leptospirosis: Topics by WorldWideScience.org [PDF]

Toggle navigation Topics by WorldWideScience.org Home About News Advanced Search Contact Us Site Map Help Sample records for leptospirosis « 1 2 3 4 5 » 1. [Leptospirosis Weyer, R.W. van der; Ramakers, B.P.; Pickkers, P. 2015-01-01 Leptospirosis is a zoonosis caused by pathogenic Leptospira species. Leptospira infection can range from subclinical to life-threatening disease. Renal failure and severe respiratory symptoms may occur and are associated with a high mortality rate. It is important to realise that renal failure and o 2. [Leptospirosis Weyer, R.W. van der; Ramakers, B.P.; Pickkers, P. 2015-01-01 Leptospirosis is a zoonosis caused by pathogenic Leptospira species. Leptospira infection can range from subclinical to life-threatening disease. Renal failure and severe respiratory symptoms may occur and are associated with a high mortality rate. It is important to realise that renal failure and 3. Leptospirosis vaccines Jin Li 2007-12-01 Full Text Available Abstract Leptospirosis is a serious infection disease caused by pathogenic strains of the Leptospira spirochetes, which affects not only humans but also animals. It has long been expected to find an effective vaccine to prevent leptospirosis through immunization of high risk humans or animals. Although some leptospirosis vaccines have been obtained, the vaccination is relatively unsuccessful in clinical application despite decades of research and millions of dollars spent. In this review, the recent advancements of recombinant outer membrane protein (OMP vaccines, lipopolysaccharide (LPS vaccines, inactivated vaccines, attenuated vaccines and DNA vaccines against leptospirosis are reviewed. A comparison of these vaccines may lead to development of new potential methods to combat leptospirosis and facilitate the leptospirosis vaccine research. Moreover, a vaccine ontology database was built for the scientists working on the leptospirosis vaccines as a starting tool. 4. Leptospirosis vaccines Jin Li; Wang Zhijun; WÄ™grzyn Alicja 2007-01-01 Abstract Leptospirosis is a serious infection disease caused by pathogenic strains of the Leptospira spirochetes, which affects not only humans but also animals. It has long been expected to find an effective vaccine to prevent leptospirosis through immunization of high risk humans or animals. Although some leptospirosis vaccines have been obtained, the vaccination is relatively unsuccessful in clinical application despite decades of research and millions of dollars spent. In this review, the... 5. Leptospirosis and Pets ... Bacterial Special Pathogens Branch (BSPB) BSPB Laboratory Submissions Pets Recommend on Facebook Tweet Share Compartir Leptospirosis is ... that can affect human and animals, including your pets. All animals can potentially become infected with Leptospirosis. ... 6. Hemorrhagic pulmonary leptospirosis; Leptospirosis hemorragica pulmonar Martin, V.; Lopez, P. [Complejo Hospitalario Nuestra Senora de la Candelaria. Sant Cruz de Tenerife (Spain) 2000-07-01 Leptospirosis is an infectious disease characteristic of humid eastern countries. It is relatively uncommon in the West. it usually presents with either hepatorenal or pulmonary involvement, two forms which generally overlap to a certain degree. We report a case of severe onset hemorrhagic pulmonary leptospirosis in a man who, during the course of the disease, presented multi systemic embolism (spleen, kidney and central nervous system). (Author) 11 refs. 7. MAT FOR LEPTOSPIROSIS DIAGNOSIS Esti Rahardianingtyas. 2014-06-01 Full Text Available Leptospirosis is a disease caused by bacterial infection leptospira interrogans.Leptospira bacteria is a spiral bacterium with solid strands with two flagella periplasmik.Septicaemic phase patient samples taken from the blood and cerebrospinal fluid, whereassamples taken at phase immune extracted from urine. The diagnosis of leptospirosis occurdirectly or indirectly. Diagnosis is done by directly isolate and identify the causative agents ofthe agent. Diagnosis is done indirectly by detecting specific antibodies from the patient's body.Gold Standard of the diagnosis of leptospirosis is MAT. Mat made by reacting antibodies toleptospira antigen. Positive results seen with clump formed.Key words: Leptospirosis, Leptospirosis Diagnostic, MAT (Microscopic Agglutination Test Leptospirosis merupakan penyakit yang disebabkan karena infeksi bakteri leptospirainterrogans. Bakteri leptospira merupakan bakteri spiral dengan untaian yang padat dengan duaflagella periplasmik. Sampel pasien pada fase septicaemic diambil dari darah dan cairanserebrospinal, sedangkan sampel yang diambil pada fase immune diambil dari urine. Diagnosisleptospirosis dilakukan secara langsung maupun tidak langsung. Diagnosis secara langsungdilakukan dengan cara mengisolasi agen penyebab dan mengidentifikasi agen tersebut. Diagnosissecara tidak langsung dilakukan dengan cara mendeteksi antibodi spesiflk dari dalam tubuhpasien. Gold Standart dari diagnosis leptospirosis adalah MAT. Mat dilakukan dengan caramereaksikan antibodi dengan antigen leptospira. Hasil positif dilihat dengan terbentuk gumpalanagglutinasiKata kunci: Leptospirosis, Leptospira, Leptospirosis Diagnosis. 8. Leptospirosis: public health perspectives. Guerra, Marta A 2013-09-01 Leptospirosis, caused by a spirochete of genus Leptospira, is considered the most widespread zoonosis in the world. It has a global distribution with a higher incidence in the tropics and subtropics, ranging from 10 to 100 human cases per 100,000 individuals. Leptospirosis is considered an "emerging" zoonosis due to increased contact between animals and humans and the resulting human encroachment into wildlife habitat. Climate change and its associated environmental shifts can affect the degree of transmission of leptospirosis. Surveillance for leptospirosis is important for early detection of cases because early treatment is crucial to decrease morbidity and mortality. In June 2012, the Council of State and Territorial Epidemiologists approved reinstatement of leptospirosis as a Nationally Notifiable Condition. Reinstatement of national surveillance will facilitate the assessment of the incidence, geographic distribution, trends, and risk factors associated with human cases and the identification of outbreaks and potential new animal reservoirs. 9. Leptospirosis in horses. Verma, Ashutosh; Stevenson, Brian; Adler, Ben 2013-11-29 Leptospirosis in horses has been considered a relatively uncommon infection. However, recent data suggest that the infection is widespread, with the incidence and infecting serovars varying considerably in different geographical regions. The majority of infections remain asymptomatic. Clinical signs in equine leptospirosis resemble those seen in other animal species. However, leptospirosis as a cause of acute respiratory distress is becoming more frequently recognised. A particular feature of equine leptospirosis is post infection recurrent uveitis (moon blindness or periodic ophthalmia), which appears to be mediated by autoimmune mechanisms involving cross reactivity between ocular tissues and leptospiral membrane proteins. There are no leptospiral vaccines licensed for use in horses, with no prospect for any becoming available in the foreseeable future. Accordingly, prevention of equine leptospirosis must rely on good hygiene practices, minimisation of rodent contact, and vaccination of other species of production and companion animals. 10. Pulmonary manifestations of leptospirosis Sameer Gulati 2012-01-01 Full Text Available Leptospirosis has a spectrum of presentation which ranges from mild disease to a severe form comprising of jaundice and renal failure. Involvement of the lung can vary from subtle clinical features to deadly pulmonary hemorrhage and acute respiratory distress syndrome. Of late, it has been identified that leptospirosis can present atypically with predominant pulmonary manifestations. This can delay diagnosis making and hence optimum treatment. The purpose of this review is to bring together all the reported pulmonary manifestations of leptospirosis and the recent trends in the management. 11. Atypical manifestations of leptospirosis. Rajapakse, Senaka; Rodrigo, Chaturaka; Balaji, Krishan; Fernando, Sumadhya Deepika 2015-05-01 Leptospirosis is an illness with a wide spectrum of clinical manifestations and severe illness affects nearly all organ systems. Serious and potentially life-threatening clinical manifestations of acute leptospirosis are caused by both direct tissue invasion by spirochaetes and by the host immune responses. In its severe form, leptospirosis can cause multiorgan dysfunction and death in a matter of days. Therefore it is critical to suspect and recognize the disease early, in order to initiate timely treatment. While the classical presentation of the disease is easily recognized by experienced clinicians practising in endemic regions, rarer manifestations can be easily missed. In this systematic review, we summarize the atypical manifestations reported in literature in patients with confirmed leptospirosis. Awareness of these unusual manifestations would hopefully guide clinicians towards early diagnosis. 12. Chest radiographic findings of leptospirosis Kim, Mee Hyun; Jung, Hee Tae; Lee, Young Joong; Yoon, Jong Sup [Hallym University College of Medicine, Seoul (Korea, Republic of) 1986-04-15 1. A study on chest radiographic findings of 54 cases with pneumonia like symptoms was performed. Of 54 cases, 8 cases were confirmed to be leptospirosis and 7 cases were leptospirosis combined with Korean hemorrhagic fever. 2. Of 8 cases of leptospirosis, 4 cases showed abnormal chest radiographic findings: acinar nodular type 2, massive confluent consolidation type 2. Of 7 cases of leptospirosis combined with Korean hemorrhagic fever: acinar nodular type 3, massive confluent consolidation type 1, and increased interstitial markings type 1 respectively. 3. It was considered to be difficult to diagnose the leptospirosis on chest radiographic findings alone, especially the case combined with Korean hemorrhagic fever. 13. Ovine leptospirosis in Brazil SB Lucheis 2011-01-01 Full Text Available Leptospirosis is a zoonosis distributed worldwide, endemic mainly in humid subtropical and tropical countries, with epidemic potential. It affects a range of both wild and domestic animals, including sheep, which transport leptospires in their urine and, therefore, can infect other animals and humans who deal with them. Therefore, leptospirosis is characterized as an occupational zoonosis. In individual herds leptospirosis can cause severe economic loss due to miscarriages and outbreaks of mastitis with a significant reduction of milk production. The disease is caused by Leptospira interrogans, which was reclassified into 13 pathogenic species, and distributed into more than 260 serovars classified into 23 serogroups. The clinical signs of infection may vary depending on the serovar and host. In maintenance hosts, antibody production is generally low; there are relatively mild signs of the disease, and a prolonged carrier state with organisms in the kidneys. In incidental hosts, the disease may be more severe, with high titers of circulating antibodies and a very short or nonexistent renal carrier state. In general, young animals with renal and hepatic failure have more serious infections than adults. Several diseases may produce symptoms similar to those of leptospirosis, so that laboratory confirmation, through microscopic agglutination test, for example, is required. The effectiveness of treatment depends on early diagnosis and appropriate therapy, depending on clinical features, since leptospirosis can develop into chronic liver disease and nephropathy, progressing towards death. Improvements in habitation and sanitary conditions, rodent control, vaccination, isolation and treatment of affected animals are the main measures for the control of leptospirosis. 14. Leptospirosis in elderly patients. Gancheva, Galya Ivanova 2013-01-01 Leptospirosis is a re-emerging zoonosis with broad clinical spectrum and high mortality in severe forms. The aim of this study was to analyze clinical manifestations, laboratory findings, epidemiological data, and management in elderly patients with leptospirosis. Toward that end, we performed a descriptive analysis of 15 leptospirosis elderly cases (age 6078 years) treated at the Clinic of Infectious Diseases of University Hospital - Pleven (1976-2012). Patients were serologically confirmed by microscopic agglutination test. Twelve cases (80%) presented with the severe form of leptospirosis. Co-morbidity (hypertonic diseases, chronic pulmonary diseases, chronic alcohol abuse, and diabetes) was registered in 13 cases. All cases had fever, oliguria, conjunctival suffusions, hepatosplenomegaly. Jaundice (14/93%), hemorrhagic diathesis (13/87%), vomiting (11/73%), abdominal pain (10/67%), myalgia (7/47%) and hypotension (7/47%) also were observed. Renal dysfunction was expressed by increased blood urea nitrogen (mean 38.1±24.1mmol/L) and serum creatinine (mean 347.6±179.8μmol/L). Hepatic dysfunction was expressed by increased total serum bilirubin level (mean 274.6±210.7μmol/L) and slightly elevated aminotransferases (ASAT mean 125.8±61.6IU/L; ALAT mean 131.3±126.5IU/L). Five cases (33%) had a lethal outcome. In conclusion, leptospirosis in elderly patients is associated with severe course and higher risk for death, and requires prompt intensive treatment. 15. Leptospirosis in elderly patients Galya Ivanova Gancheva 2013-10-01 Full Text Available Leptospirosis is a re-emerging zoonosis with broad clinical spectrum and high mortality in severe forms. The aim of this study was to analyze clinical manifestations, laboratory findings, epidemiological data, and management in elderly patients with leptospirosis. Toward that end, we performed a descriptive analysis of 15 leptospirosis elderly cases (age 60-78 years treated at the Clinic of Infectious Diseases of University Hospital - Pleven (1976-2012. Patients were serologically confirmed by microscopic agglutination test. Twelve cases (80% presented with the severe form of leptospirosis. Co-morbidity (hypertonic diseases, chronic pulmonary diseases, chronic alcohol abuse, and diabetes was registered in 13 cases. All cases had fever, oliguria, conjunctival suffusions, hepatosplenomegaly. Jaundice (14/93%, hemorrhagic diathesis (13/87%, vomiting (11/73%, abdominal pain (10/67%, myalgia (7/47% and hypotension (7/47% also were observed. Renal dysfunction was expressed by increased blood urea nitrogen (mean 38.1 ± 24.1 mmol/L and serum creatinine (mean 347.6 ± 179.8 µmol/L. Hepatic dysfunction was expressed by increased total serum bilirubin level (mean 274.6 ± 210.7 µmol/L and slightly elevated aminotransferases (ASAT mean 125.8 ± 61.6 IU/L; ALAT mean 131.3 ± 126.5 IU/L. Five cases (33% had a lethal outcome. In conclusion, leptospirosis in elderly patients is associated with severe course and higher risk for death, and requires prompt intensive treatment. 16. Leptospirosis in humans. Haake, David A; Levett, Paul N 2015-01-01 Leptospirosis is a widespread and potentially fatal zoonosis that is endemic in many tropical regions and causes large epidemics after heavy rainfall and flooding. Infection results from direct or indirect exposure to infected reservoir host animals that carry the pathogen in their renal tubules and shed pathogenic leptospires in their urine. Although many wild and domestic animals can serve as reservoir hosts, the brown rat (Rattus norvegicus) is the most important source of human infections. Individuals living in urban slum environments characterized by inadequate sanitation and poor housing are at high risk of rat exposure and leptospirosis. The global burden of leptospirosis is expected to rise with demographic shifts that favor increases in the number of urban poor in tropical regions subject to worsening storms and urban flooding due to climate change. Data emerging from prospective surveillance studies suggest that most human leptospiral infections in endemic areas are mild or asymptomatic. Development of more severe outcomes likely depends on three factors: epidemiological conditions, host susceptibility, and pathogen virulence (Fig. 1). Mortality increases with age, particularly in patients older than 60 years of age. High levels of bacteremia are associated with poor clinical outcomes and, based on animal model and in vitro studies, are related in part to poor recognition of leptospiral LPS by human TLR4. Patients with severe leptospirosis experience a cytokine storm characterized by high levels of IL-6, TNF-alpha, and IL-10. Patients with the HLA DQ6 allele are at higher risk of disease, suggesting a role for lymphocyte stimulation by a leptospiral superantigen. Leptospirosis typically presents as a nonspecific, acute febrile illness characterized by fever, myalgia, and headache and may be confused with other entities such as influenza and dengue fever. Newer diagnostic methods facilitate early diagnosis and antibiotic treatment. Patients progressing to 17. Pulmonary manifestation of leptospirosis Im, Jung Gi; Yeon, Kyung Mo; Han, Man Chung; Kim, Chu Wan; Lee, Jung Sang; Kim, Suhng Gwon; Han, Yong Chol; Chang, Woo Hyun; Chi, Je Geun [Seoul National University College of Medicine, Seoul (Korea, Republic of) 1986-02-15 Authors analysed and present chest X-ray findings of serologically proven leptospirosis from Seoul National University Hospital, either admitted or referred for serological verification, during recent 2 years. Radiological findings were correlated with the lung specimen findings of experimentally induced leptospirosis in guinea pig. The results are as follows: 1. 24 cases (56%) showed positive X-ray findings. 2. Predominant radiological patterns of involved lung were tiny dot, small nodule, rosette density in 11 cases, massive confluent consolidation in 4 cases, and diffuse ill-defined velly increased density in 9 cases. 3. Distribution of pulmonary lesions were bilateral (100%), non-lobar, non-segmental (95%), and there were conspicuous tendency of peripheral lung predominance. 4. Extrapulmonary manifestation, such as pleural effusion or cardiomegaly was rate. 5. Pulmonary lesions resolved completely usually 5 to 10 days after their appearance. 6. From the gross and microscopic findings of serially sacrificed guinea pig's lung and a case of autopsy, authors concluded that fine dot-like density in chest X-ray was due to paleolithic hemorrhage in intraalveolar space at initial stage, growing up to ressette density or confluent consolidation as the pathetic extends to surrounding lung forming purpura and coalescent hemorrhage. 18. Leptospirosis after a stay in Madagascar. Pagès, Frédéric; Kuli, Barbara; Moiton, Marie-Pierre; Goarant, Cyrille; Jaffar-Bandjee, Marie-Christine 2015-01-01 We report a case of polymerase chain reaction (PCR)-confirmed leptospirosis in a patient who recently traveled to Madagascar, a country where only two cases have been reported since 1955. Although laboratory and clinical presentations were atypical and despite leptospirosis not being a documented disease in Madagascar, blood and urine tests for leptospirosis enabled retrospective confirmation of the diagnosis. 19. Leptospirosis presenting as honeymoon fever. de Sainte Marie, B; Delord, M; Dubourg, G; Gautret, P; Parola, P; Brouqui, P; Lagier, J C 2015-05-01 An increasing number of travelers from western countries visit tropical regions, questioning western physicians on the prophylaxis, the diagnosis and the therapeutic management of patients with travel-associated infection. In July 2014, a French couple stayed for an adventure-travel in Columbia without malaria prophylaxis. A week after their return the woman presented with fever, myalgia, and retro-orbital pain. Three days later, her husband presented similar symptoms. In both patients, testing for malaria, arboviruses and blood cultures remained negative. An empirical treatment with doxycycline and ceftriaxone was initiated for both patients. Serum collected from the female patient yielded positive IgM for leptospirosis but was negative for her husband. Positive Real-Time PCR were observed in blood and urine from both patients, confirming leptospirosis. Three lessons are noteworthy from this case report. First, after exclusion of malaria, as enteric fever, leptospirosis and rickettsial infection are the most prevalent travel-associated infections, empirical treatment with doxycycline and third generation cephalosporin should be considered. In addition, the diagnosis of leptospirosis requires both serology and PCR performed in both urine and blood samples. Finally, prophylaxis using doxycycline, also effective against leptospirosis, rickettsial infections or travellers' diarrhea should be recommended for adventure travelers in malaria endemic areas. 20. Unusual clinical manifestations of leptospirosis Bal A 2005-01-01 Full Text Available Leptospirosis has protean clinical manifestations. The classical presentation of the disease is an acute biphasic febrile illness with or without jaundice. Unusual clinical manifestations may result from involvement of pulmonary, cardiovascular, neural, gastrointestinal, ocular and other systems. Immunological phenomena secondary to antigenic mimicry may also be an important component of many clinical features and may be responsible for reactive arthritis. Leptospirosis in early pregnancy may lead to fetal loss. There are a few reports of leptospirosis in HIV- infected individuals but no generalisation can be made due to paucity of data. It is important to bear in mind that leptospiral illness may be a significant component in cases of dual infections or in simultaneous infections with more than two pathogens.

