From 2004 to 2012, 414 hospitalized cases were reported. Cases of leptospirosis occurred mostly during the rainy season from December to May. Approximately 41% of infections occurred at home, 12% of infections occurred during aquatic leisure and 5% of cases were linked to professional activities. Furthermore, for 41% of cases, the place of infection could not be determined due to the accumulation of residential and non-residential exposure. Most of the cases of leptospirosis were linked to rural areas or traditional, rural occupations. We did not observe a shift to recreational leptospirosis as described in some developed countries. According to the new surveillance system, the number of reported cases has regularly increased since 2004. This situation is in part due to the improvement of the system in the first years but also to a real increase in the number of detected cases due to the introduction of molecular methods and to increased biological investigation into the Dengue-like syndrome by medical practitioners on the island since the Chikungunya crisis in 2006. This increase is probably due to surveillance and diagnosis biases but need to be carefully monitored. Nevertheless, the possibility of an outbreak is always present due to climatic events, such as after the “hyacinth” hurricane in 1980. Full article

(This article belongs to the Special Issue Leptospirosis in the Animal—Human-Ecosystem Interface)

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Review

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Animal Leptospirosis in Latin America and the Caribbean Countries: Reported Outbreaks and Literature Review (2002–2014)

by Jessica Petrakovsky, Alejandra Bianchi, Helen Fisun, Patricia Nájera-Aguilar and Martha Maria Pereira

Int. J. Environ. Res. Public Health 2014, 11(10), 10770-10789; https://doi.org/10.3390/ijerph111010770 - 16 Oct 2014

Cited by 57 | Viewed by 12816

Abstract

Leptospirosis is a worldwide zoonotic disease whose transmission is linked through multiple factors in the animal-human-ecosystem interface. The data on leptospirosis reported to the World Organization for Animal Health (OIE) for Latin America and Caribbean (LAC) countries/sovereign territories from 2005–2011 were mapped, showing [...] Read more.

Leptospirosis is a worldwide zoonotic disease whose transmission is linked through multiple factors in the animal-human-ecosystem interface. The data on leptospirosis reported to the World Organization for Animal Health (OIE) for Latin America and Caribbean (LAC) countries/sovereign territories from 2005–2011 were mapped, showing a wide distribution of outbreaks in the region. Tropical terrestrial biomes are the predominate ecosystems showing reports of outbreaks. Climatic and ecological factors were relevant to the occurrence of epidemic outbreaks. The available scientific information from 2002–2014 was summarized to obtain a general overview and identify key issues related to the One Health approach. The primary serological test used for diagnosis and for conducting surveys was the microscopic agglutination test (MAT). Reports regarding the isolation and typing of leptospires were scattered and limited to data from a few countries, but their results revealed considerable biodiversity at the species and serovar levels. A total of six out of 11 currently named pathogenic species were found in the region. There was also high diversity of animal species showing evidence of infection by leptospires, including rodents, pets, livestock and wild animals. Prevention and control measures for leptospirosis should consider issues of animal and human health in the context of ecosystems, the territorial land borders of countries and trade. Full article

(This article belongs to the Special Issue Leptospirosis in the Animal—Human-Ecosystem Interface)

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Open AccessComment

A Global, Multi-Disciplinary, Multi-Sectorial Initiative to Combat Leptospirosis: Global Leptospirosis Environmental Action Network (GLEAN)

by Kara N. Durski, Michel Jancloes, Tej Chowdhary and Eric Bertherat

Int. J. Environ. Res. Public Health 2014, 11(6), 6000-6008; https://doi.org/10.3390/ijerph110606000 - 5 Jun 2014

Cited by 21 | Viewed by 7726

Abstract

Leptospirosis has emerged as a major public health problem in both animals and humans. The true burden of this epidemic and endemic disease is likely to be grossly under-estimated due to the non-specific clinical presentations of the disease and the difficulty of laboratory [...] Read more.

Leptospirosis has emerged as a major public health problem in both animals and humans. The true burden of this epidemic and endemic disease is likely to be grossly under-estimated due to the non-specific clinical presentations of the disease and the difficulty of laboratory confirmation. The complexity that surrounds the transmission dynamics, particularly in epidemic situations, requires a coordinated, multi-disciplinary effort. Therefore, the Global Leptospirosis Environmental Action Network (GLEAN) was developed to improve global and local strategies of how to predict, prevent, detect, and intervene in leptospirosis outbreaks in order to prevent and control leptospirosis in high-risk populations. Full article

(This article belongs to the Special Issue Leptospirosis in the Animal—Human-Ecosystem Interface)

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