« 1 2 3 4 5 » « 1 2 3 4 5 » 21. Leptospirosis in rural Sri Lanka: Hellung Schønning, Marie; Agampodi, Suneth; Phelps, Matthew 2016-01-01 Sri Lanka has one of the highest incidences of human leptospirosis worldwide. Outbreaks of this zoonotic infection are related to the monsoons and flooding. The present study investigates risks associated with environmental, animal and occupational exposure. Data was obtained from structured.......213-93.582). Leptospirosis in paddy workers was associated with environmental factors linked to contamination and wetness in paddy fields. Interestingly abandoned paddy fields were found to have a protective effect against transmission to paddy workers (OR=0.421, 95% CI 0.237-0.748). Keeping animals on these dryer fields...... may act as a boundary for contamination of paddy fields with infectious animal urine. This finding could be considered in public health interventions targeting leptospirosis among paddy workers.... 22. Pulmonary hemorrhage resulting from leptospirosis Mauro Razuk Filho 2016-07-01 Full Text Available Leptospirosis is one of the most widespread zoonoses in the world, although the mechanisms responsible for the pathogenesis of spirochetes of the genus Leptospira are largely unknown. Human infection occurs either by direct contact with infected animals or indirectly, through contact with water or soil contaminated with urine, as the spirochetes easily penetrate human skin. The present report exposes the case of a female patient, diagnosed with leptospirosis after having had contact with a dog infected by Leptospira sp. that developed pulmonary hemorrhage, acute respiratory distress syndrome and acute renal failure. 23. A serological study of leptospirosis in Chennai R. Kanimozhi 2016-01-01 Conclusions: This study shows leptospirosis found more common among female than male, probably due to occupational status of leptospirosis. Based on our study we suggest that senior age group people (age more than 60 years are highly proven to this disease probably due to the less immunity factor. [Int J Res Med Sci 2016; 4(1.000: 268-271 24. Leptospirosis and Peripheral Artery Occlusive Disease Chiu, Chun-Hsiang; Lin, Cheng-Li; Lee, Feng-You; Wang, Ying-Chuan; Kao, Chia-Hung 2016-01-01 Abstract Data on the association between peripheral artery occlusive disease (PAOD) and leptospirosis are limited. We conducted a retrospective cohort study for determining whether leptospirosis is one of the possible risk factors for PAOD. Patients diagnosed with leptospirosis by using 2000 to 2010 data from the Taiwan National Health Insurance Research Database. Patients with leptospirosis without a history of PAOD were selected. For each leptospirosis patient, 4 controls without a history of leptospirosis and PAOD were randomly selected and frequency-matched for sex, age, the year of the index date, and comorbidity diseases. The follow-up period was from the time of the initial diagnosis of leptospirosis to the diagnosis date of PAOD, or December 31, 2011. The Cox proportional hazard regression models were used for analyzing the risk of PAOD. During the followup period, the cumulative incidence of PAOD was higher among the patients from the leptospirosis cohort than among the nonleptospirosis cohort (log-rank test, P 10–50%) is poorly understood. We conducted a multi-parameter investigation of patients with acute leptospirosis to identify mechanisms associated with case fatality. Whole blood transcriptional profiling of 16 hospitalized Brazilian patients with acute leptospirosis (13 survivors, 3 deceased) revealed fatal cases had lower expression of the antimicrobial peptide, cathelicidin, and chemokines, but more abundant pro-inflammatory cytokine receptors. In contrast, survivors generated strong adaptive immune signatures, including transcripts relevant to antigen presentation and immunoglobulin production. In an independent cohort (23 survivors, 22 deceased), fatal cases had higher bacterial loads (P = 0.0004) and lower anti-Leptospira antibody titers (P = 0.02) at the time of hospitalization, independent of the duration of illness. Low serum cathelicidin and RANTES levels during acute illness were independent risk factors for higher bacterial loads (P = 0.005) and death (P = 0.04), respectively. To investigate the mechanism of cathelicidin in patients surviving acute disease, we administered LL37, the active peptide of cathelicidin, in a hamster model of lethal leptospirosis and found it significantly decreased bacterial loads and increased survival. Our findings indicate that the host immune response plays a central role in severe leptospirosis disease progression. While drawn from a limited study size, significant conclusions include that poor clinical outcomes are associated with high systemic bacterial loads, and a decreased antibody response. Furthermore, our data identified a key role for the antimicrobial peptide, cathelicidin, in mounting an effective bactericidal response against the pathogen, which represents a valuable new therapeutic approach for leptospirosis. PMID:27812211 38. Leptospirosis: An Unusual Cause of ARDS Marc Clavel 2010-01-01 Full Text Available Severe leptospirosis usually associates shock, jaundice, renal failure, and thrombocytopenia. Massive hemoptysis due to diffuse alveolar haemorrhage may rarely occur leading to an acute respiratory failure and multiple organ failure. We present the case of an acute respiratory distress syndrome caused by a severe leptospirosis. The severity of the respiratory failure contrasted with the absence of significant liver or renal dysfunction. Bedside open lung biopsy was only consistent with a postinfectious BOOP. The diagnosis was retrospective when the niece of the patient presented with similar inaugural symptoms ten days later after being scratched by a wild rat which was considered by our patient as a pet. 39. Leptospirosis and Peripheral Artery Occlusive Disease: A Nationwide Cohort Analysis. Chiu, Chun-Hsiang; Lin, Cheng-Li; Lee, Feng-You; Wang, Ying-Chuan; Kao, Chia-Hung 2016-03-01 Data on the association between peripheral artery occlusive disease (PAOD) and leptospirosis are limited. We conducted a retrospective cohort study for determining whether leptospirosis is one of the possible risk factors for PAOD. Patients diagnosed with leptospirosis by using 2000 to 2010 data from the Taiwan National Health Insurance Research Database. Patients with leptospirosis without a history of PAOD were selected. For each leptospirosis patient, 4 controls without a history of leptospirosis and PAOD were randomly selected and frequency-matched for sex, age, the year of the index date, and comorbidity diseases. The follow-up period was from the time of the initial diagnosis of leptospirosis to the diagnosis date of PAOD, or December 31, 2011. The Cox proportional hazard regression models were used for analyzing the risk of PAOD. During the follow-up period, the cumulative incidence of PAOD was higher among the patients from the leptospirosis cohort than among the nonleptospirosis cohort (log-rank test, P leptospirosis cohort and 81 from the nonleptospirosis cohort were observed with the incidence rates of 2.1 and 1.3 per 1000 person-years, respectively, yielding a crude hazards ratio (HR) of 1.62 (95% confidence interval [CI] = 1.44-1.81) and adjusted HR (aHR) of 1.75 (95% CI = 1.58-1.95).The risk of PAOD was 1.75-fold higher in the patients with leptospirosis than in the general population. 40. A comparative study of leptospirosis and dengue in Thai children. Daniel H Libraty Full Text Available Leptospirosis is an emerging zoonosis that is often under-recognized in children and commonly confused with dengue in tropical settings. An enhanced ability to distinguish leptospirosis from dengue in children would guide clinicians and public health personnel in the appropriate use of limited healthcare resources.We conducted a prospective, hospital-based, study of children with acute febrile illnesses and dengue in Thailand. Among the children without dengue, we identified those with leptospirosis using anti-leptospira IgM and microscopic agglutination titers in paired acute and convalescent blood samples. We then performed a case-control comparison of symptoms, signs, and clinical laboratory values between children with leptospirosis and dengue. In a semi-rural region of Thailand, leptospirosis accounted for 19% of the non-dengue acute febrile illnesses among children presenting during the rainy season. None of the children with leptospirosis were correctly diagnosed at the time of hospital discharge, and one third (33% were erroneously diagnosed as dengue or scrub typhus. A predictive model to distinguish pediatric leptospirosis from dengue was generated using three variables: the absolute neutrophil count, plasma albumin, and aspartate aminotransferase levels in the first 72 hours of illness.Unrecognized leptospirosis can be a significant cause of "dengue-like" febrile illness in children. Increased awareness of pediatric leptospirosis, and an enhanced ability to discriminate between leptospirosis and dengue early in illness, will help guide the appropriate use of healthcare resources in often resource-limited settings. «

1 2 3 4 5 » « 1 2 3 4 5 » 41. Leptospirosis: epidemiology, clinical aspects and diagnosis M.G.A. Goris (Marga) 2016-01-01 markdownabstractLeptospirosis is among the most widespread zoonotic diseases in the world. The clinical manifestations of the disease are not specific, can vary widely and therefore are consistent with many other diseases. A diagnosis can only be confirmed with certainty by laboratory tests. Infecti 42. Leptospirosis in a Dutch catfish farm Kolwijck, E.; Dofferhoff, A.S.M.; Leur, J. van der; Meis, J.F.G.M. 2011-01-01 A 51-year-old farm worker presented with jaundice and fever. There had been a rat infestation around the farm ponds and in the shed. He was admitted to our hospital with acute renal and liver failure, thrombocytopenia and rhabdomyolysis. Because of the clinical clues, leptospirosis was suspected and 43. Leptospirosis: epidemiology, clinical aspects and diagnosis M.G.A. Goris (Marga) 2016-01-01 markdownabstractLeptospirosis is among the most widespread zoonotic diseases in the world. The clinical manifestations of the disease are not specific, can vary widely and therefore are consistent with many other diseases. A diagnosis can only be confirmed with certainty by laboratory tests. 44. Leptospirosis-associated hospitalizations, United States, 1998-2009. Traxler, Rita M; Callinan, Laura S; Holman, Robert C; Steiner, Claudia; Guerra, Marta A 2014-08-01 A small percentage of persons with leptospirosis, a reemerging zoonosis, experience severe complications that require hospitalization. The number of leptospirosis cases in the United States is unknown. Thus, to estimate the hospitalization rate for this disease, we analyzed US hospital discharge records for 1998-2009 for the total US population by using the Nationwide Inpatient Sample. During that time, the average annual rate of leptospirosis-associated hospitalizations was 0.6 hospitalizations/1,000,000 population. Leptospirosisassociated hospitalization rates were higher for persons >20 years of age and for male patients. For leptospirosis-associated hospitalizations, the average age of patients at admission was lower, the average length of stay for patients was longer, and hospital charges were higher than those for nonleptospirosis infectious disease-associated hospitalizations. Educating clinicians on the signs and symptoms of leptospirosis may result in earlier diagnosis and treatment and, thereby, reduced disease severity and hospitalization costs. 45. LEPTOSPIROSIS PADA MANUSIA DI KABUPATEN BANYUMAS, PROVINSI JAWA TENGAH Bina Ikawati 2013-09-01 Full Text Available ABSTRACT. Leptospirosis is one of infected diseases that caused by bacteria pathogen called Leptospira Sp,transmitted direct or indirect from infected animal to human, also known as zoonotic deseases. Indonesia includein middle category for leptospirosis incidence with 1-10 per 100.000 population.Leptospirosis in Central Java at2011 reported in Demak, Purworejo, Klaten, Pati, Wonogiri, Cilacap, Jepara District, Semarang District andSemarang City. Clinical leptospirosis in Banyumas District found but underreported. Aimed of this research wasto confirm leptospirosis at human in Banyumas district. Cross sectional design by case screening in 3 hospital and2 Primary Health Care at Juni-November 2012. Sera from patient examine by leptotec IgG IgM and MAT(Microscopic Aglutination Test, risk factor tracer had been done in patient from Banyumas. As much 25 clinicalleptospirosis examinated with laboratory test showed 6 serra positive by leptotec IgG IgM and with MAT(Microscopic Aglutination Test. MAT test showed 4 sera clinical leptospirosis that reactive with Leptospira Spand 1 negative but reactive at low titre 1:80. Risk factor of leptospirosis was flood and poor housing, bad hygienesanitation, bad waste management. Leptospirosis case confirmed in BanyumasKey words: leptospirosis, Banyumas 46. Human Leptospirosis Trends: Northeast Thailand, 2001–2012 Wilawan Thipmontree 2014-08-01 Full Text Available 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. 47. Leptospirosis: a globally increasing zoonotic disease. Rock, Clare 2010-01-01 A 27-year-old previously healthy man was admitted to the intensive care unit with severe jaundice, dyspnoea with haemoptysis, anaemia, thrombocytopenia and acute renal injury. He had no recent history of foreign travel but had been building a shed in his back garden in Cork, Ireland, for the preceding week. The patient\\'s history, clinical observations, haematological and radiological results were all consistent with icteric leptospirosis or Weil\\'s disease. This was confirmed on serological testing. He completed 7 days intravenous ceftriaxone and made a complete recovery. While endemic in tropical climates, leptospirosis incidence is increasing in temperate climates. Recent cases seen in temperate climates can be severe, particularly with pulmonary manifestations. The report of this case serves to increase awareness of this re-emerging potentially fatal infectious disease. 48. Leptospirosis: an emerging global public health problem P Vijayachari; A P Sugunan; A N Shriram 2008-11-01 Leptospirosis has been recognized as an emerging global public health problem because of its increasing incidence in both developing and developed countries. A number of leptospirosis outbreaks have occurred in the past few years in various places such as Nicaragua, Brazil and India. Some of these resulted due to natural calamities such as cyclone and floods. It is a direct zoonotic disease caused by spirochetes belonging to different pathogenic species of the genus Leptospira. Large number of animals acts as carriers or vectors. Human infection results from accidental contact with carrier animals or environment contaminated with leptospires. The primary source of leptospires is the excretor animal, from whose renal tubules leptospires are excreted into the environment with the animal urine. Majority of leptospiral infections are either sub clinical or result in very mild illness and recover without any complications. However, a small proportion develops various complications due to involvement of multiple organ systems. In such patients, the clinical presentation depends upon the predominant organs involved and the case fatality ratio could be about 40% or more. Febrile illness with icterus, splenomegaly and nephritis (known as Weil’s disease), acute febrile illness with severe muscle pain, febrile illness with pulmonary haemorrhages in the form of haemoptysis, jaundice with pulmonary haemorrhages, jaundice with heamaturea, meningitis with haemorrhages including sub conjunctival haemorrhage or febrile illness with cardiac arrhythmias with or without haemorrhages are some of the syndromes. Because of the protean manifestations of leptospirosis it is often misdiagnosed and under-reported. Although the basic principles of prevention such as source reduction, environmental sanitation, more hygienic work-related and personal practices etc., are same everywhere, there is no universal control method applicable to all epidemiological settings. Comprehensive 49. Pigs leptospirosis at the territory of Belgrade Vojinović Dragica 2014-01-01 Full Text Available Examinations of pig blood samples have been carried out at public pig farms in three Belgrade municipalities: Palilula, Surcin and Obrenovac. The number of tested blood serums of pigs at Palilula was 18990, in Surcin 7739 and in Obrenovac it was 8200. The number of positive blood serums on leptospirosis in pigs was 760, and out of that number the most positive samples (496 were in Surcin, followed by Palilula (217, and the least were found in Obrenovac (47. In the period from 2000 to 2009, there were tested 34929 blood serums of pigs from farms located at the territory of Belgrade. For the investigations there was used the microscopic agglutination test (MAT on seven varieties of L. interrogans: L. pomona, L. icterohaemorrhagiae, L. grippotyphosa, L. sejroe, L. canicola, L. bataviae and L. australis. Seropositivity in pigs was determined in 760 blood serums, or in 2.17%. Leptospirosis prevalence was not very high, but it was constant, which indicates that leptospirosis infection maintained at the territory of Belgrade for ten years throughout our continual investigation. 50. Diagnostic testing for Leptospirosis in California sea lions (Zalophus californianus) Leptospirosis is a relatively common bacterial disease in California sea lions (Zalophus californianus); however, there remain gaps in our understanding of maintenance hosts relative to animals demonstrating clinical disease. To effectively study the epidemiology of leptospirosis in any species, a s... 51. Leptospirosis in a French traveler returning from Mauritius. Simon, Fabrice; Morand, Gabriel; Roche, Céline; Coton, Thierry; Kraemer, Philippe; Fournier, Pierre-Edouard; Gautret, Philippe 2012-01-01 We report the first case of leptospirosis in a patient with a travel history to Mauritius, where the disease has very occasionally been reported in local populations. Following an initial dengue-like presentation, the patient suffered pancreatic involvement and trigeminal neuralgia, which are two unusual delayed features of leptospirosis. 52. European consensus statement on leptospirosis in dogs and cats Leptospirosis is a zoonotic disease of worldwide distribution affecting most mammalian species. Clinical leptospirosis is common in dogs but seems to be rare in cats. Both dogs and cats however, can shed leptospires in the urine. This is problematic as it can lead to exposure of humans. The control ... 53. Leptospirosis in Ireland: annual incidence and exposures associated with infection. Garvey, P 2013-08-05 SUMMARY Human leptospirosis is found throughout the world, albeit with a higher incidence in tropical regions. In temperate regions it is associated with certain occupational and recreational activities. This paper reports both on the incidence of human leptospirosis in Ireland and on possible associated exposures, using leptospirosis case notification, enhanced surveillance, hospital discharge data and death registrations. Based on official notification data, there was a threefold increase in the reported incidence of leptospirosis in Ireland between 1995-1999 and 2004-2009, which appears partially to be due to improved reporting. The exposures most associated with infection were those involving contact with livestock or water-based recreational sports, in particular kayaking. Advice on prevention should continue to be targeted in the first instance at these groups. The variety of potential transmission routes reported should inform clinicians to consider leptospirosis in individuals with a compatible clinical profile who were not from occupational groups historically considered at risk. 54. Leptospirosis in Ireland: annual incidence and exposures associated with infection. Garvey, P; Connell, J; O'Flanagan, D; McKeown, P 2014-04-01 Human leptospirosis is found throughout the world, albeit with a higher incidence in tropical regions. In temperate regions it is associated with certain occupational and recreational activities. This paper reports both on the incidence of human leptospirosis in Ireland and on possible associated exposures, using leptospirosis case notification, enhanced surveillance, hospital discharge data and death registrations. Based on official notification data, there was a threefold increase in the reported incidence of leptospirosis in Ireland between 19951999 and 2004-2009, which appears partially to be due to improved reporting. The exposures most associated with infection were those involving contact with livestock or waterbased recreational sports, in particular kayaking. Advice on prevention should continue to be targeted in the first instance at these groups. The variety of potential transmission routes reported should inform clinicians to consider leptospirosis in individuals with a compatible clinical profile who were not from occupational groups historically considered at risk. 55. Pathology and pathophysiology of pulmonary manifestations in leptospirosis Marisa Dolhnikoff 2007-02-01 Full Text Available Leptospirosis is a re-emerging zoonosis occurring as large outbreaks throughout the world caused by Leptospira interrogans. The incidence of pulmonary involvement in leptospirosis has been reported to be increasing in the last years, affecting up to 70% of the patients. Alveolar hemorrhage presented as dyspnea and hemoptysis is the main pulmonary manifestation. The emergence of massive hemoptysis and acute respiratory distress syndrome has characterized the recent changes reported in the clinical patterns of leptospirosis. The pulmonary involvement has been emerged as a serious life threat, becoming the main cause of death due to leptospirosis in some countries. In this review we present the main clinical and pathological manifestations of pulmonary involvement in leptospirosis, with special focus on recent data concerning the pathophysiological mechanisms underlying lung injury. 56. Acalculous cholecystitis：A rare presentation of leptospirosis progressing to Weil’s disease George Peter; Hegde Narasimha 2011-01-01 Leptospirosis is a zoonotic infection with higher incidence in tropics. Leptospirosis, is known for its variable manifestations, and is a clinical challenge for physicians in the tropics. Experienced clinicians, at times can mistake leptospirosis for non-medical conditions. A few reports of leptospirosis presenting as acalculous cholecystitis was found in review of literature. We intent to highlight acalculous cholecystitis as a rare but clinically significant presentation of leptospirosis. 57. Valuing human leptospirosis prevention using the opportunity cost of labor. Arbiol, Joseph; Borja, Maridel; Yabe, Mitsuyasu; Nomura, Hisako; Gloriani, Nina; Yoshida, Shin-ichi 2013-05-03 Leptospirosis is a serious public health concern in the Philippines, not only because of its increasing incidence rate, but also because of its significant health and economic impacts. Despite its relatively high seroprevalence, knowledge on the economic burden of disease, particularly on the value that the society places on disease prevention remains limited. Obtaining such information is important within the context of public health policy. This study was conducted in Metro Manila to determine the economic burden of leptospirosis, by asking respondents about their willingness to contribute to labor (WTCL) for the prevention of leptospirosis. The respondents pledged an average labor contribution of 10.66 h/month. The average WTCL corresponded to a monetary value of US$4.01 per month when valued using the opportunity cost of labor (leisure rate of time). From the monetized labor contribution, the total economic value of preventing leptospirosis was estimated at US$124.97 million per annum, which represents 1.13% of Metro Manila's gross domestic product (GDP). Estimates from a Tobit regression model identified the respondents' knowledge regarding leptospirosis, the susceptibility of their homes to flooding, and the proximity of their homes to sewers as significant factors to consider when developing resource contribution programs for leptospirosis prevention. More efforts need to be made in developing community level preventive programs, and in improving public's knowledge and awareness about leptospirosis. 58. Human leptospirosis distribution pattern analysis in Hulu Langat, Selangor Zulkifli, Zuhafiza; Shariff, Abdul Rashid Mohamed; Tarmidi, Zakri M. 2016-06-01 This paper discussed the distribution pattern of human leptospirosis in the Hulu Langat District, Selangor, Malaysia. The data used in this study is leptospirosis cases’ report, and spatial boundaries. Leptospirosis cases, data were collected from Health Office of Hulu Langat and spatial boundaries, including lot and district boundaries was collected from the Department of Mapping and Surveying Malaysia (JUPEM). A total of 599 leptospirosis cases were reported in 2013, and this data was mapped based on the addresses provided in the leptospirosis cases’ report. This study uses three statistical methods to analyze the distribution pattern; Moran's I, average nearest neighborhood (ANN) and kernel density estimation. The analysis was used to determine the spatial distribution and the average distance of leptospirosis cases and located the hotspot locations. Using Moran's I analysis, results indicated the cases were random, with a value of -0.202816 which show negative spatial autocorrelation exist among leptospirosis cases. The ANN analysis result, indicated the cases are in cluster pattern, with value of the average nearest neighbor ratio is -21.80. And results also show the hotspots are has been identified and mapped in the Hulu Langat District. 59. Human leptospirosis trends: northeast Thailand, 2001-2012. Thipmontree, Wilawan; Suputtamongkol, Yupin; Tantibhedhyangkul, Wiwit; Suttinont, Chuanpit; Wongswat, Ekkarat; Silpasakorn, Saowaluk 2014-08-20 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 Thailand. However, the case fatality rate of severe leptospirosis has increased. Severe lung hemorrhage associated with leptospirosis remained the major cause of death. 60. Standardized morbidity ratio for leptospirosis mapping in Malaysia Awang, Aznida Che; Samat, Nor Azah 2017-05-01 Leptospirosis is a worldwide zoonotic disease that affects human health in many parts of the world including Malaysia. Leptospirosis is a disease caused by the infection of pathogenic Leptospira genus called Spirochaetes. Leptospirosis can be transmitted directly or indirectly from rats to human. The human infection is usually caused by human contact with urine or tissues of infected animal. This disease can be spread through mucus membrane such as mouth, nose and eyes, ingestion of contaminated food and water and also exposed injured skin to contaminated water or soil. There is still no vaccine currently available for the prevention or treatment of leptospirosis disease but this disease can be treated if it is diagnosed early. Therefore, the aim of this study is to estimate the relative risk for leptospirosis disease based initially on the most common statistic used in the study of disease mapping called Standardized Morbidity Ratio (SMR). We then apply SMR to leptospirosis data obtained in Malaysia. The results show that the states of Melaka have very high risk areas. The states of Kedah, Terengganu and Kelantan are identified as high risk areas. The states of Perak, Perlis, Sabah and Sarawak showed medium risk areas. This is followed by low risk by other states except Pahang, Johor and Labuan with very low risk areas. In conclusion, SMR method is the best method for mapping leptospirosis because by referring to the relative risk maps, the states that deserve closer look and disease prevention can be identified. « 1 2 3 4 5 » « 2 3 4 5 6 » 61. Leptospirosis. Revisión de tema Helbert Acosta 2014-11-01 Full Text Available La leptospirosis es una enfermedad aguda y febril causada por una bacteria del género Leptospira que comprende sobre todo a los animales salvajes y domésticos. El hombre se contamina en forma accidental por el contacto con orina o tejidos de animales infectados y presenta cuadros clÃnicos variables que van desde infecciones inaparentes, meningitis aséptica, hasta formas severas como el sÃndrome de Weil. La penicilina sigue siendo la droga de elección. 62. Leptospirosis: enfermedad zoonótica reemergente

Céspedes Z., Manuel; Laboratorio de Leptospiras, División de BacteriologÃa, Centro Nacional en Salud Pública. Instituto Nacional de Salud. Lima, Perú. 2014-01-01 La leptospirosis es un problema de salud pública a nivel mundial, en particular en áreas tropicales y subtropicales y en paÃses en vÃas de desarrollo. La magnitud del problema es atribuido a las condiciones climáticas y ambientales, pero también al contacto que se tiene con ambientes contaminados por Leptospira, esto se observa en las actividades agrÃcolas, ganadera, minera, recreacionales, deportivas y condiciones de salubridad en la vivienda. Es una enfermedad potencialmente mortal pero tra... 63. Leptospirosis: Enfermedad Zoonótica Emergente Manuel Céspedes Z 2005-01-01 La leptospirosis es un problema de salud pública a nivel mundial, en particular en áreas tropicales y subtropicales y en paÃses en vÃas de desarrollo. La magnitud del problema es atribuido a las condiciones climáticas y ambientales, pero también al contacto que se tiene con ambientes contaminados por Leptospira, esto se observa en las actividades agrÃcolas, ganadera, minera, recreacionales, deportivas y condiciones de salubridad en la vivienda. Es una enfermedad potencialmente mortal pero tra... 64. Towards the Burden of Human Leptospirosis: Duration of Acute Illness and Occurrence of Post-Leptospirosis Symptoms of Patients in The Netherlands M.G.A. Goris (Marga); V. Kikken (Vanessa); M. Straetemans (Masja); S. Alba (Sandra); M. Goeijenbier (Marco); E.C.M. van Gorp (Eric); K.R. Boer (Kimberly); J.F.P. Wagenaar (Jiri); R.A. Hartskeerl (Rudy) 2013-01-01 textabstractBackground:Leptospirosis is a global zoonotic disease. Although important for the assessment of the burden of leptospirosis, data on the duration of the illness and the occurrence of post-leptospirosis complaints are not well documented. Hence the main objective of this study was to esti 65. Increasing Incidence of Canine Leptospirosis in Switzerland Andrea Major 2014-07-01 Full Text Available 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 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. 66. [Leptospirosis in a family after whitewater rafting in Thailand]. Gallardo, C; Williams-Smith, J; Jaton, K; Asner, S; Cheseaux, J-J; Troillet, N; Manuel, O; Berthod, D 2015-04-15 Leptospirosis is a zoonosis found worldwide, with an incidence that is approximately 10 times higher in the tropics than in temperate regions. The main reservoir of leptospirosis is the rat and human infection usually results from exposure to infected animal urine or tissues. Only 10% of cases are symptomatic. We present here two confirmed and two probable cases of leptospirosis in a family returning from whitewater rafting in Thailand, illustrating the wide variety of the clinical manifestations of this infection. Two of the patients were hospitalized and presented a probable Jarisch-Herxheimer reaction after initiation of beta-lactam therapy. The two others patients were treated empirically with doxycycline. We discuss here some relevant aspects of the epidemiology, clinical manifestations, therapy and the challenge of an early diagnosis of leptospirosis. 67. Interactions between environment, wild animals and human leptospirosis LS Ullmann 2011-01-01 Full Text Available Leptospirosis, a worldwide distributed zoononis caused by bacteria of the genus Leptospira (antigenically classified into serovars, may be direct or indirectly transmitted through infected urine or environment. Several domestic and wild animals are leptospirosis reservoirs. The disease presents occupational character since it is widely reported in professionals that work in humid environments - such as sewage workers and fishermen - and in places where rodents or susceptible animals are found, like slaughterhouses and veterinary clinics. In developing countries, outbreaks are related to lack of sanitation, overcrowding in inadequate housing and climatic conditions. In developed countries, sporadic cases occur in aquatic recreational activities including swimming and triathlon. The diagnosis of leptospirosis is complex due to the variety of symptoms, disease severity and the lack of techniques that are able to early detect the infection. Thus, leptospirosis causes numerous public health problems and educational activities are very important to its control. 68. Leptospirosis; AND#8220;Fever Aftermath of DelugeAND#8221; Ahmet Karakas 2010-12-01 Full Text Available Flooding provides an opportunity for epidemics of waterborne viral, protozoan, or bacterial diseases to develop in affected areas. May be, the only epidemicprone infection which can be transmitted directly from contaminated water is leptospirosis, a zoonotic bacterial disease. Leptospirosis is commonly founded in bodies of water, moist soil, or vegetation contaminated by the urine or tissues of infected animals. Outbreaks of leptospirosis have occurred many times following flood events in different part of the world especially in India, Latin America and South-East Asia. Leptospirosis should be kept in mind of health workers and local administrators in every where even also developed regios and countries especially during the water associated nature events. Many of the leptospirosis symptoms can be mistaken for other epidemic prone diseases. So, spesific laboratuary methods are needed for accurate diagnosis. Both of medical facilities and medical personnels might be affected by natural disasters. Beyond of these, reason of a lot of leptospirosis cases and other water based contagious diseases, running of the complicated and time consuming or expensive tests could be impossible. So, preferring of the rapid tests like slide agglutination test or urine dipstick tests for leptospirosis diagnosis could be reasonable. Concisely, due to Leptospirosis is a water-borne disease and can often be overlooked, it should be kept in mind especially for patients presenting with fever and multi-organ involvement just after natural disasters like tsunami, land sliding, flooding, sudden or heavy reains. This fact is extremely important nowadays and in the future, because of ingreasingly aggravated global climatic change. [TAF Prev Med Bull 2010; 9(6.000: 651-654 69. Leptospirosis in children: A review for family physicians Tullu Milind 2009-08-01 Full Text Available Leptospirosis is an important cause of acute febrile illness in the monsoon season in India. It is a zoonotic disease that is spread primarily by rodents. There exist two clinical types: anicteric and icteric leptospirosis. Both have an initial septicemic phase followed by an immune phase. The clinical manifestations vary and the disease manifestations may range from a nonspecific febrile illness to one with severe multiorgan failure. Weil′s disease is the severe form of the infection; which occurs in less than 10% of the patients and is associated with high mortality. The methods available for diagnosis and treatment of leptospirosis are discussed in this review. Crystalline penicillin is the drug of choice for treatment of leptospirosis in children. Avoidance of contact with flood waters and rodent control are vital for prevention of the disease. We also discuss the differences between childhood leptospirosis and adult disease. We used two methods to garner the information presented in this article: i we searched the PubMed database (http://www.ncbi.nlm.nih.gov/pubmed/ using the keywords ′leptospirosis′ and ′children,′ with special emphasis given to articles from the Indian literature; and ii we reviewed the chapters on leptospirosis in the standard textbooks of pediatric and infectious diseases. 70. Geographical Scale Effects on the Analysis of Leptospirosis Determinants Renata Gracie 2014-10-01 Full Text Available 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. 71. Geographical Scale Effects on the Analysis of Leptospirosis Determinants Gracie, Renata; Barcellos, Christovam; Magalhães, Mônica; Souza-Santos, Reinaldo; Barrocas, Paulo Rubens Guimarães 2014-01-01 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. PMID:25310536 72. Endothelial glycocalyx damage is associated with leptospirosis acute kidney injury. Libório, Alexandre Braga; Braz, Marcelo Boecker Munoz; Seguro, Antonio Carlos; Meneses, Gdayllon C; Neves, Fernanda Macedo de Oliveira; Pedrosa, Danielle Carvalho; Cavalcanti, Luciano Pamplona de Góes; Martins, Alice Maria Costa; Daher, Elizabeth de Francesco 2015-03-01 Leptospirosis is a common disease in tropical countries, and the kidney is one of the main target organs. Membrane proteins of Leptospira are capable of causing endothelial damage in vitro, but there have been no studies in humans evaluating endothelial glycocalyx damage and its correlation with acute kidney injury (AKI). We performed a cohort study in an outbreak of leptospirosis among military personnel. AKI was diagnosed in 14 of 46 (30.4%) patients. Leptospirosis was associated with higher levels of intercellular adhesion molecule-1 (ICAM-1; 483.1 ± 31.7 versus 234.9 ± 24.4 mg/L, P leptospirosis-associated AKI had increased level of syndecan-1 (112.1 ± 45.4 versus 41.5 ± 11.7 ng/mL, P = 0.021) and ICAM-1 (576.9 ± 70.4 versus 434.9 ± 35.3, P = 0.034) compared with leptospirosis patients with no AKI. Association was verified between syndecan-1 and ICAM-1 with serum creatinine elevation and neutrophil gelatinase-associated lipocalin (NGAL) levels. This association remained even after multivariate analysis including other AKIassociated characteristics. Endothelial injury biomarkers are associated with leptospirosis-associated renal damage. 73. Outbreak of leptospirosis among triathlon participants in Germany, 2006 Hartelt Katrin 2010-04-01 Full Text Available Abstract Background In August 2006, a case of leptospirosis occurred in an athlete after a triathlon held around Heidelberg and in the Neckar river. In order to study a possible outbreak and to determine risk factors for infection an epidemiological investigation was performed. Methods Participants of the triathlon were contacted by e-mail and were asked to fill out a standardized questionnaire. In addition, they were asked to supply a serum sample for laboratory diagnosis of leptospirosis. A confirmed case patient was defined as a clinical case (i.e. fever and at least one additional symptom suggestive for leptospirosis with at least two of the following tests positive: ELISA IgM, latex agglutination testing, or microscopic agglutination testing. Rainfall and temperature records were obtained. Results A total of 142 of 507 triathletes were contacted; among these, five confirmed leptospirosis cases were found. Open wounds were identified as the only significant risk factor for illness (p = 0.02. Heavy rains that preceded the swimming event likely increased leptospiral contamination of the Neckar River. Discussion This is the first outbreak of leptospirosis related to a competitive sports event in Germany. Among people with contact to freshwater, the risk of contracting leptospirosis should be considered by health care providers also in temperate countries, particularly in the summer after heavy rains. 74. Studying risk factors associated with Human Leptospirosis Ramachandra Kamath 2014-01-01 Full Text Available Background: Leptospirosis is one of the most under diagnosed and underreported disease in both developed and developing countries including India. It is established that environmental conditions and occupational habit of the individuals put them at risk of acquiring disease, which varies from community to community. Various seroprevalence studies across the world have documented emerging situation of this neglected tropical disease, but limited have probed to identify the risk factors, especially in India. Objectives: The objective of this study was to identify the environmental and occupational risk factors associated with the disease in Udupi District. Materials and Methods: This population-based case-control study was carried out in Udupi, a District in Southern India from April 2012 until August 2012. Udupi is considered to be endemic for Leptospirosis and reported 116 confirmed cases in the year 2011. Seventy of 116 laboratory confirmed cases and 140 sex matched neighborhood healthy controls participated in the study. A predesigned, semi-structured and validated questionnaire was used for data collection through house to house visit and observations were noted about environmental conditions. Univariate analysis followed by multivariate analysis (back ward conditional logistic regression was performed by using STATA version 9.2 (StataCorp, College Station, TX, USA to identify potential risk factors. Results: Occupational factors such as outdoor activities (matched odds ratio [OR] of 3.95, 95% confidence interval [CI]: 1.19-13.0, presence of cut or wound at body parts during work (matched OR: 4.88, CI: 1.83-13.02 and environmental factors such as contact with rodents through using the food materials ate by rat (matched OR: 4.29, CI: 1.45-12.73 and contact with soil or water contaminated with urine of rat (matched OR: 4.58, CI: 1.43-14.67 were the risk factors identified to be associated with disease. Conclusion: Leptospirosis is still 75. Confirmación por laboratorio de leptospirosis: laboratory confirmation Leptospirosis MarÃa De los Ãngeles Valverde-Jiménez 2008-03-01 Full Text Available Se presenta el caso de un joven de quince años de edad que consulta a un hospital privado por enfermedad febril aguda de origen desconocido, asociada a elevación discreta de transaminasas y otras alteraciones inespecÃficas de los exámenes de laboratorio. Fue referido para observación a un hospital de la Caja Costarricense de Seguro Social, donde se le maneja como cuadro de dengue clásico. La atención en la clÃnica privada se restableció luego de su egreso, se confirmó el diagnóstico de leptospirosis por parte del laboratorio del Centro Nacional de Referencia de Leptospirosis del iNCIENSA y se manejó con antibióticos hasta su resolución. El artÃculo enfatiza la importancia del diagnóstico de la leptospirosis mediante un alto grado de sospecha, una historia clÃnica precisa, un buen examen fisico y la confirmación diagnóstica por laboratorio con el fin de tratarla apropiadamente.A case of a 15 year old young man is presented, who consulted at a private hospital for acute fever, initially of unknown origin, associated with mild elevation of transaminases and other unspecific alterations of laboratory tests. He was referred for observation to a Hospital, where he was treated as a case of classic dengue fever. Afier his discharge his case was re-taken by a private practitioner, his diagnosis of leptospirosis was confirmed by the laboratory of the National Leptospirosis Referal Center in the INCIENSA, and he was properly treated with antibiotics until complete resolution of his episode. This article emphasizes the importance of a high level of suspicion, a precise and thorough clinical history, as well as a meticulous physical examination, followed by laboratory evidence, in order to diagnose and treat this illness in a proper way. 76. Leptospirosis: A re-emerging zoonosis Alcides Troncoso 2016-09-01 Full Text Available Leptospirosis is a zoonotic disease caused by a bacteria of the genus Leptospira, which attacks people and domestic and wild animals. The bacteria can live and reproduce in rivers, streams, lakes, ponds and swamps. The risk of transmission increases in the rainy and flood seasons due to the characteristics of the survival of the bacteria, which can survive in water and even in stagnant water. Reservoirs are mainly rodents and dogs that eliminate Lepstospira through urine, thus contaminating the environment inside and outside homes. In the documented epidemics, weather, health and environmental conditions in the geographical region could cause the disease. In this review, risk factors related to the disease in different epidemiological scenarios are analysed. 77. Diagnóstico de leptospirosis humana Piedad Agudelo-Flórez 2010-04-01 Full Text Available La leptospirosis ha re-emergido como una enfermedad infecciosa importante de distribución universal. El agente etiológico es un grupo de 17 especies del género Leptospira. En el humano la enfermedad puede ser asintomática o presentarse como una enfermedad febril bifásica con sintomatologÃa inespecÃfica y autolimitada que puede durar de 5-10 dÃas. Los sÃntomas iniciales además de la fiebre, incluyen dolor de cabeza, escalofrÃos, vómito, cefalalgia, mialgias generalizadas e infección conjuntival y malestar, a veces, postración. En su forma más común la leptospirosis adopta el aspecto clÃnico de un sÃndrome febril anictérico. Lasegunda fase presenta las caracterÃsticas de la fase inmune y se correlaciona con la aparición de anticuerpos circulantes de clase IgM. En 5-10% de los casos se agregan ictericia, manifestaciones hemorrágicas e insuficiencia renal aguda y bilirrubinas elevadas, constituyendo la enfermedad de Weil. Otros casos presentan sÃntomas menÃngeos o cursan como sÃndrome pulmonar hemorrágico que es la forma más grave y fatal descrita hasta el momento, con 25 a 50% de mortalidad asociada, superando la ocasionada por el clásico sÃndrome de Weil. En términos generales es ampliamente aceptado que el diagnóstico oportuno, el inicio temprano de antibióticos, junto con el manejo apropiado, de la falla renal aguda y la insuficiencia respiratoria, en los casos que lo requieran, disminuye las probabilidades de que la enfermedad curse a formas graves y potencialmente fatales (1-3. 78. Leptospirosis: Enfermedad Zoonótica Emergente Manuel Céspedes Z 2005-10-01 Full Text Available La leptospirosis es un problema de salud pública a nivel mundial, en particular en áreas tropicales y subtropicales y en paÃses en vÃas de desarrollo. La magnitud del problema es atribuido a las condiciones climáticas y ambientales, pero también al contacto que se tiene con ambientes contaminados por Leptospira, esto se observa en las actividades agrÃcolas, ganadera, minera, recreacionales, deportivas y condiciones de salubridad en la vivienda. Es una enfermedad potencialmente mortal pero tratable; su espectro clÃnico va desde la enfermedad asintomático, sÃntomas mÃnimos similares a un resfrió común, hepatitis, dengue clásico o pueden ser graves como las fiebres hemorrágicas virales y meningitis. Al ser frecuente en zonas tropicales donde confluyen otras infecciones como el dengue, tienden a confundirse sus cuadros clÃnicos, siendo generalmente subdiagnósticada, sin embargo estudios recientes han demostrado su importancia en la salud pública. Los nuevos y menos complicados métodos de diagnóstico se han desarrollado en años recientes, permitiendo que la infección sea identificada en campo sin la necesidad de tener laboratorios tan sofisticados. La falta de disponibilidad de una vacuna que proteja contra todos los serovares de leptospiras hace que la prevención hasta ahora dependa de la implantación de medidas de saneamiento. En esta revisión se brinda información sobre aspectos relacionados a la bacteria, epidemiologÃa, reservorios, transmisión, patogenia, clÃnica, diagnóstico y manejo de la leptospirosis. 79. Retrospective study of severe cases of leptospirosis admitted in the intensive care unit Ittyachen A; Krishnapillai T; Nair M; Rajan A 2007-01-01 Objectives: Evaluate patient demographics, risk factors, complications, seropositivity, treatment and outcome among leptospirosis patients. Design: Retrospective analysis of 104 patients admitted in the intensive care unit (ICU) with a clinical suspicion of leptopirosis. Setting: Ten-bedded medical ICU in a medical school situated in a rural area endemic for leptospirosis. Main Outcome Measures: Seropositivity for leptospirosis, patient demographics, risk factors, complications, treatment a... 80. Autochthonous leptospirosis in South-East Austria, 2004-2012. Martin Hoenigl Full Text Available BACKGROUND: Leptospirosis is one of the world's mostly spread zoonoses causing acute fever. Over years, leptospirosis has been reported to occur rarely in Austria and Germany (annual incidence of 0.06/100,000 in Germany. Only imported cases have been on the increase. Objectives of this case-series study were to retrospectively assess epidemiologic and clinical characteristics of leptospirosis illnesses in South-East Austria, to describe risk exposures for autochthonous infections, and to compare patients with imported versus autochthonous infection. METHODOLOGY/PRINCIPAL FINDINGS: During the 9-year period between 2004 and 2012, 127 adult patients (49 females, 78 males who tested positive by rapid point-of-care test for Leptospira-specific IgM (Leptocheck® were identified through electronic hospital databases. Follow-up telephone interviews were conducted with 82 patients. A total of 114 (89.8% of the 127 patients enrolled had acquired leptospirosis within Austria and 13 (10.2% had potentially imported infections. Most autochthonous cases were diagnosed during the months of June and July, whereas fewest were diagnosed during the winter months. Exposure to rodents, recreational activities in woods or wet areas, gardening, cleaning of basements or huts were the most common risk exposures found in autochthonous infection. Serogroups Australis (n = 23, Sejroe (n = 22, and Icterohaemorrhagiae (n = 11 were identified most frequently by MAT testing in autochthonous infections. Patients with imported leptospirosis were significantly younger, less likely to be icteric and had significantly lower liver transaminase levels (p = 0.004 than those with autochthonous infections. CONCLUSIONS/SIGNIFICANCE: Leptospirosis is endemic in South-East Austria. In contrast to reports from other countries we found a relatively high proportion of leptospirosis cases to be female (39% vs. ∼ 10%, likely the result of differing risk exposures for South-East Austria. « 2 3 4 5 6 » « 3 4 5 6 7 » 81. Environmental and Behavioural Determinants of Leptospirosis Transmission: A Systematic Review.

Mwanajaa Abdalla Mwachui Full Text Available Leptospirosis is one of the most widespread zoonotic diseases, which is of global medical and veterinary importance, and also a re-emerging infectious disease. The main tracks of transmission are known; however, the relative importance of each of the components and the respective environmental risk factors are unclear. We aimed to assess and specify quantitative evidence of environmental risks of leptospirosis transmission.A database of pre-selected studies, with publication dates from 1970 until 2008, was provided by an expert group. The database has been updated until 2015 using a text mining algorithm. Study selection was based on stringent quality criteria. A descriptive data analysis was performed to calculate the medians of the log transformed odds ratios. From a selection of 2723 unique publications containing information on leptospirosis, 428 papers dealing with risk factors were identified. Of these, 53 fulfilled the quality criteria, allowing us to identify trends in different geo-climatic regions. Water associated exposures were, with few exceptions, associated with an increased leptospirosis risk. In resource poor countries, floods and rainfall were of particular importance, whereas recreational water activities were more relevant in developed countries. Rodents were associated with increased leptospirosis risk, but the variation among studies was high, which might be partly explained by differences in exposure definition. Livestock contact was commonly associated with increased risk; however, several studies found no association. The median odds ratios associated with dog and cat contacts were close to unity. Sanitation and behavioural risk factors were almost always strongly associated with leptospirosis, although their impact was rarely investigated in Europe or North America.This review confirms the complex environmental transmission pathways of leptospirosis, as previously established. Although, floods appeared to be among the 82. Using discrete choice modeling to evaluate the preferences and willingness to pay for leptospirosis vaccine. Arbiol, Joseph; Yabe, Mitsuyasu; Nomura, Hisako; Borja, Maridel; Gloriani, Nina; Yoshida, Shin-ichi 2015-01-01 Leptospirosis is highly endemic in the Philippines and a serious concern to public health. Local research on candidate vaccine is moving through the development pipeline. The availability of vaccines alone does not guarantee acceptance because individuals' vaccination choice decision is influenced by several factors. This study assessed how vaccine attributes and socio-demographic factors affect the acceptability of leptospirosis vaccine; and estimated individuals' willingness to pay for leptospirosis vaccine. A discrete choice experiment was conducted among leptospirosis and non-leptospirosis case respondents (n = 342) living in Metro Manila. Random Parameters Logit model was used to estimate the relative importance of vaccine attributes and socio-demographic variables on respondents' leptospirosis vaccination choice decision. The estimated model coefficients were used to derive implicit prices and willingness to pay for leptospirosis vaccine. Both case respondents preferred leptospirosis vaccine with 70-100% efficacy, mild to moderate risk of sideeffects, given in a single shot, and at a lower price. Non-leptospirosis case respondents preferred a vaccine with 7 to 10 y of protection, while leptospirosis case respondents preferred a vaccine with 10 y protection. The probability of leptospirosis vaccination acceptance was affected by respondents' age, education, family size and income, proximity of home to rivers and sewers, and leptospirosis awareness level. Respondents' willingness to pay for leptospirosis vaccine (US$ 31.14-US$ 65.89) was higher than the Japanese retail price (US$ 21.60-US$ 24.00). Our findings indicated significant potential for introducing leptospirosis vaccine in the Philippine vaccine market. Delivery strategies to ensure equitable access to future leptospirosis vaccine are recommended. 83. Micronutrients and Leptospirosis: A Review of the Current Evidence Herman, Heather S.; Mehta, Saurabh; Cárdenas, Washington B.; Stewart-Ibarra, Anna M. 2016-01-01 Background Leptospirosis is one of the most widespread zoonoses and represents a major threat to human health. Due to the high burden of disease, limitations in diagnostics, and limited coverage and availability of effective human and veterinary vaccines, leptospirosis remains an important neglected zoonotic disease. Improved surveillance and identification of modifiable risk factors for leptospirosis are urgently needed to inform preventive interventions and reduce the risk and severity of Leptospira infection. Methodology/Principal Findings This review was conducted to examine the evidence that links micronutrient status and Leptospira infection. A total of 56 studies were included in this review: 28 in vitro, 17 animal, and 11 observational human studies. Findings indicated that Leptospira infection is associated with higher iron and calcium concentrations and hypomagnesemia. Conclusions/Significance Few prospective studies and no randomized trials have been conducted to date to examine the potential role of micronutrients in Leptospira infection. The limited literature in this area constrains our ability to make specific recommendations; however, the roles of iron, calcium, and magnesium in leptospirosis represent important areas for future research. The role of micronutrients in leptospirosis risk and severity needs to be elucidated in larger prospective human studies to inform public health interventions. PMID:27387046 84. High dose corticosteroids in severe leptospirosis: a systematic review. Rodrigo, Chaturaka; Lakshitha de Silva, Nipun; Goonaratne, Ravindi; Samarasekara, Keshinie; Wijesinghe, Indika; Parththipan, B; Rajapakse, Senaka 2014-12-01 The role of corticosteroids in the treatment of severe leptospirosis is unclear. The rationale for their use is that, in severe leptospirosis, there is a severe immunological response that is harmful to the host resulting in multi-organ dysfunction, which is potentially offset by the nonspecific immunosuppression of high dose steroids. We conducted a systematic review of studies that have assessed the use of high dose corticosteroids in patients with severe leptospirosis by searching MEDLINE and Scopus SciVerse without any language or time restrictions. We identified five studies, including one open randomized clinical trial, which had assessed the use of high dose steroids in severe leptospirosis. Four studies demonstrated a benefit of corticosteroids in treating severe disease with pulmonary involvement when administered early in the course of the disease, but these studies had several methodological constraints as highlighted in the text. Only the randomized controlled trial study showed that corticosteroids are ineffective and may increase the risk of nosocomial infections. There is no robust evidence to suggest that high dose corticosteroids are effective in severe leptospirosis, and a well-designed randomized clinical trial is needed to resolve this. 85. KONDISI LINGKUNGAN PEMUKIMAN YANG TIDAK SEHAT BERISIKO TERHADAP KEJADIAN LEPTOSPIROSIS (STUDIKASUS DI KOTA SEMARANG Tri Ramadhani 2012-07-01 Full Text Available Leptospirosis is an acute febrile illness infecting human and animal (zoonotic and caused by the bacteria leptospira. Semarang city is one endemic leptospirosis with incidence rate in 2009 of 13,27/100.000 and case fatality rate 3,5%. The research objective was to find out the impact of settlement environment conditional with leptospirosis cases. The study was observational with cross sectional design. Population are the people who visit the health center in Semarang city and sample is a part patient in health center with clinical sympthoms leptosirosis from May up to November 2009. Leptospirosis case maintained with laboratory test uses leptotek lateral flow. Data collection with interview and obsen'ation, analyzing by univariat, bivariat (chi square and multivariate with regresi logistic metode. Out of 105 responden, 67 (63,8% leptospirosis positive and 38 (36,2% negative. Poor housing had a 3,4-fold increase for leptospirosis (OR=3.4; 95% CI=1.050-10.779. Sanitary-conditional to indoor and outdoor is not significant with leptospirosis (p=0,051. Rat eksistensi in house had a 6.4-ford increase for leptospirosis (OR=6.4; 95% CI=2.081-19.983 and there is dominant factor that affect leptospirosis. Poor environmental of settlement increases risk for leptospirosis  Key words, environmental, settlement, leptospirosis 86. Outbreak of leptospirosis after white-water rafting: sign of a shift from rural to recreational leptospirosis in Sri Lanka? Agampodi, S B; Karunarathna, D; Jayathilala, N; Rathnayaka, H; Agampodi, T C; Karunanayaka, L 2014-04-01 This paper reports the first recreation-related leptospirosis outbreak in Sri Lanka in 20 office workers who were involved in white-water rafting during a staff outing. Two weeks after the rafting event on 7 September 2012, six participants developed fever, of which four had classical clinical features of leptospirosis. Four weeks after the exposure, an outbreak investigation was conducted for 19 of the 20 participants. Of the six fever patients, four were confirmed as having acute leptospirosis using either single sample MAT titre ≥ 1/400 (n = 2) or positive IgM ELISA (n = 2). An afebrile patient with headache and myalgia also had a MAT titre ≥ 1/400. Seventeen of the 19 participants investigated showed antileptospiral antibodies. None of the participants had a history of leptospirosis or recent outdoor exposures other than the rafting event. This outbreak provides evidence of the changing epidemiology of leptospirosis and suggests a wider range of risk exposures including those related to recreational activities of more affluent urban populations in addition to the well recognized occupational hazards of rural farming. 87. [Leptospirosis in children: a not infrequent disease (author's transl)]. Chabrolle, J P; Derrida, S; Mailloux, M; Rossier, A A total of 14 cases of leptospirosis in children aged from 5 to 15 years, hospitalized in the Paris region, are reported. The polymorphe character of the disease is pointed out. The necessity for respecting a rigorous chronological order when requesting complementary examinations, which could confirm the diagnosis, is stressed. Domestic animals, team-mates, and while swimming at week-ends or during holidays, are potential sources or means of infection in the young. This justifies searching for leptospirosis in cases of unexplained fever, a pseudo-influenza syndrome, a meningitis which is mainly of the lymphocytic type, or more rarely, in cases of jaundice. Leptospirosis should be a disease well-known by the pediatrician. 88. Acute pancreatitis caused by leptospirosis: Report of two cases Ekrem Kaya; Adem Dervisoglu; Cafer Eroglu; Cafer Polat; Mustafa Sunbul; Kayhan Ozkan 2005-01-01 Two cases of acute pancreatitis with leptospirosis are reported in this article. Case 1: A 68-year-old woman,presented initially with abdominal pain, nausea, vomiting,and jaundice. She was in poor general condition, and had acute abdominal signs and symptoms on physical examination. Emergency laparotomy was performed, acute pancreatitis and leptospirosis were diagnosed on the basis of surgical findings and serological tests. The patient died on postoperative d 6. Case 2: A 62-year-old man, presented with fever, jaundice, nausea, vomiting, and malaise. Acute pancreatitis associated with leptospirosis was diagnosed,according to abdominal CT scanning and serological tests.The patient recovered fully with antibiotic treatment and nutritional support within 19 d. 89. Leptospirosis in a caver returned from Sarawak, Malaysia. Mortimer, Roger B 2005-01-01 This article describes a case of leptospirosis in a man who returned from caving in Sarawak, Malaysia, and includes a discussion of epidemiology, pathophysiology, diagnosis, prevention, and treatment. The patient presented with symptoms of leptospirosis, which was confirmed by microhemagglutination titers. He became infected despite taking doxycycline daily for malaria prophylaxis. Leptospirosis is an important consideration in any returned traveler with fever. The spirochete spreads from animals to humans via water. Caving in tropical endemic zones may increase exposure risk due to the combination of multiple skin abrasions with immersions. Water in caves may increase infection risk because of increased water pH. Standard prophylaxis may be inadequate in cases of high-risk exposures. 90. Interpretation of microscopic agglutination test for leptospirosis diagnosis and seroprevalence Chintana Chirathaworn; Rajada Inwattana; Yong Poovorawan; Duangjai Suwancharoen 2014-01-01 Determination of antibody titer by microscopic agglutination test (MAT) has been used as a tool for leptospirosis diagnosis. Four fold or greater rise in antibody titers between acute and convalescent sera suggests recent Leptospira infection. In addition, results obtained by MAT have been used to predict infecting serovars. However, cross reactivity among various Leptospira serovars have been reported when patient sera were tested with a battery of Leptospira serovars. This study demonstrates cross- reactivity among several Leptospira serovars when MAT was performed on leptospirosis sera. The data support a role of MAT as a tool for diagnosis. However, for information on infecting serovars, Leptospira isolation and molecular identification should be performed. 91. Serum nitrite levels in Sri Lankan patients with leptospirosis Rohini I Gunaratna; Shiroma M Handunnetti; MRC Bulathsinghalage; Pranitha Somaratne; Ananda Jayanaga; HJ de Silva; Senaka Rajapakse 2012-01-01 Objective:To determine whether blood nitrite levels are elevated in patients with leptospirosis. Methods: Male patients fulfilling clinical and epidemiological criteria for a diagnosis of leptospirosis were recruited. Those with MAT titre of≥400 together with those seroconverting to a titer of≥200 were included in the analysis. Serum nitrite levels were measured in these patients and age, sex matched healthy controls. Results:Patients from 3 hospitals (n=75) were screened during a 3 month period from 28th June to 3rd September 2009, of whom 20 were eligible for the study. Serum nitrite levels were found to be significantly higher in patients with acute leptospirosis [n=20, (0.359±0.229)μM] compared to controls [(n=13,(0.216±0.051)μM] (P=0.014). A significant correlation was also observed between the MAT titre and the day of illness (r = 0.547; P. The leptospirosis cases were 15 yearsold or more (87,4%, their occupationwere farmer orfisherman (52,6%, housewife(36,2% andseller (20%. Their house were easy enteredby rats 74,6% (RR; 23,6-33,2.Thepeoplewho gotleptospires common using water from the river for their daily activities 83,2% (RR; 15,4-17,6 andthey have not any cattle 82,5%(RR; 1,6-4,7. During the survey was found 57 rats, such asRattustanezumi 36 rats,Norwayrats, R. norvegicus21 rats and theinsectivore Suncusmurinus15 rats. Inaddition,R.tanezumi andR. norvegicuswere foundinfected byleptospires and they wereestimatedasleptospirosisreservoir.Keywords:leptospirosis, DemakRegency,epidemiology,reservoir.AbstrakStudidistribusi dan faktor risiko lingkungan leptospirosis telah dilakukandi KecamatanBonang,KabupatenDemak,padabulanMeiJuli2006.Tujuanpenelitianadalahmengetahuipenyebarandanfaktor risiko lingkungan kejadian leptospirosis di daerah penelitian. Penelitian menggunakanrancangan cross sectional. Penentuan kasus leptospirosis dengan pemeriksaan darah tepimenggunakanleptotek latteral flow 183. Investigating the Link Between Climate and Leptospirosis in the Caribbean Using Wavelet Analysis. Batchelor, T. W.; Amarakoon, D.; Taylor, M. A.; Stephenson, T. 2009-05-01 The Caribbean has shown changes in its climate (temperature and rainfall) as a result of urbanisation, population growth and industrialisation. The climatic changes have implications for the emergence and re- emergence of rodent-borne diseases such as leptospirosis. In this paper wavelet analysis is used to investigate the relationship between the incidence of leptospirosis in the Caribbean and climate variables such as temperature and precipitation. Wavelet analysis takes into account characteristics unique to climate and epidemiological data which other spectral techniques failed to do. The analysis reveals 2-3 year periodic signals in both the wavelet power spectrum and wavelet coherency. There is also a correlation between incidence of leptospirosis and late season Caribbean rainfall. 184. Leptospirosis risk increases with changes in species composition of rat populations Theuerkauf, Jörn; Perez, Julie; Taugamoa, Alefosio; Niutoua, Iasinito; Labrousse, Didier; Gula, Roman; Bogdanowicz, Wieslaw; Jourdan, Hervé; Goarant, Cyrille 2013-04-01 Rats are major reservoirs of leptospirosis and considered as a main threat to biodiversity. A recent introduction of Rattus rattus to the island of Futuna (Western Polynesia) provided the opportunity to test if a possible change in species composition of rat populations would increase the risk of leptospirosis to humans. We trapped rodents on Wallis and Futuna and assessed Leptospira carriage in 357 rodents ( Rattus norvegicus, R. rattus, Rattus exulans, and Mus domesticus) from 2008 to 2012. While Leptospira prevalence in rodents and the composition of rat populations on Futuna fluctuated with rainfall, the biomass of Leptospira-carrying rodents has been continuously rising from 2008 to 2012. Our results suggest that the introduction of R. rattus increases the risk to humans being infected with leptospirosis by rats. 185. Incidence of canine leptospirosis in the metropolitan area of Curitiba, State of Parana, Southern Brazil Camila Marinelli Martins 2013-12-01 Full Text Available Introduction The incidence of canine leptospirosis in Brazil needs to be assessed Methods The same dogs in southern Brazil were sampled over two years to determine the prevalence, incidence and association of canine leptospirosis with various risk factors. Results In 2009, the prevalence was 33 (14.4% of 228 dogs, with a predominance of serovar Canicola (33.4%. In 2010, 90 dogs were re-evaluated (the remaining dogs were lost to deaths, address changes and donations, and the prevalence was found to be 35 (38.9% of 90, with the predominant serovar being Icterohaemorrhagiae (51.4%. Moreover, the incidence was 26 of 90 (28.9%, and the disease was statistically associated with age (2009 and street access (2010. Conclusions Our findings revealed instability in the dog population and age to be relevant risk factors for canine leptospirosis. 186. Molecular typing of Leptospira spp. strains isolated from field mice confirms a link to human leptospirosis. Li, S J; Wang, D M; Zhang, C C; Li, X W; Yang, H M; Tian, K C; Wei, X Y; Liu, Y; Tang, G P; Jiang, X G; Yan, J 2013-11-01 In recent years, human leptospirosis has been reported in Jinping and Liping counties, Guizhou province, but the leptospires have never been isolated. To track the source of infection and understand the aetiological characteristics, we performed surveillance for field mice carriage of leptospirosis in 2011. Four strains of leptospire were isolated from Apodemus agrarius. PCR confirmed the four isolates as pathogenic. Multiple-locus variable-number tandem repeat analysis (MLVA) showed that the four strains were closely related to serovar Lai strain 56601 belonging to serogroup Icterohaemorrhagiae, which is consistent with the antibody detection results from local patients. Furthermore, the diversity of leptospiral isolates from different hosts and regions was demonstrated with MLVA. Our results suggest that A. agrarius may be the main carrier of Leptospira in Jinping and Liping counties, and the serogroup Icterohaemorrhagiae serovar may be the epidemic serogroup of Leptospira. This will contribute to the control and prevention of leptospirosis in these localities. 187. Leptospirosis risk increases with changes in species composition of rat populations. Theuerkauf, Jörn; Perez, Julie; Taugamoa, Alefosio; Niutoua, Iasinito; Labrousse, Didier; Gula, Roman; Bogdanowicz, Wieslaw; Jourdan, Hervé; Goarant, Cyrille 2013-04-01 Rats are major reservoirs of leptospirosis and considered as a main threat to biodiversity. A recent introduction of Rattus rattus to the island of Futuna (Western Polynesia) provided the opportunity to test if a possible change in species composition of rat populations would increase the risk of leptospirosis to humans. We trapped rodents on Wallis and Futuna and assessed Leptospira carriage in 357 rodents (Rattus norvegicus, R. rattus, Rattus exulans, and Mus domesticus) from 2008 to 2012. While Leptospira prevalence in rodents and the composition of rat populations on Futuna fluctuated with rainfall, the biomass of Leptospira-carrying rodents has been continuously rising from 2008 to 2012. Our results suggest that the introduction of R. rattus increases the risk to humans being infected with leptospirosis by rats. 188. MILD, SELF-RESOLVING ACUTE LEPTOSPIROSIS IN AN HIV-INFECTED PATIENT IN THE PERUVIAN AMAZON GANOZA, CHRISTIAN A.; SEGURA, EDDY R.; SWANCUTT, MARK A.; GOTUZZO, EDUARDO; VINETZ, JOSEPH M. 2008-01-01 We report a case of acute, self-resolving leptospirosis presenting in a HIV-positive patient from the Peruvian Amazon. The patient presented with an undifferentiated acute febrile illness that resolved without treatment, diagnosed retrospectively as leptospirosis by serology and real-time polymerase chain reaction. Five months later, he was admitted because of a febrile illness with jaundice, hepatosplenomegaly, peripheral edema, and oral candidiasis. Because of the clinical suspicion of AIDS, stored sera of the previous admission were tested, and HIV seropositivity was confirmed, proving that the condition was present at the first admission. Acute leptospirosis in HIV coinfection is not inevitably severe, and there is probably a wide variation in clinical manifestations similar to what occurs in immuno-competent hosts. PMID:16014835 189. Serologic and Molecular Studies of Leptospira and Leptospirosis among Rats in the Philippines Villanueva, Sharon Y. A. M.; Ezoe, Hirokazu; Baterna, Rubelia A.; Yanagihara, Yasutake; Muto, Maki; Koizumi, Nobuo; Fukui, Takashi; Okamoto, Yoshihiro; Masuzawa, Toshiyuki; Cavinta, Lolita L.; Gloriani, Nina G.; Yoshida, Shin-ichi 2010-01-01 Rats are known to be the most important reservoirs and transmission sources of leptospirosis. However, the status of leptospirosis in the Philippines regarding reservoirs and transmission remains unknown. A survey was conducted in Metro Manila and Laguna that analyzed samples obtained from 106 rats. Using the microscopic agglutination test, we found that 92% of rat serum samples were positive for anti-Leptospira antibodies; the most common infecting serovars were Manilae, Hebdomadis, and Losbanos. On the basis of pulsed-field gel electrophoresis and gyrase B gene sequence analyses, four groups of rat kidney isolates were found: L. interrogans serovar Manilae, serovar Losbanos, and serogroup Grippotyphosa, and L. borgpetersenii serogroup Javanica. Most isolates were lethal after experimental infection of golden Syrian hamsters. Results showed that these four Leptospira serovars and serogroups are circulating among rats, and that these animals may be one of the possible transmission sources of leptospirosis in the Philippines. PMID:20439972 190. A Rapid In-Clinic Test Detects Acute Leptospirosis in Dogs with High Sensitivity and Specificity. Kodjo, Angeli; Calleja, Christophe; Loenser, Michael; Lin, Dan; Lizer, Joshua 2016-01-01 A rapid IgM-detection immunochromatographic test (WITNESS® Lepto, Zoetis) has recently become available to identify acute canine leptospirosis at the point of care. Diagnostic sensitivity and specificity of the test were evaluated by comparison with the microscopic agglutination assay (MAT), using a positive cut-off titer of ≥800. Banked serum samples from dogs exhibiting clinical signs and suspected leptospirosis were selected to form three groups based on MAT titer: (1) positive (n = 50); (2) borderline (n = 35); and (3) negative (n = 50). Using an analysis to weight group sizes to reflect French prevalence, the sensitivity and specificity were 98% and 93.5% (88.2% unweighted), respectively. This test rapidly identifies cases of acute canine leptospirosis with high levels of sensitivity and specificity with no interference from previous vaccination. 191. Strategies for diagnosis and treatment of suspected leptospirosis: a cost-benefit analysis. Yupin Suputtamongkol Full Text Available BACKGROUND: Symptoms and signs of leptospirosis are non-specific. Several diagnostic tests for leptospirosis are available and in some instances are being used prior to treatment of leptospirosis-suspected patients. There is therefore a need to evaluate the cost-effectiveness of the different treatment strategies in order to avoid misuse of scarce resources and ensure best possible health outcomes for patients. METHODS: The study population was adult patients, presented with uncomplicated acute febrile illness, without an obvious focus of infection or malaria or typical dengue infection. We compared the cost and effectiveness of 5 management strategies: 1 no patients tested or given antibiotic treatment; 2 all patients given empirical doxycycline treatment; patients given doxycycline when a patient is tested positive for leptospirosis using: 3 lateral flow; 4 MCAT; 5 latex test. The framework used is a cost-benefit analysis, accounting for all direct medical costs in diagnosing and treating patients suspected of leptospirosis. Outcomes are measured in length of fever after treatment which is then converted to productivity losses to capture the full economic costs. FINDINGS: Empirical doxycycline treatment was the most efficient strategy, being both the least costly alternative and the one that resulted in the shortest duration of fever. The limited sensitivity of all three diagnostic tests implied that

their use to guide treatment was not cost-effective. The most influential parameter driving these results was the cost of treating patients with complications for patients who did not receive adequate treatment as a result of incorrect diagnosis or a strategy of no-antibiotic-treatment. CONCLUSIONS: Clinicians should continue treating suspected cases of leptospirosis on an empirical basis. This conclusion holds true as long as policy makers are not prioritizing the reduction of use of antibiotics, in which case the use of the latex test would be 192. Global Burden of Leptospirosis: Estimated in Terms of Disability Adjusted Life Years. Paul R Torgerson Full Text Available Leptospirosis, a spirochaetal zoonosis, occurs in diverse epidemiological settings and affects vulnerable populations, such as rural subsistence farmers and urban slum dwellers. Although leptospirosis can cause life-threatening disease, there is no global burden of disease estimate in terms of Disability Adjusted Life Years (DALYs available.We utilised the results of a parallel publication that reported global estimates of morbidity and mortality due to leptospirosis. We estimated Years of Life Lost (YLLs from age and gender stratified mortality rates. Years of Life with Disability (YLDs were developed from a simple disease model indicating likely sequelae. DALYs were estimated from the sum of YLLs and YLDs. The study suggested that globally approximately 2.90 million DALYs are lost per annum (UIs 1.25-4.54 million from the approximately annual 1.03 million cases reported previously. Males are predominantly affected with an estimated 2.33 million DALYs (UIs 0.98-3.69 or approximately 80% of the total burden. For comparison, this is over 70% of the global burden of cholera estimated by GBD 2010. Tropical regions of South and South-east Asia, Western Pacific, Central and South America, and Africa had the highest estimated leptospirosis disease burden.Leptospirosis imparts a significant health burden worldwide, which approach or exceed those encountered for a number of other zoonotic and neglected tropical diseases. The study findings indicate that highest burden estimates occur in resource-poor tropical countries, which include regions of Africa where the burden of leptospirosis has been under-appreciated and possibly misallocated to other febrile illnesses such as malaria. 193. Strategies for Diagnosis and Treatment of Suspected Leptospirosis: A Cost-Benefit Analysis Suputtamongkol, Yupin; Pongtavornpinyo, Wirichada; Lubell, Yoel; Suttinont, Chuanpit; Hoontrakul, Siriwan; Phimda, Kriangsak; Losuwanaluk, Kitti; Suwancharoen, Duangjai; Silpasakorn, Saowaluk; Chierakul, Wirongrong; Day, Nick 2010-01-01 Background Symptoms and signs of leptospirosis are non-specific. Several diagnostic tests for leptospirosis are available and in some instances are being used prior to treatment of leptospirosis-suspected patients. There is therefore a need to evaluate the cost-effectiveness of the different treatment strategies in order to avoid misuse of scarce resources and ensure best possible health outcomes for patients. Methods The study population was adult patients, presented with uncomplicated acute febrile illness, without an obvious focus of infection or malaria or typical dengue infection. We compared the cost and effectiveness of 5 management strategies: 1) no patients tested or given antibiotic treatment; 2) all patients given empirical doxycycline treatment; patients given doxycycline when a patient is tested positive for leptospirosis using: 3) lateral flow; 4) MCAT; 5) latex test. The framework used is a cost-benefit analysis, accounting for all direct medical costs in diagnosing and treating patients suspected of leptospirosis. Outcomes are measured in length of fever after treatment which is then converted to productivity losses to capture the full economic costs. Findings Empirical doxycycline treatment was the most efficient strategy, being both the least costly alternative and the one that resulted in the shortest duration of fever. The limited sensitivity of all three diagnostic tests implied that their use to guide treatment was not cost-effective. The most influential parameter driving these results was the cost of treating patients with complications for patients who did not receive adequate treatment as a result of incorrect diagnosis or a strategy of no-antibiotic-treatment. Conclusions Clinicians should continue treating suspected cases of leptospirosis on an empirical basis. This conclusion holds true as long as policy makers are not prioritizing the reduction of use of antibiotics, in which case the use of the latex test would be the most efficient 194. Epidemiological Study of Animal Leptospirosis in New Caledonia Cédric Roqueplo 2013-01-01 Full Text Available Leptospirosis is an important zoonotic disease in the world and a real public health concern for many years in New Caledonia. A cross-sectional survey was carried out on domestic and wild animals from New Caledonia in April 2009. Blood samples were collected from 30 cattle, 29 deers, (Cervus timorensis russa, 25 horses, 51 dogs, and 8 cats and were tested for 23 serovars of pathogenic Leptospira species by the microscopic agglutination test. From the total number of 143 samples, 84 (58.7% were found to be positive towards one or several serovars of pathogenic leptospires. According to the species, the positive sera were obtained from 43% of 30 cattle, 72% of 29 Rusa deer, 80% of 25 horses, and 43% of 51 dogs, and fromall of the 8 cats tested. This study shows the broad dispersion and the high prevalence of the different serogroups of pathogenic Leptospira species tested, particularly among deer and horses. The disease is endemic in domestic animals and concerns all the species. 195. Cross-protection between experimental anti-leptospirosis bacterins Cristina Corsi Dib 2014-09-01 Full Text Available We investigated the existence of cross-protection between two anti-leptospirosis monovalent experimental bacterins produced with two strains of Leptospira serogroup Pomona: Fromm strain of serovar Kennewicky, isolated from pigs in the United States, and strain GR6 of serovar Pomona isolated from pigs in Brazil. Both were added of aluminum hydroxide as an adjuvant. Experimental bacterins were tested with the hamster potency test in order to assess protection provided against the disease and against the establishment of kidney infection. Controls were polyvalent commercial vaccine produced with Leptospira strains isolated outside Brazil, which included a representative of Pomona serovar, or Sorensen solution added of aluminum hydroxide adjuvant. The challenge was performed with cross-strains of serogroup Pomona tested in accordance with international standards established for the potency test. After 21 days of the challenge, survivors were killed to evaluate the condition of Leptospira renal carrier. Experimental bacterins protected hamsters against homologous and heterologous strains, demonstrating the existence of cross-protection. The commercial vaccine protected the hamsters challenged with both strains, but there was a high proportion of animals diagnosed as renal carriers when the challenge was performed with strain GR6, isolated from pigs in Brazil. 196. Cross-protection between experimental anti-leptospirosis bacterins Dib, Cristina Corsi; Gonçales, Amane Paldês; de Morais, Zenaide Maria; de Souza, Gisele Oliveira; Miraglia, Fabiana; Abreu, Patricia Antonia Estima; Vasconcellos, Silvio Arruda 2014-01-01 We investigated the existence of cross-protection between two anti-leptospirosis monovalent experimental bacterins produced with two strains of Leptospira serogroup Pomona: Fromm strain of serovar Kennewicky, isolated from pigs in the United States, and strain GR6 of serovar Pomona isolated from pigs in Brazil. Both were added of aluminum hydroxide as an adjuvant. Experimental bacterins were tested with the hamster potency test in order to assess protection provided against the disease and against the establishment of kidney infection. Controls were polyvalent commercial vaccine produced with Leptospira strains isolated outside Brazil, which included a representative of Pomona serovar, or Sorensen solution added of aluminum hydroxide adjuvant. The challenge was performed with cross-strains of serogroup Pomona tested in accordance with international standards established for the potency test. After 21 days of the challenge, survivors were killed to evaluate the condition of Leptospira renal carrier. Experimental bacterins protected hamsters against homologous and heterologous strains, demonstrating the existence of cross-protection. The commercial vaccine protected the hamsters challenged with both strains, but there was a high proportion of animals diagnosed as renal carriers when the challenge was performed with strain GR6, isolated from pigs in Brazil. PMID:25477946 197. Perilaku Pengendalian Tikus di Daerah Berisiko Penularan Leptospirosis Tri Isnani 2016-10-01 Full Text Available Abstrak Tikus merupakan binatang yang mempunyai daya adaptasi dan daya kembang biak yang tinggi sehingga bisa hidup di semua tempat. Dampak tikus bagi manusia antara lain tikus sebagai hama pertanian dan menularkan penyakit seperti pes dan leptospirosis. Berbagai pengendalian tikus telah dilakukan baik secara tradisional yang telah ada sejak nenek moyang maupun cara-cara modern. Tulisan ini mengeksplorasi perilaku masyarakat dalam usaha pengendalian serta faktor-faktor yang mempengaruhi dilakukannya cara-cara tersebut. Penelitian dilakukan dengan metode kualitatif desain deskriptif. Pengumpulan data dengan wawancara mendalam dan diskusi kelompok terarah pada 5 informan dan 2 kelompok Diskusi Kelompok Terarah (DKT. Lokasi penelitian di sebuah desa di Nanggulan, Kulon Progo, Daerah Istimewa Yogyakarta. Hasil penelitian menunjukkan terdapat beberapa cara dalam pengendalian tikus yaitu gropyokan, burung hantu, lem, racun tikus, pengemposan, menggunakan pewangi pakaian, dengan makanan umpan, kucing, dan dengan slametan. Ada pengendalian tikus dengan mengusirnya saja atau tidak membunuhnya, dan ada pengendalian dengan membunuhnya. Terdapat mitos dan kepercayaan terhadap tikus. Kesimpulan penelitian bahwa perilaku dalam pengendalian tikus dipengaruhi oleh latar belakang pengetahuan dan kepercayaan.  kata kunci : perilaku; pengendalian tikus; mitos dan kepercayaan 198. Seroprevalence of leptospirosis in stray dogs from Patos city, state of ParaÃba, Brazil Carolina de Sousa Américo Batista 2004-04-01 Full Text Available This work aimed to survey the prevalence of leptospirosis in stray dogs from Patos city, state of ParaÃba, Brazil. This study was held during the period of February to April of 2003, when 130 serum samples were collected. The diagnostic method run for leptospirosis was the microscopic agglutination test, using a batch of 22 leptospiral serovars. The most prevalent serovars were found crossing the results of frequency and titer of agglutinins. The results obtained indicated a prevalence of 20% and most frequent reactant serovars were autumnalis (20%, pomona (17,5%, grippotyphosa (10% e patoc (10%. 199. Leptospirosis-Associated Severe Pulmonary Hemorrhagic Syndrome with Lower Back Pain as an Initial Symptom Søndergaard, Mads Madsen; tursunovic, Amela; Thye-Roenn, Peter 2016-01-01 BACKGROUND Leptospirosis is a zoonosis transmitted through urine of infected animals. Symptoms range from mild influenza-like symptoms to severe pulmonary hemorrhagic syndrome (SPHS); the latter are often fatal. The serogroup distribution in Denmark has changed from 1988 to 2012, with Icterohaemo......BACKGROUND Leptospirosis is a zoonosis transmitted through urine of infected animals. Symptoms range from mild influenza-like symptoms to severe pulmonary hemorrhagic syndrome (SPHS); the latter are often fatal. The serogroup distribution in Denmark has changed from 1988 to 2012... 200. [Detection of leptospirosis reservoirs in Madagascar using the polymerase chain reaction technique]. Ralaiarijaona, R L; Bellenger, E; Chanteau, S; Roger, F; Pérolat, P; Rasolofo Razanamparany, V 2001-01-01 A polymerase chain reaction (PCR) technique was used for detection of the Leptospira interrogans rrs gene in kidney tissue from 115 rats, 50 zebu cattles and 13 pigs in an attempt to identify a possible animal reservoir of leptospirosis in Madagascar. In addition, serological testing of 105 individuals in close contact with animals was carried out. The PCR analysis was negative for all the samples tested and only one person was found seropositive at a low titer. The findings suggest that leptospirosis, if prevalent in Madagascar, is likely rare. « 8 9 10 11 12 » « 9 10 11 12 13 » 201. [Immunomodulation in severe leptospirosis with multiple organ failure: plasma exchange, intravenous immunoglobulin or corticosteroids?]. Meaudre, E; Asencio, Y; Montcriol, A; Martinaud, C; Graffin, B; Palmier, B; Goutorbe, P 2008-02-01 We report a case of severe leptospirosis complicated with a multiple organ failure syndrome. A 62-year-old patient presented a picture associating fever, asthenia and myalgias, particularly intense on the calves. The assessment showed acute renal failure, hyperbilirubinemia, severe rhabdomyolysis and thrombocytopenia. Although initial management associating amoxicilline and continuous veino-venous hemodiafiltration, evolution was unfavourable, with SDRA and increase of hyperbilirubinemia. Administration of a bolus of 500 mg of methylprednisolone, associated with intravenous immunoglobulin (0,4 g/kg per day during five days), led to a rapid clinical and biological improvement. Immunomodulation aspects during leptospirosis are discussed. 202. Leptospirosis outbreak following severe flooding: a rapid assessment and mass prophylaxis campaign; Guyana, January-February 2005. Amy M Dechet Full Text Available BACKGROUND: Leptospirosis is a zoonosis usually transmitted through contact with water or soil contaminated with urine from infected animals. Severe flooding can put individuals at greater risk for contracting leptospirosis in endemic areas. Rapid testing for the disease and large-scale interventions are necessary to identify and control infection. We describe a leptospirosis outbreak following severe flooding and a mass chemoprophylaxis campaign in Guyana. METHODOLOGY/PRINCIPAL FINDINGS: From January-March 2005, we collected data on suspected leptospirosis hospitalizations and deaths. Laboratory testing included anti-leptospiral dot enzyme immunoassay (DST, immunohistochemistry (IHC staining, and microscopic agglutination testing (MAT. DST testing was conducted for 105 (44% of 236 patients; 52 (50% tested positive. Four (57% paired serum samples tested by MAT were confirmed leptospirosis. Of 34 total deaths attributed to leptospirosis, postmortem samples from 10 (83% of 12 patients were positive by IHC. Of 201 patients interviewed, 89% reported direct contact with flood waters. A 3-week doxycycline chemoprophylaxis campaign reached over 280,000 people. CONCLUSIONS: A confirmed leptospirosis outbreak in Guyana occurred after severe flooding, resulting in a massive chemoprophylaxis campaign to try to limit morbidity and mortality. 203. Pengaruh Penyuluhan (Ceramah dengan Power Point terhadap Pengetahuan tentang Leptospirosis di Kecamatan Tembalang, Kota Semarang Jawa Tengah Tri Wijayanti 2016-07-01 Full Text Available ABSTRACT In Semarang City, leptospirosis mostly prevalent in Tembalang Sub District, particularly in the area of Kedungmundu Public Health Centre. Research of Epidemiology showed that 91 % of the community have lack knowledge about leptospirosis. Many risk factors of leptospirosis related with people behaviours, so they need more knowledge about it. Knowledge discourse can be done by media promotion. The objective of this research was to examine the effect of spreading information about leptospirosis with power point using LCD to the community. This research was quasi experiment design by pre-post test with control. The samples used 30 respondens as intervention group and the other 30 respondens as control group. Purposive sampling were use to get samples. Intervention was a discourse to address leptospirosis using power point and LCD. The data obtained by interview the respondents before and a month after intervention. Data analyzed by Mann Whitney, Wilcoxon Signed Ranks Test and Kruskall Wallis. The result of this research showed that intervention could increase knowledge about leptospirosis in the community. Conclusion of this research was discourse with power point using LCD evidently increase community knowledge about leptopirosis and can be used as one of health promotion method. Keywords: leptospirosis, knowledge, promotion media, lecture, power point 204. Surveillance for leptospirosis in the Americas, 1996–2005: a review of data from ministries of health Costa, Federico; Martinez-Silveira, Martha Silvia; Hagan, José E.; Hartskeerl, Rudy A.; dos Reis, Mitermayer Galvão; Ko, Albert Icksang 2014-01-01 Objective To characterize current leptospirosis reporting practices in the Americas. Methods Information was collected from the official websites of national ministries of health from the Americas region and two international organizations; personal communications; and three international morbidity databases. For all sources other than the morbidity databases, the review was limited to official reports citing clinically suspected and laboratory confirmed leptospirosis cases or deaths during the period 1996–2005. Results A total of 73 out of 1 644 reports met the selection criteria and were included in the analysis. Published leptospirosis data were available from half of the countries/sovereign territories (24 out of 48), and 18 of them had mandatory notification policies for leptospirosis. The sum of the median number of leptospirosis cases notified annually by the 24 countries/territories was 4 713.5, but just three countries (Brazil, Costa Rica, and Cuba) accounted for 83.1% (3 920 cases) of the notifications. Eight (16.7%) countries reported deaths due to leptospirosis. The sum of the median number of deaths reported annually for the eight countries was 380, but 349 (91.8%) were reported by Brazil. Conclusions Notification practices in the Americas for leptospirosis are limited. Therefore, the numbers of cases and deaths reported are not representative for the region. The lack of leptospirosis data for many countries/territories may reflect weaknesses in certain aspects of national surveillance systems, including mandatory reporting policies, clinical laboratory infrastructure for performing case confirmation, and capacity to collect reported cases. Improved surveillance of leptospirosis cases and deaths in the Americas is needed to allow monitoring of regional epidemiological patterns and to estimate the burden of this important disease. PMID:23183556 205. Epidemiological investigation of a human leptospirosis case reported in a suburban area near Marseille J. Dupouey 2014-05-01 Full Text Available Leptospirosis has been re-emerging in both developed and developing countries, including in Europe, where the phenomenon has notably been associated with urban transmission. In this work, we describe an epidemiological investigation that demonstrated a case of human infection due to peri-urban transmission of Leptospira interrogans serovar icterohaemorrhagiae in southeastern France. 206. Social Cost of Leptospirosis Cases Attributed to the 2011 Disaster Striking Nova Friburgo, Brazil Carlos Pereira 2014-04-01 Full Text Available 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. 207. PEMERIKSAAN BAKTERI LEPTOSPIRA PADA SAMPEL DARAH MANUSIA SUSPECT LEPTOSPIROSIS MENGGUNAKAN METODE PCR (POLYMERASE CHAIN REACTION Sefrita Tri Utami 2014-01-01 Full Text Available ABSTRACTLeptospirosis is a zoonotic disease, which is caused by leptospira. Leptospirosis cases often show no specificclinical symptoms and is difficult to diagnose without testing samples in the laboratory. Testing using PCR(Polymerase Chain Reaction is considered more accurate than the other methods. Components required in theexamination Leptospira bacteria in human blood samples using PCR method is DNA template, DNA polymeraseenzyme, forward primer (PU1 and SU1 and reverse primer (Lep R1, nuclease free water, Mg 2 +, and dNTPs.Examination of Leptospira bacteria in human blood samples include sampling, DNA isolation, examination byPCR, and electrophoresis running.Key words: leptospirosis, Leptospira, PCR methodsABSTRAKLeptospirosis adalah penyakit zoonosis yang disebabkan oleh bakteri Leptospira. Kasus leptospirosis seringtidak menunjukkan gejala klinis yang spesifik dan sulit didiagnosis tanpa pengujian sampel di laboratorium.Pengujian dengan menggunakan metode PCR (Polymerase Chain Reaction dinilai lebih akurat dibandingkandengan metode yang lain. Komponen-komponen yang dibutuhkan dalam pemeriksaan bakteri Leptospira padasampel darah manusia menggunakan metode PCR adalah DNA template, enzim polymerase, Primer PU 1 danPrimer SU 1, Primer Lep R1, air, Mg2+ , dan dNTP. Pemeriksaan bakteri Leptospira pada sampel darah manusiameliputi pengambilan sampel, isolasi DNA, pemeriksaan dengan metode PCR, dan running elektroforesis.Kata kunci: leptospirosis, Leptospira, metode PCR 208. Acute renal failure in leptospirosis in the black-sea region in Turkey. Cengiz, Kuddusi; Sahan, Cem; Sünbül, Mustafa; LeblebicioÄŸlu, Hakan; Cüner, Ertugrul 2002-01-01 Leptospirosis is an infectious disease caused by pathogenic leptospires and is characterized by a broad spectrum of clinical manifestations, varying from inappearent infection to fulminant, fetal disease. Eighty-five to 90% of leptospirosis infections are self-limiting. However, 5-10% of infection by L. interrogans can cause renal tubular damage, microvascular injury, acute renal failure (ARF), and interstitial nephritis. We studied 36 patients with leptospirosis. Twenty-seven (65%) cases of 36 patients had ARF. Fourteen (51%) had nonoliguric ARF. In thirteen (48%) oliguria appeared on the third or fourth days of hospitalization. Serum BUN, creatinine, serum bilirubine, ALT, AST, potassium and thrombocytopenia levels were higher in oliguric than nonoliguric patients (p 0.05). Thirteen patients (48%) needed in renal replacement therapy (RRT). 8 of them were treated by hemodialysis (HD) alone and 5 patients by HD in combination with hemoperfusion. Twenty-five patients (92%) recovered completely after 3-5 weeks. Two patients (7.4%) who had severe hepatorenal and hemorrhagic syndromes, died. We concluded that till now leptospirosis is actual problem for nephrologist in the developing countries because of very high percentage of renal disease, with good prognosis in patients without multiorgan failure and early treatment. 209. STUDI FAUNA TIKUS DAN CECURUT DI DAERAH DITEMUKAN KASUS LEPTOSPIROSIS DI KABUPATEN KLATEN, PROVINSI JAWA TENGAH Bina Ikawati 2013-09-01 Full Text Available ABSTRACTData obtained from Central Java Health Province Agency showed there were six districts of cities withleptospirosis problem. Leptospirosis cases in Klaten District was third sequence after Semarang City and Demak District.Research that had been done in Klaten focused in Jogonalan Sub district. In 2009-2010 leptospirosis cases found in outsideJogonalan. The aims of this research was to identifying of rats and suncus in leptospirosis area at Klaten district.This research was an observasional research using ecology study. Rat trapped and had been done in this researchfollowed by rat identification.Data were analyzed by simple statistic include tabulating, quantifying, multiplicationpresented in table or graph.Result of this research showed that from three study locations, trap success Kalikotes was showed highest (11,5%,while Wonosari and Gantiwarno was respectively 6,3% and 4,5%. Shanon Wiener Diversity Index was low(90% for homologous sera. Except for Ballum LPS, no other LPS showed cross-reactivity to heterologous sera. An attempt was made to develop LPS based ICG-LFA for rapid and sensitive serogroup specific diagnostics of leptospirosis. The developed ICG-LFA showed sensitivity in the range between 93 and 100% for homologous sera. The Wilcoxon analysis showed LPS based ICG-LFA did not differ significantly from the gold standard MAT (P>0.05.The application of single array of LPS for serogroup specific diagnosis is first of its kind. The developed assay could potentially be evaluated and employed for as MAT alternative. 280. Human Leptospirosis on Reunion Island, Indian Ocean: Are Rodents the (Only Ones to Blame? Vanina Guernier 2016-06-01 Full Text Available Although leptospirosis is a zoonosis of major concern on tropical islands, the molecular epidemiology of the disease aiming at linking human cases to specific animal reservoirs has been rarely explored within these peculiar ecosystems.Five species of wild small mammals (n = 995 as well as domestic animals (n = 101 were screened for Leptospira infection on Reunion Island; positive samples were subsequently genotyped and compared to Leptospira from clinical cases diagnosed in 2012-2013 (n = 66, using MLST analysis. We identified two pathogenic species in human cases, namely Leptospira interrogans and Leptospira borgpetersenii. Leptospira interrogans was by far dominant both in clinical samples (96.6% and in infected animal samples (95.8%, with Rattus spp and dogs being its exclusive carriers. The genetic diversity within L. interrogans was apparently limited to two sequence types (STs: ST02, identified among most clinical samples and in all rats with complete MLST, and ST34, identified in six humans, but not in rats. Noteworthy, L. interrogans detected in two stray dogs partially matched with ST02 and ST34. Leptospira borgpetersenii was identified in two clinical samples only (3.4%, as well as in cows and mice; four haplotypes were identified, of which two seemingly identical in clinical and animal samples. Leptospira borgpetersenii haplotypes detected in human cases were clearly distinct from the lineage detected so far in the endemic bat species Mormopterus francoismoutoui, thus excluding a role for this volant mammal in the local human epidemiology of the disease.Our data confirm rats as a major reservoir of Leptospira on Reunion Island, but also pinpoint a possible role of dogs, cows and mice in the local epidemiology of human leptospirosis. This study shows that a comprehensive molecular characterization of pathogenic Leptospira in both clinical and animal samples helps to gaining insight into leptospirosis epidemiology within a specific « 12 13 14 15 16 » « 13 14 15 16 17 » 281. Cases distribution of leptospirosis in City of Manaus, State of Amazonas, Brazil, 2000-2010 Michele Silva de Jesus 2012-12-01 Full Text Available INTRODUCTION: Leptospirosis is an infectious disease caused by microorganisms of the genus Leptospira that affects several species of animals, including the human beings. The study described the confirmed cases of leptospirosis in Manaus, from 2000 to 2010. METHODS: A descriptive study based on secondary data analysis of Secretaria Municipal de Saúde (SEMSA, Sistema de Informação de Agravos de Notificação SINAN and Sistema de Informação sobre Mortalidade (SIM analyzing the variables: age group, gender, clinical aspects and geographic area and lethality. RESULTS: Were reported 665 cases of leptospirosis, 339 were confirmed and 35 (10.3% died. The largest number of cases occurred in May (16.8%, March (13.3% and April (11.4%, a period of intense rainfall. The city areas with the greatest occurrence of the disease were South (26.6%, West (23.5% and East (19.7%, areas of the greatest precariousness socio-environment. The largest number of cases, including deaths, occurred in the age group from 14 to 44.9 years (74%, being that 291 (85.8% were male and 48 (14.1% females. The most frequent symptoms were fever, myalgia, headache and jaundice. In relation to the social conditions were identified low education, poor housing, absence of sanitation and low income. CONCLUSIONS: In Manaus, despite the implementation of the Social and Environmental Program of Igarapés of Manaus (PROSAMIM, there are still areas that need a proper urbanization and improvements in socio-environmental conditions, reducing the level of exposure of the human beings that living in these locations. 282. Investigation of a leptospirosis outbreak in triathlon participants, Réunion Island, 2013. Pagès, F; Larrieu, S; Simoes, J; Lenabat, P; Kurtkowiak, B; Guernier, V; Le Minter, G; Lagadec, E; Gomard, Y; Michault, A; Jaffar-Bandjee, M C; Dellagi, K; Picardeau, M; Tortosa, P; Filleul, L 2016-02-01 We report herein the investigation of a leptospirosis outbreak occurring in triathlon competitors on Réunion Island, Indian Ocean. All participants were contacted by phone or email and answered a questionnaire. Detection and molecular characterization of pathogenic Leptospira was conducted in inpatients and in rodents trapped at the vicinity of the event. Of the 160 athletes competing, 101 (63·1%) agreed to participate in the study. Leptospirosis was biologically confirmed for 9/10 suspected cases either by real-time PCR or serological tests (MAT or ELISA). The total attack rate, children's attack rate, swimmers' attack rate, and the attack rate in adult swimmers were respectively estimated at 8·1% [95% confidence interval (CI) 4·3-14·7], 0%, 12·7% (95% CI 6·8-22·4) and 23·1% (95% CI 12·6-33·8). Leptospirosis cases reported significantly more wounds [risk ratio (RR) 4·5, 95% CI 1·6-13], wore complete neoprene suits less often (RR 4·3, 95% CI 1·3-14·5) and were most frequently unlicensed (RR 6·6, 95% CI 2·9-14·8). The epidemiological investigation supported that some measures such as the use of neoprene suits proved efficient in protecting swimmers against infection. PCR detection in rats revealed high Leptospira infection rates. Partial sequencing of the 16S gene and serology on both human and animal samples strongly suggests that rats were the main contaminators and were likely at the origin of the infection in humans. 283. Brotes de leptospirosis humana en la provincia de Ciego de Ãvila, Cuba Human leptospirosis outbreak in the district of Ciego de Ãvila, Cuba Miguel Suárez Hernández 1999-02-01 Full Text Available Se analizan los brotes de leptospirosis ocurridos en la provincia de Ciego de Ãvila en el periodo de 1980 a 1995. En la etapa se notifican 40 brotes. Las actividades principales vinculadas a los mismos fueron la atención al cultivo de la caña de azúcar, al cultivo del plátano, el baño en rÃo y las inundaciones. Se nota un incremento de brotes a partir del mes de junio. En los meses de octubre y noviembre se reportan las mayores incidencias. Los grupos de edades que más casos aportaron fueron de 10-14 años, 15-19 años y 30-34 años. El sexo más afectado fue el masculino. Los grupos más afectados fueron los estudiantes, pobladores urbanos y trabajadores agrÃcolas cañeros. De los 40 brotes, 21 fueron confirmados por medio de la prueba de microaglutinación y 19 por la prueba hemolitica, siendo los serogrupos más frecuentes Pomona y Australis.Forty leptospirosis outbreaks occurred in Ciego de Avila province from 1980 to 1995. The main events involved in the outbreaks were floods, bathing in rivers and activities related to sugar cane and banana cultivation. The number of cases increased after June, with higher incidences reported in October and November. The most affected age groups were 10-14 years, 15-19 years and 30-34 years. Men were more affected than women. Students, people residing in the urban zone and farmers were the most affected groups. A total of 21 outbreaks out of 40 were confirmed by the microagglutination test and the remaining 19 by the hemolytic test. Pomona and Australis were the serogroups most frequently detected by microagglutination. 284. Haemoglobin and red cell counts in leptospirosis patients infected with different serovars Scott Benjamin Craig 2013-04-01 Full Text Available Introduction The aim of the study was to compare haemoglobin and red cell counts between patients known to be infected with a range of leptospiral serovars. Methods The study retrospectively compared the haemoglobin and red cell count results from the first blood samples taken from 207 patients at presentation to a Queensland Health hospital. Results Significant differences were observed in haemoglobin and red cell counts in those infected with Leptospira interrogans serovars Szwajizak and Canicola when compared with most of the other serovars. Conclusions These findings suggest that haemoglobin and red cell counts may be useful in differentiating leptospiral serovars in leptospirosis patients. 285. Leptospirosis: serie de casos en un centro penitenciario de la costa de Ecuador D. Valarezo-Sevilla; V. Sarzosa-Terán 2014-01-01 Se describe los casos de dos pacientes inicialmente diagnosticados como dengue e infección urinaria. Los pacientes eran personas privadas de la libertad en la misma prisión y

estuvieron en contacto con agua dulce estancada aproximadamente dos semanas antes del inicio de los sÃntomas durante las fiestas del carnaval, siendo el sitio probable de la contaminación. El tiempo transcurrido entre el ingreso al hospital y la sospecha de leptospirosis (y el inicio del tratamiento) fue de cuatro dÃas p... 286. Diagnóstico de leptospirosis en ganado bovino productor de carne Alejandro Córdova Izquierdo; Sergio Cano Muñiz; Luis P. Moles y Cervantes; Miguel A. Cisneros Puebla; Gustavo RodrÃguez Ariza; Jorge Ãvila GarcÃa; José F. Pérez Gutiérrez 2005-01-01 La leptospirosis bovina es una de las enfermedades zoonóticas que ha adquirido mayor importancia, debido a sus serias repercusiones en la reproducción del ganado. El objetivo presente trabajo fue identificar las serovariedades de Leptospira interrogans existentes en bovinos de carne en un Municipio del Estado de Campeche, México. Se analizaron 203 muestras, de las cuales, la frecuencia de seropositividad a una o más serovariedades fue de 75.5%. Los mayores porcentajes de serorreacción fueron ... 287. Ionic imbalance and lack of effect of adjuvant treatment with methylene blue in the hamster model of leptospirosis Cleiton Silva Santos 2013-06-01 Full Text Available Leptospirosis in humans usually involves hypokalaemia and hypomagnesaemia and the putative mechanism underlying such ionic imbalances may be related to nitric oxide (NO production. We previously demonstrated the correlation between serum levels of NO and the severity of renal disease in patients with severe leptospirosis. Methylene blue inhibits soluble guanylyl cyclase (downstream of the action of any NO synthase isoforms and was recently reported to have beneficial effects on clinical and experimental sepsis. We investigated the occurrence of serum ionic changes in experimental leptospirosis at various time points (4, 8, 16 and 28 days in a hamster model. We also determined the effect of methylene blue treatment when administered as an adjuvant therapy, combined with late initiation of standard antibiotic (ampicillin treatment. Hypokalaemia was not reproduced in this model: all of the groups developed increased levels of serum potassium (K. Furthermore, hypermagnesaemia, rather than magnesium (Mg depletion, was observed in this hamster model of acute infection. These findings may be associated with an accelerated progression to acute renal failure. Adjuvant treatment with methylene blue had no effect on survival or serum Mg and K levels during acute-phase leptospirosis in hamsters. 288. Knowledge, Attitude and Practices towards Leptospirosis among Lakeshore Communities of Calamba and Los Baños, Laguna, Philippines Joseph Arbiol 2016-04-01 Full Text Available Leptospirosis is a serious and potentially fatal zoonotic disease, but often neglected owing to lack of awareness. This study examined the knowledge, attitudes, and practices concerning leptospirosis among agricultural (n = 152 and non-agricultural (n = 115 workers in the lakeshore communities of Calamba and Los Baños, Laguna, Philippines. The findings showed no significant differences for the knowledge and attitude scores between agricultural and non-agricultural workers. However, agricultural workers had significantly lower prevention practice scores than non-agricultural workers. The ordinary least squares regression model identified gender, use of broadcast media as a source of health information, and knowledge and attitudes about leptospirosis as significant predictors of prevention practices common to both workers. Higher educational attainment was significantly associated with prevention practices among agricultural workers, while higher age and income level were significantly associated with prevention practices among nonagricultural workers. Public health interventions to improve leptospirosis knowledge and prevention practices should include health education and promotion programs, along with the strengthening of occupational health and safety programs in the agricultural sector. 289. The prevalence of interstitial nephritis and leptospirosis in 283 raccoons (Procyon lotor) from 5 different sites in the United States. Hamir, A N; Hanlon, C A; Niezgoda, M; Rupprecht, C E 2001-01-01 A retrospective histopathological study was carried out on tissues of 283 raccoons from 5 different geographical locations for presence of interstitial nephritis and renal leptospirosis. Results of this study indicate that although interstitial nephritis was common in raccoons from all locations, the presence of renal leptospiral spirochetes was not. PMID:11708206 290. Seroprevalence of Brucellosis, Leptospirosis, and Q Fever among Butchers and Slaughterhouse Workers in South-Eastern Iran. Esmaeili, Saber; Naddaf, Saied Reza; Pourhossein, Behzad; Hashemi Shahraki, Abdolrazagh; Bagheri Amiri, Fahimeh; Gouya, Mohammad Mehdi; Mostafavi, Ehsan 2016-01-01 Zoonotic diseases can be occupational hazards to people who work in close contact with animals or their carcasses. In this cross-sectional study, 190 sera were collected from butchers and slaughterhouse workers in different regions of the Sistan va Baluchestan province, in Iran in 2011. A questionnaire was filled for each participant to document personal and behavioural information. The sera were tested for detection of specific IgG antibodies against brucellosis, leptospirosis, and Q fever (phase I and II) using commercial enzymelinked immunosorbent assays (ELISA). The seroprevalence of brucellosis was 7.9%, leptospirosis 23.4%, and phase I and II of Q fever were 18.1% and 14.4%, respectively. The seroprevalence of Q fever and leptospirosis, but not brucellosis, varied among regions within the province (p = 0.01). Additionally, a significant relationship was found between seropositivity of Q fever and camel slaughtering (p = 0.04). Reduced seropositivity rate of brucellosis was associated with use of personal protective equipment (PPE) (p = 0.004). This study shows that brucellosis, leptospirosis and Q fever occur among butchers and slaughterhouse workers in this area. 291. Seroprevalence of Brucellosis, Leptospirosis, and Q Fever among Butchers and Slaughterhouse Workers in South-Eastern Iran. Saber Esmaeili Full Text Available Zoonotic diseases can be occupational hazards to people who work in close contact with animals or their carcasses. In this cross-sectional study, 190 sera were collected from butchers and slaughterhouse workers in different regions of the Sistan va Baluchestan province, in Iran in 2011. A questionnaire was filled for each participant to document personal and behavioural information. The sera were tested for detection of specific IgG antibodies against brucellosis, leptospirosis, and Q fever (phase I and II using commercial enzyme-linked immunosorbent assays (ELISA. The seroprevalence of brucellosis was 7.9%, leptospirosis 23.4%, and phase I and II of Q fever were 18.1% and 14.4%, respectively. The seroprevalence of Q fever and leptospirosis, but not brucellosis, varied among regions within the province (p = 0.01. Additionally, a significant relationship was found between seropositivity of Q fever and camel slaughtering (p = 0.04. Reduced seropositivity rate of brucellosis was associated with use of personal protective equipment (PPE (p = 0.004. This study shows that brucellosis, leptospirosis and Q fever occur among butchers and slaughterhouse workers in this area. 292. [A Case of Leptospirosis in which the Causative Pathogen was Detected Using Cerebrospinal Fluid PCR Eight Days after Onset]. Arita, Yuki; Tono, Toshihiro; Hosoda, Tomohiro; Taguchi, Hiroaki; Sakamoto, Mitsuo; Osone, Yasuo; Nozaki, Hiroyuki 2016-05-01 We report a patient with leptospirosis caused by infection with Leptospira interrogans serovar Rachmati. A 30-year-old Japanese man took part in a survival camp on Iriomote Island, Okinawa, from July 9 to July 15, 2014. During the camp, he swam in the river and kayaked. He developed a high fever and fatigue 7 days after completing his trip and was admitted to our hospital on July 22. On admission, he complained of a posterior cervical pain and a loss of appetite. Laboratory findings revealed granulocytosis, mildly elevated AST and ALT levels, elevated BUN and Cr levels, and a significantly elevated CRP level. No pathogenic bacteria were isolated from blood, urine, or cerebrospinal fluid cultures. We included leptospirosis in the differential diagnosis because of the patient's history of participating in a survival camp on Iriomote Island. Minocycline 200 mg, p.o. showed an excellent efficacy. The Leptospira flagellar gene FlaB was detected using a cerebrospinal fluid PCR. A microscopic agglutination test (MAT) during the convalescent stage demonstrated significant increases in antibodies against L. interrogans serovar Rachmati, confirming the diagnosis of leptospirosis. A medical history including occupation and recent travel history, and an adequate specimen sampling are crucial for the accurate and early diagnosis of leptospirosis. 293. Leptospira Serovars for Diagnosis of Leptospirosis in Humans and Animals in Africa: Common Leptospira Isolates and Reservoir Hosts. Mgode, Georgies F; Machang'u, Robert S; Mhamphi, Ginethon G; Katakweba, Abdul; Mulungu, Loth S; Durnez, Lies; Leirs, Herwig; Hartskeerl, Rudy A; Belmain, Steven R 2015-12-01 The burden of leptospirosis in humans and animals in Africa is higher than that reported from other parts of the world. However, the disease is not routinely diagnosed in the continent. One of major factors limiting diagnosis is the poor availability of live isolates of locally circulating Leptospira serovars for inclusion in the antigen panel of the gold standard microscopic agglutination test (MAT) for detecting antibodies against leptospirosis. To gain insight in Leptospira serovars and their natural hosts occurring in Tanzania, concomitantly enabling the improvement of the MAT by inclusion of fresh local isolates, a total of 52 Leptospira isolates were obtained from fresh urine and kidney homogenates, collected between 1996 and 2006 from small mammals, cattle and pigs. Isolates were identified by serogrouping, cross agglutination absorption test (CAAT), and molecular typing. Common Leptospira serovars with their respective animal hosts were: Sokoine (cattle and rodents); Kenya (rodents and shrews); Mwogolo (rodents); Lora (rodents); Qunjian (rodent); serogroup Grippotyphosa (cattle); and an unknown serogroup from pigs. Inclusion of local serovars particularly serovar Sokoine in MAT revealed a 10-fold increase in leptospirosis prevalence in Tanzania from 1.9% to 16.9% in rodents and 0.26% to 10.75% in humans. This indicates that local serovars are useful for diagnosis of human and animal leptospirosis in Tanzania and other African countries. 294. Leptospira Serovars for Diagnosis of Leptospirosis in Humans and Animals in Africa: Common Leptospira Isolates and Reservoir Hosts. Georgies F Mgode 2015-12-01 Full Text Available The burden of leptospirosis in humans and animals in Africa is higher than that reported from other parts of the world. However, the disease is not routinely diagnosed in the continent. One of major factors limiting diagnosis is the poor availability of live isolates of locally circulating Leptospira serovars for inclusion in the antigen panel of the gold standard microscopic agglutination test (MAT for detecting antibodies against leptospirosis. To gain insight in Leptospira serovars and their natural hosts occurring in Tanzania, concomitantly enabling the improvement of the MAT by inclusion of fresh local isolates, a total of 52 Leptospira isolates were obtained from fresh urine and kidney homogenates, collected between 1996 and 2006 from small mammals, cattle and pigs. Isolates were identified by serogrouping, cross agglutination absorption test (CAAT, and molecular typing. Common Leptospira serovars with their respective animal hosts were: Sokoine (cattle and rodents; Kenya (rodents and shrews; Mwogolo (rodents; Lora (rodents; Qunjian (rodent; serogroup Grippotyphosa (cattle; and an unknown serogroup from pigs. Inclusion of local serovars particularly serovar Sokoine in MAT revealed a 10-fold increase in leptospirosis prevalence in Tanzania from 1.9% to 16.9% in rodents and 0.26% to 10.75% in humans. This indicates that local serovars are useful for diagnosis of human and animal leptospirosis in Tanzania and other African countries. 295. Leptospira Serovars for Diagnosis of Leptospirosis in Humans and Animals in Africa: Common Leptospira Isolates and Reservoir Hosts Mgode, Georgies F.; Machang’u, Robert S.; Mhamphi, Ginethon G.; Katakweba, Abdul; Mulungu, Loth S.; Durnez, Lies; Leirs, Herwig; Hartskeerl, Rudy A.; Belmain, Steven R. 2015-01-01 The burden of leptospirosis in humans and animals in Africa is higher than that reported from other parts of the world. However, the disease is not routinely diagnosed in the continent. One of major factors limiting diagnosis is the poor availability of live isolates of locally circulating Leptospira serovars for inclusion in the antigen panel of the gold standard microscopic agglutination test (MAT) for detecting antibodies against leptospirosis. To gain insight in Leptospira serovars and their natural hosts occurring in Tanzania, concomitantly enabling the improvement of the MAT by inclusion of fresh local isolates, a total of 52 Leptospira isolates were obtained from fresh urine and kidney homogenates, collected between 1996 and 2006 from small mammals, cattle and pigs. Isolates were identified by serogrouping, cross agglutination absorption test (CAAT), and molecular typing. Common Leptospira serovars with their respective animal hosts were: Sokoine (cattle and rodents); Kenya (rodents and shrews); Mwogolo (rodents); Lora (rodents); Qunjian (rodent); serogroup Grippotyphosa (cattle); and an unknown serogroup from pigs. Inclusion of local serovars particularly serovar Sokoine in MAT revealed a 10-fold increase in leptospirosis prevalence in Tanzania from 1.9% to 16.9% in rodents and 0.26% to 10.75% in humans. This indicates that local serovars are useful for diagnosis of human and animal leptospirosis in Tanzania and other African countries. PMID:26624890 296. New parameters available on Sysmex XE-5000 hematology analyzers contribute to differentiating dengue from leptospirosis and enteric fever. Oehadian, A; Michels, M; de Mast, Q; Prihatni, D; Puspita, M; Hartantri, Y; Sinarta, S; van der Ven, A J A M; Alisjahbana, B 2015-12-01 Distinguishing dengue virus infection from other febrile thrombocytopenic illnesses such as leptospirosis or enteric fever is important but difficult, due to the unavailability of reliable diagnostic tests. Sysmex XE-5000 hematology analyzers use fluorescence flow cytometry to quantitate new parameters including cells in the atypical lymphocyte area (AL), highfluorescent lymphocyte counts (HFLC), immature granulocytes (IG), and immature platelets (IPF). This study aimed to investigate whether these parameters can help to discriminate between the diseases. We compared hematocytometry performed by a Sysmex XE-5000 analyzer in Indonesian adults with dengue (n = 93), leptospirosis (n = 11), and enteric fever (n = 6) infection, and in healthy controls (n = 28). Receiver operating characteristic curves comparing dengue and leptospirosis showed that dengue was characterized by increased %AL (AUC 0.87; 95% CI 0.70-1.03), %HFLC (AUC 0.89; 95% CI 0.78-0.99), and %IPF (AUC 0.81; 95% CI 0.65-0.97), while patients with leptospirosis had increased %IG (AUC 0.86; 95% CI 0.71-1.02). Low %AL, %HFLC, and %IG supported a diagnosis of enteric fever. The detection of AL, HFLC, IG, and IPF by Sysmex XE-5000 hematology analyzers can help to differentiate between common causes of febrile illnesses with thrombocytopenia in dengue endemic areas. We recommend further investigating the discriminatory value of these parameters in clinical practice. © 2015 John Wiley & Sons Ltd. 297. Socio-environmental determinants of the leptospirosis outbreak of 1996 in western Rio de Janeiro: a geographical approach. Barcellos, C; Sabroza, P C 2000-12-01 The environmental and social context in which a leptospirosis outbreak took place during the summer of 1996 in the Rio de Janeiro Western Region was examined by using spatial analysis of leptospirosis cases merged with population and environmental data in a Geographical Information System (GIS). Important differences were observed between places where residences of leptospirosis cases are concentrated and other places in the region. Water supply coverage, solid waste collection, sewerage system coverage and flood risk area were the main determining variables from an initial list of ten. The influence of these unfavorable social and environmental factors is verified hundreds of meters distant from the leptospirosis case residences, demonstrating a necessity to broaden the area of health surveillance practices. The geocoding indicated that some cases did not report contact with flood water, even though they were geographically adjacent to cases who did report this contact. Cases may only report exposures they believe are related to the disease. Geocoding is a useful tool for evaluating such bias in the exposure recall. 298. Epidemiological study on human and canine leptospirosis in Central and North Kerala Manju Soman 2014-10-01 Full Text Available Aim: The aim was to study the epidemiology of human and animal leptospirosis in Central and Northern Kerala, by isolation techniques and serology. Materials and Methods: Kidney tissues from 35 rodents (11 bandicoots and 24 rats, autopsy specimens from two canines, blood from 15 canines and 30 human beings were subjected to isolation trials for Leptospira. Sera from these animals and human beings were screened for leptospiral antibodies by microscopic agglutination test (MAT. Results: Leptospira could be isolated from human blood as well as from rodent kidney tissues. The MAT could detect the presence of leptospiral antibodies in 54.54% of human sera, 36.36% of dog sera and 21.42% of rodent sera. Pomona and Australis were the most predominant serovars detected in man, dog, and rodents. Tentative serotyping of the isolates by MAT revealed its identity as Leptospira interrogans serovar Pomona. Conclusion: Detection of common serovars of Leptospira in man and animals by serology as well as isolation reiterates the major role played by animals in the epidemiology of human leptospirosis. 299. Leptospirosis: serie de casos en un centro penitenciario de la costa de Ecuador D. Valarezo-Sevilla 2014-06-01 Full Text Available Se describe los casos de dos pacientes inicialmente diagnosticados como dengue e infección urinaria. Los pacientes eran personas privadas de la libertad en la misma prisión y estuvieron en contacto con agua dulce estancada aproximadamente dos semanas antes del inicio de los sÃntomas durante las fiestas del carnaval, siendo el sitio probable de la contaminación. El tiempo transcurrido entre el ingreso al hospital y la sospecha de leptospirosis (y el inicio del tratamiento fue de cuatro dÃas para el paciente del caso 1 y dos dÃas para el caso 2; entre el ingreso y la confirmación diagnóstica por laboratorio fue de diez dÃas para el caso 1 y cuatro dÃas para el caso 2. Se concluye que la leptospirosis no se considera como una opción dentro del diagnóstico diferencial inicial sino luego de descartar otras patologÃas. 300. é’©ç«¯èžºæ—‹ä½“ç—…çš„ç ”ç©¶è¿›å±•%Research progress on leptospirosis 邹å°é™; 皮定芳; 田德英 2008-01-01 钩端螺旋体病(钩体病)是全世界范围内æµè¡Œçš„人兽共患病,也是洪æ¶ç¾åŒºé‡ç‚¹ç›‘æŽ§çš„ä¼ æŸ“ç—…ä¹‹ä¸€.2007å¹ ´6月,我国多个çœå¸‚éå—暴雨洪ç¾,钩体病一旦爆å‘,å°†æˆä¸ºé‡å¤§å…¬å…±å«ç”Ÿé—®é¢˜.æ¤æ–‡å°±é’©ä½“病的病原å¦ã€æµè¡Œç—…å¦ã€å‘ç—… 机制ã€è¯Šæ–åŠé¢„防进行综述.%Leptospirosis is a serious worldwide zoonotic disease,and especially monitored in flood distress area.In June 2007,many cities in China suffered from pelting rain or flood,once the leptospimsis outbreak,it could be a serious public health problem.The paper will review the pathogen,epidemiology,pathogenesis,diagnosis and prevention of leptospirosis in recent years. « 13 14 15 16 17 » « 14 15 16 17 18 » 301. Diagnostic features in 10 naturally occurring cases of acute fatal canine leptospirosis. Rissi, Daniel R; Brown, Cathy A 2014-11-01 The current report describes the diagnostic features in 10 cases of acute fatal canine leptospirosis with minimal renal and hepatic changes that may present a diagnostic challenge for the pathologist. Most affected dogs were less than 6 months of age and had a biochemical profile consistent with hepatorenal dysfunction. Clinical signs consisted of vomiting, depression, icterus, dehydration, diarrhea, and anorexia. All dogs died or were humanely euthanized within 3-7 days after the onset of clinical disease. Necropsy findings included pulmonary edema with hemorrhages, icterus, renal and hepatic pallor and swelling, and gastric edema with hemorrhage. Despite severe azotemia, histological changes in the kidneys were subtle in all dogs, and included mild renal tubular simplification, with single-cell necrosis and attenuation, along with minimal interstitial lymphoplasmacytic inflammation, edema, and hemorrhage. Hepatic lesions included scattered hepatocellular single-cell necrosis and hepatocellular dissociation. Prominent extrarenal lesions typically associated with uremia including vascular fibrinoid necrosis in multiple organs, pulmonary mineralization with occasional fibrinosuppurative exudation, and gastric mineralization were also present. Postmortem diagnostic confirmation was based on the detection of leptospiral antigen on fresh renal samples by fluorescent antibody test and on the demonstration of intact spirochetes in sections of kidneys using immunohistochemical staining. Acute fatal canine leptospirosis occurred as a fulminant hepatorenal disease affecting mainly young dogs, and the diagnosis was dependent on the recognition of the subtle renal changes with confirmation via fluorescent antibody testing or immunohistochemical staining. 302. Algunos aspectos clinicoepidemiológicos en fallecidos por leptospirosis humana en Ciudad de La Habana Beatriz RodrÃguez Alonso 2001-02-01 Full Text Available Se realizó un estudio descriptivo de carácter retrospectivo en 9 hospitales clinicoquirúrgicos de Ciudad de La Habana, revisándose las historias clÃnicas de los fallecidos por leptospirosis humana durante el quinquenio 1992-1997. Las variables estudiadas fueron: edad, sexo, fuente de infección, tipo de contacto, época del año, sÃntomas y signos más frecuentes y enfermedades asociadas. Entre los principales resultados se señalan el predominio de fallecidos mayores de 50 años y del sexo masculino; la principal fuente de infección es la crianza de cerdos. Todos los fallecidos presentaron fiebre y mialgias en miembros inferioresA descriptive restrospective study was conducted in 9 clinical and surgical hospitals of Havana City. The medical histories of the dead due to human leptospirosis from 1992 to 1997 were reviewed. The studied variables were: age, sex, source of infection, type of contact, season of the year, the most frequent symptoms and signs and associated diseases. The predominance of male dead individuals over 50 was among the main results. The main source of infection was pig breeding. All those who died had fever and myalgias in the lower limbs 303. Leptospirosis in dogs and cats: epidemiology, clinical disease, zoonotic implications and prevention L Azócar-Aedo 2014-01-01 Full Text Available Leptospirosis is a zoonotic disease of worldwide distribution caused by spirochetes of the genus Leptospira. The genus includes a large number of serovars that may be sheed in the urine of infected animals creating a highly infectious source of transmission. Numerous species of wild and domestic mammals act as maintenance hosts and form reservoirs of the bacteria, with other species being incidental hosts that may develop the disease. In dogs and cats, the disease is caused by different serovars and while dogs act as maintenance host for some serovars, both species are incidental host for others. Dogs and cats may have frequent contact with wild and domestic farm animals, therefore they are an important link in the transmission route. Leptospira may survive in the environment which increases the complexity of the epidemiology. The presentation of the disease can be highly variable and, particularly for feline leptospirosis, not well described. Laboratory testing is essential for the diagnosis, however, it is complicated due to the need to discriminate between Leptospira infection in animals with clinical disease from leptospiral specific antibody responses in maintenance hosts, or in animals with subclinical infection. Infection in pets may have important economic and public health implications and because of the risk of transmission from pets to their owners and to other animals, preventive measures need to be applied and an increased awareness is adviced. 304. A ten-year follow-up of human leptospirosis in Uruguay: an unresolved health problem Felipe Schelotto 2012-04-01 Full Text Available Leptospira spp. are delicate bacteria that cannot be studied by usual microbiological methods. They cause leptospirosis, a zoonotic disease transmitted to humans through infected urine of wild or domestic animals. We studied the incidence of this disease in the Uruguayan population, its epidemiologic and clinical features, and compared diagnostic techniques. After examining 6,778 suspect cases, we estimated that about 15 infections/100,000 inhabitants occurred yearly, affecting mainly young male rural workers. Awareness about leptospirosis has grown among health professionals, and its lethality has consequently decreased. Bovine infections were probably the principal source of human disease. Rainfall volumes and floods were major factors of varying incidence. Most patients had fever, asthenia, myalgias or cephalalgia, with at least one additional abnormal clinical feature. 30-40% of confirmed cases presented abdominal signs and symptoms, conjunctival suffusion and altered renal or urinary function. Jaundice was more frequent in patients aged > 40 years. Clinical infections followed an acute pattern and their usual outcome was complete recovery. Laboratory diagnosis was based on indirect micro-agglutination

standard technique (MAT. Second serum samples were difficult to obtain, often impairing completion of diagnosis. Immunofluorescence was useful as a screening test and for early detection of probable infections. 305. Leptospirosis en niños de la Provincia de Ciego de Ãvila, Cuba Suárez Hernández Miguel 1999-01-01 Full Text Available Se analiza la morbilidad por leptospirosis humana en niños de la Provincia de Ciego de Ãvila, Cuba en el perÃodo de 1982 a 1995 donde se diagnosticaron 253 casos. Los casos aislados predominaron sobre los presentados en brotes. Con respecto a los grupos de edades predominó el de 10 a 14 años seguido del grupo de 5 a 9 aà ±os. Fue más frecuente el sexo masculino que el femenino, en esta etapa se presentó un fallecido. En la presentación de casos por meses se reporta un incremento de enfermos a partir del mes de julio, siendo agosto, octubre y noviembre los meses de mayor incidencia; los sÃntomas y signos de mayor frecuencia fueron fiebre, cefalea y mialgia; el 92% de los casos eran anictéricos. Los diagnósticos presuntivos más planteados fueron sÃndrome febril agudo, leptospirosis y meningoencefalitis viral. En las posibles fuentes de infección el contacto con terrenos bajos y el baño en fuentes de agua dulce, presentaron el mayor número de casos. En lo referente al diagnóstico 162 se diagnosticaron por microaglutinación y 91 por prueba hemolÃtica. En la primera los serogrupos CanÃcola Australis y Pomona tuvieron el mayor reporte. 306. Sero-Prevalence and Risk Factors for Leptospirosis in Abattoir Workers in New Zealand Anou Dreyfus 2014-02-01 Full Text Available 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. 307. Sero-prevalence and risk factors for leptospirosis in abattoir workers in New Zealand. Dreyfus, Anou; Benschop, Jackie; Collins-Emerson, Julie; Wilson, Peter; Baker, Michael G; Heuer, Cord 2014-02-05 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. 308. Accuracy of a Commercial IgM ELISA for the Diagnosis of Human Leptospirosis in Thailand Desakorn, Varunee; Wuthiekanun, Vanaporn; Thanachartwet, Vipa; Sahassananda, Duangjai; Chierakul, Wirongrong; Apiwattanaporn, Apichat; Day, Nicholas P.; Limmathurotsakul, Direk; Peacock, Sharon J. 2012-01-01 The Leptospira immunoglobulin M enzyme-linked immunosorbent assay (IgM ELISA) has been recommended for the rapid diagnosis of leptospirosis in endemic areas. We conducted a retrospective case-control study of 218 patients (109 leptospirosis cases confirmed by Leptospira culture and/or microscopic agglutination test and 109 control patients with acute febrile illness) to evaluate the diagnostic accuracy of a commercial IgM ELISA (Panbio) in northeast Thailand. Paired serum samples taken on admission and at least 10 days after the onset of symptoms were tested. Using the cutoff value recommended by the manufacturer (11 Panbio units), sensitivity and specificity of IgM ELISA on paired sera were 90.8% and 55.1%. A receiver operating characteristic curve was used to determine the optimal cutoff value. This was 20 Panbio units, which gave a sensitivity and specificity of 76.1% and 82.6%, respectively, on paired sera. We conclude that using either cutoff value, the accuracy of IgM ELISA is limited in our setting. PMID:22403329 309. New approach for serological testing for leptospirosis by using detection of leptospira agglutination by flow cytometry light scatter analysis. Yitzhaki, S; Barnea, A; Keysary, A; Zahavy, E 2004-04-01 Leptospirosis is considered an important reemerging infectious disease worldwide. The standard and most widespread method for the diagnosis of leptospirosis is the microscopic agglutination test (MAT). This test is laborious and time-consuming, and the interpretation of the results is subjective. In the present work we describe an application of flow cytometry (FCM) as a tool for the serological diagnosis of leptospirosis. The analysis is based on the sensitivity of FCM to the size and shape of the bacteria analyzed by measurement of light scatter parameters: forward scatter (FSC) and side scatter (SSC). The addition of positive serum to an infecting leptospiral serovar results in a shift of the light scatter parameter to a different location with higher FSC and SSC values, indicating the formation of leptospiral aggregates. By using immunofluorescent staining, we have shown that the large particles formed are the agglutinated leptospires. Quantification of the agglutination process has been achieved by calculating an agglutination factor (Af), based on changes in the light scatter parameters measured by FCM. Af enables us to determine the specificity of the serological reaction of the patient serum with each leptospiral serovar. In this work, 27 serum samples from 18 leptospirosis patients were tested by both the MAT and the FCM techniques, in which each serum sample was tested against 13 serovars. Twenty-six human serum samples derived from patients with a variety of other defined illnesses were used as negative controls and enabled us to define the Af threshold value as < 9.3 for negative patients, while any value higher than that would be a positive result for leptospirosis. Compared to MAT, the FCM technique was found to be more specific and sensitive, especially in identifying the serogroup in the acute phase of the disease. The whole process was found to be rapid and took less than 1.5 h. Moreover, FCM analysis is objective and can be automated for the 310. Role of 72 kDa protein of Leptospira interrogans as a diagnostic marker in acute leptospirosis M Riazi 2014-01-01 Full Text Available Background & objectives: Leptospirosis is a widespread zoonotic disease and a public health problem, particularly in tropical and subtropical countries. Varied clinical manifestations of the disease frequently lead to misdiagnosis resulting in life-threatening multi-organ complications. Therefore, early laboratory investigation using an appropriate diagnostic approach is crucial. In the present study, a potential protein marker was identified and evaluated for its usefulness in the serodiagnosis of acute leptospirosis. Methods: Leptospira interrogans serovar Icterohaemorrhagiae (L44, which represents a commonly prevalent serovar in Malaysia, was cultivated for preparation of sequential protein extract (SEQ. SDS-PAGE and immunoblotting were performed with a serum panel comprising confirmed cases of leptospirosis and controls (n=42 each. Identification and characterization of the highest scoring protein from the antigenic band was performed. Subsequently based on the nucleotide coding sequence of the protein, the corresponding recombinant protein was custom-produced. It was then evaluated for sensitivity and specificity by testing against 20 serum samples from leptospirosis patients and 32 from controls. Results: Among the antigenic components, a 72kDa protein band demonstrated significant sensitivity (83.3% and specificity (95.2% for the detection of specific anti-leptospiral IgM antibodies. The protein was identified by mass-spectrometry analysis as heat shock protein DnaK of L. interrogans. Recombinant form of the protein (r72SEQ showed 85 per cent sensitivity and 81 per cent specificity for the detection of specific anti-leptospiral IgM antibodies. Interpretation & conclusions: The findings of our study indicate that a protein (72kDa of L. interrogans has the potential utility of being used for the diagnosis of acute leptospirosis. Further studies need to be done to confirm these findings. 311. Human Leptospirosis Infection in Fiji: An Eco-epidemiological Approach to Identifying Risk Factors and Environmental Drivers for Transmission: e0004405 Colleen L Lau; Conall H Watson; John H Lowry; Michael C David; Scott B Craig; Sarah J Wynwood; Mike Kama; Eric J Nilles 2016-01-01  Leptospirosis is an important zoonotic disease in the Pacific Islands. In Fiji, two successive cyclones and severe flooding in 2012 resulted in outbreaks with 576 reported cases and 7% case-fatality... 312. Validation of a case definition for leptospirosis diagnosis in patients with acute severe febrile disease admitted in reference hospitals at the State of Pernambuco, Brazil Alfredo Pereira Leite de Albuquerque Filho 2011-12-01 Full Text Available INTRODUCTION: Leptospirosis is often mistaken for other acute febrile illnesses because of its nonspecific presentation. Bacteriologic, serologic, and molecular methods have several limitations for early diagnosis: technical complexity, low availability, low sensitivity in early disease, or high cost. This study aimed to validate a case definition, based on simple clinical and laboratory tests, that is intended for bedside diagnosis of leptospirosis among hospitalized patients. METHODS: Adult patients, admitted to two reference hospitals in Recife, Brazil, with a febrile illness of less than 21 days and with a clinical suspicion of leptospirosis, were included to test a case definition comprising ten clinical and laboratory criteria. Leptospirosis was confirmed or excluded by a composite reference standard (microscopic agglutination test, ELISA, and blood culture. Test properties were determined for each cutoff number of the criteria from the case definition. RESULTS: Ninety seven patients were included; 75 had confirmed leptospirosis and 22 did not. Mean number of criteria from the case definition that were fulfilled was 7.8±1.2 for confirmed leptospirosis and 5.9±1.5 for non-leptospirosis patients (p1:400 utilizando diagnóstico serológico por microaglutinación o pruebas que detecten IgM, o 5 resultado positivo de la prueba de reacción en cadena de la polimerasa en sangre, orina, lÃquido cefalorraquÃdeo o muestras de tejidos post mórtem. Debido a que las dos primeras formas de diagnóstico requieren de un personal experto para la visualización de Leptospira spp., nos proponemos presentar a la comunidad médica imágenes de referencia de Leptospira spp. que se observan en el microscopio de campo oscuro provenientes de muestras de sangre o de cultivo. Se necesita disponer de métodos de diagnóstico para leptospirosis en los laboratorios de salud pública, además de personal capacitado para realizarlos, lo cual permite confirmar el diagnóstico clÃnico de una etiologÃa que como ésta, presenta sÃntomas comunes a 367. High levels of serum mannose-binding lectin are associated with the severity of clinical signs of leptospirosis K.A. Miranda 2009-04-01 Full Text Available The clinical heterogeneity observed in leptospirosis may be associated with host factors or bacteria virulence. Human serum mannose-binding lectin (MBL recognizes many pathogens, and low levels of this lectin are associated with susceptibility to infection. MBL is also implicated in the modulation of the inflammatory process. We determined the levels of serum MBL during leptospirosis infection. A double-antibody sandwich ELISA was used to detect the immunoreactive serum MBL. The ELISA plates were coated with monoclonal antibody to MBL and bound MBL or recombinant human MBL were detected by rabbit anti-human MBL serum. HRPO-conjugated goat anti-rabbit antibody was used for detection of the reaction. Two groups of patients seen at referral hospitals in Recife, PE, Brazil, were divided according to the year of infection, 2001 (N = 61 or 2002 (N = 57 and compared in terms of disease severity and levels of serum MBL. A group of healthy volunteers (N = 97 matched by age, gender, and ethnic background was used as control. Patients infected in 2001 had more severe outcomes than those infected in 2002, including jaundice, hemorrhage, respiratory alteration, and renal complication (P = 0.0009; chi-square test. The frequency of patients producing serum MBL >1000 ng/mL was higher in the 2001 group than in the 2002 and control groups (P < 0.01, suggesting an association of MBL level with disease severity. The involvement of MBL and genetic variation of the MBL2 gene should be further evaluated to establish the role of this lectin in the pathogenesis of leptospirosis. 368. Producción y evaluación serológica de una bacterina contra la leptospirosis bovina Edna Sánchez C; Benito Gutiérrez; Cindy Fernández; Janeth Arias P 2007-01-01 Objetivo. Producir una bacterina contra leptospirosis bovina. Materiales y métodos. La producción de la bacterina se realizó a partir de cultivos de L. pomona, L. grippotyphosa, L. hardjobovis, L. hardjoprajitno, L. icterohaemorrhagiae y L. canicola con concentraciones entre 1x108 y 1x1010 células/ml. Las leptospiras se inactivaron con formol y se adsorbieron en hidróxido de aluminio para formular la vacuna. La concentración final de cada serovar fue de 1x108 Leptospiras/ml. Para realizar la ... 369. Prevention and Treatment of Canine Leptospirosis Disease%犬钩端螺旋体病的防治措施 王飞; 刘士国 2015-01-01 The pathogen,epidemiolo-gy,clinical symptoms,necropsy lesions and diagnosis methods of canine lep-tospirosis disease were elaborated,and some prevention measures were proposed to provide a reference for the prevention and treatment of this disease.%é˜è¿°äº†çŠ¬é’©ç«¯èžºæ—‹ä½“病的病原ã€æµè¡Œç—…å¦ã€ä¸´åºŠç—‡çŠ¶ã€ç—… ç†å˜åŒ–ã€è¯Šæ–方法，并æ出了相应的防治措施，旨在为该病的防治æä¾›å‚考。 370. Zero-modified Poisson model: Bayesian approach, influence diagnostics, and an application to a Brazilian leptospirosis notification data. Conceição, Katiane S; Andrade, Marinho G; Louzada, Francisco 2013-09-01 In this paper, a Bayesian method for inference is developed for the zero-modified Poisson (ZMP) regression model. This model is very flexible for analyzing count data without requiring any information about inflation or deflation of zeros in the sample. A general class of prior densities based on an information matrix is considered for the model parameters. A sensitivity study to detect influential cases that can change the results is performed based on the Kullback-Leibler divergence. Simulation studies are presented in order to illustrate the performance of the developed methodology. Two real datasets on leptospirosis notification in Bahia State (Brazil) are analyzed using the proposed methodology for the ZMP model. 371. Human Leptospirosis Infection in Fiji: An Eco-epidemiological Approach to Identifying Risk Factors and Environmental Drivers for Transmission. Colleen L Lau 2016-01-01 Full Text Available Leptospirosis is an important zoonotic disease in the Pacific Islands. In Fiji, two successive cyclones and severe flooding in 2012 resulted in outbreaks with 576 reported cases and 7% case-fatality. We conducted a cross-sectional seroprevalence study and used an eco-epidemiological approach to characterize risk factors and drivers for human leptospirosis infection in Fiji, and aimed to provide an evidence base for improving the effectiveness of public health mitigation and intervention strategies. Antibodies indicative of previous or recent infection were found in 19.4% of 2152 participants (81 communities on the 3 main islands. Questionnaires and geographic information systems data were used to assess variables related to demographics, individual behaviour, contact with animals, socioeconomics, living conditions, land use, and the natural environment. On multivariable logistic regression analysis, variables associated with the presence of Leptospira antibodies included male gender (OR 1.55, iTaukei ethnicity (OR 3.51, living in villages (OR 1.64, lack of treated water at home (OR 1.52, working outdoors (1.64, living in rural areas (OR 1.43, high poverty rate (OR 1.74, living 0.05). The main species of rat were Sewer rat before and Insectivorea after the storage of water. The germ-carrying rate of rats was 1.72% (10/583) and positive carrying rate of rats was 16.51% (18/109) when using PCR. Results showed a significant difference when comparing it to culture method (chi2 = 51.80, P leptopirosis occurred in the Three Gorges dam area. There was no significant difference between mouse density before and after the storage of water in the reservoir. However, the major species of rats had a change. The natural infection level of people living in the dam area was low, but there existed potential of leoptopirosis outbreak. « 17 18 19 20 21 » « 18 19 20 21 22 » 381. Efficacy of cefepime, ertapenem and norfloxacin against leptospirosis and for the clearance of pathogens in a hamster model. Zhang, Wenlong; Zhang, Naisheng; Wang, Wei; Wang, Fei; Gong, Yue; Jiang, Haichao; Zhang, Zecai; Liu, Xiaofei; Song, Xiaojing; Wang, Tiancheng; Ding, Zhuang; Cao, Yongguo 2014-12-01 Animals and humans with severe leptospirosis may require empirical treatment. Although many antibiotics are active against multiple leptospira serovars in vitro, their efficacy in vivo is limited. We evaluated the efficacy of cefepime (daily dose: 2, 5, 10, and 20 mg/kg), ertapenem (daily dose: 2.5, 5, and 10 mg/kg) and norfloxacin (daily dose: 20, 40, and 80 mg/kg) for the treatment of leptospirosis and the ability to clear leptospira in target organs (liver, kidney, lung, heart, and spleen) in a lethal hamster model using Leptospira interrogans serovar Autumnalis. The histopathology of infected kidney, lung and liver was also evaluated using hematoxylin and eosin stain (H&E stain). All untreated animals, serving as a negative control, died with leptospira existing in the target organs between the 5th and 7th day after infection. All of the treated groups displayed improved survival compared to the untreated group and demonstrated a dose-dependent decrease in the presence of leptospira in the target organs. Cefepime showed survival benefit comparable to the standard treatment, doxycycline. We conclude that all of the antibiotics tested in vivo produce a statistically significant survival advantage, alleviate tissue injury and decrease the abundance of leptospira in target organs. Copyright © 2014 Elsevier Ltd. All rights reserved. 382. Human leptospirosis in Seychelles: A prospective study confirms the heavy burden of the disease but suggests that rats are not the main reservoir. Leon Biscornet 2017-08-01 Full Text Available Leptospirosis is a bacterial zoonosis caused by pathogenic Leptospira for which rats are considered as the main reservoir. Disease incidence is higher in tropical countries, especially in insular ecosystems. Our objectives were to determine the current burden of leptospirosis in Seychelles, a country ranking first worldwide according to historical data, to establish epidemiological links between animal reservoirs and human disease, and to identify drivers of transmission.A total of 223 patients with acute febrile symptoms of unknown origin were enrolled in a 12-months prospective study and tested for leptospirosis through real-time PCR, IgM ELISA and MAT. In addition, 739 rats trapped throughout the main island were investigated for Leptospira renal carriage. All molecularly confirmed positive samples were further genotyped.A total of 51 patients fulfilled the biological criteria of acute leptospirosis, corresponding to an annual incidence of 54.6 (95% CI 40.7-71.8 per 100,000 inhabitants. Leptospira carriage in Rattus spp. was overall low (7.7% but dramatically higher in Rattus norvegicus (52.9% than in Rattus rattus (4.4%. Leptospira interrogans was the only detected species in both humans and rats, and was represented by three distinct Sequence Types (STs. Two were novel STs identified in two thirds of acute human cases while noteworthily absent from rats.This study shows that human leptospirosis still represents a heavy disease burden in Seychelles. Genotype data suggests that rats are actually not the main reservoir for human disease. We highlight a rather limited efficacy of preventive measures so far implemented in Seychelles. This could result from ineffective control measures of excreting animal populations, possibly due to a misidentification of the main contaminating reservoir(s. Altogether, presented data stimulate the exploration of alternative reservoir animal hosts. 383. Leptospirosis en la población de la Región Huetar Norte durante el periodo comprendido entre 1997 y 2000 Ana Catalina Sáenz -Zamora 2004-10-01 Full Text Available Justificación y objetivo: Determinar el comportamiento epidemiológico de la leptospirosis en la población de la Región Huetar Norte, durante el periodo comprendido entre 1997 y 2000, según la información biomédica de la sede regional del Ministerio de Salud y del Hospital San Carlos. Método: Se pidió a INCIENSA una lista de los casos con serologÃa positiva por leptospirosis de la Región Huetar Norte, vistos de 1997 al 2000; se solicitaron los expedientes clÃnicos de estos pacientes a la oficina de BioestadÃstica del Hospital San Carlos y de allà se obtuvieron los datos requeridos por una hoja previamente confeccionada. Resultados: Se encontró un total de 58 pacientes diagnosticados con leptospirosis en dicha región, en el periodo en estudio; predominó el género masculino, en una relación de 13:1. La población más afectada fue la de los adultos jóvenes, entre los 15 y los 30 años. El cantón de donde provinieron más personas con la enfermedad fue San Carlos. Más de la tercera parte de estas personas se ocupaban de labores agrÃcolas o ganaderÃa. Los serotipos encontrados de manera más frecuente fueron pyrogenes, seguido de sejroe, tarassovi y hebdomadis. Las principales manifestaciones fueron: fiebre, cefalea, mialgias, sangrados, alteración en las pruebas de función renal y hepática, trombocitopenia y aumento de la creatinin fosfoquinasa. Conclusiones: En casi la totalidad de los pacientes fue posible determinar factores de riesgo, y en la mayorÃa el principal factor fue la exposición ocupacional. El hallazgo de leucopenia es tres veces más frecuente que el de leucocitosis, por lo que se puede afirmar que existe un comportamiento clÃnico diferente de la leptospirosis descrito en la bibliografÃaAim and objectives: To determine the epidemiological behavior of leptospirosis among the population of the northern region (Región Huetar Norte of Costa Rica, during the 4 year period comprised between 1997 to 2000 384. Comportamiento de la vigilancia epidemiológica de la leptospirosis humana en Colombia, 2007-2011 Solmara Bello 2013-08-01 Full Text Available Introducción. La leptospirosis es una zoonosis reemergente de distribución mundial causada por una espiroqueta del género Leptospira. Durante los últimos años en Colombia aumentó el número de casos en humanos y animales. Objetivo. Caracterizar epidemiológicamente los casos de leptospirosis notificados al Sistema Nacional de Vigilancia en Salud Pública de Colombia y hacer una aproximación para conocer los serogrupos que circulan en el paÃs. Materiales y métodos. Se diseñó un estudio observacional de corte retrospectivo, con registros del proceso de vigilancia de los casos reportados por el software Sivigila y muestras enviadas al Grupo de MicrobiologÃa de la Red Nacional de Laboratorios, durante el periodo 2007 a 2011. Se registraron variables de tipo sociodemográficas y se analizaron 17 serogrupos de Leptospira. En el análisis seutilizaron medidas de frecuencia, tendencia central y dispersión. Resultados. Se procesaron 11.786 registros, confirmándose 4.621 casos de leptospirosis. Las entidades territoriales con mayor registro fueron Valle del Cauca, Antioquia, Risaralda, Atlántico y Barranquilla; y las de incidencia más alta fueron Guaviare, Risaralda, San Andrés, Santa Marta y Barranquilla. El mayor número de casos reportados perteneció al área urbana, con mayor frecuencia de hombres (77 %, estudiantes (19,4 % y amas de casas (13,6 %, con una mediana por edad de 29 años (rango intercuartÃlico: 45-19. Se evidenció la circulación de 17 serogrupos en el paÃs; los más frecuentes fueron Australis (24,89 %, Hebdomadis (9,33 % y Sejroe (8,0 %. Conclusión. En Colombia se ha mejorado la notificación y clasificación final de los casos, lo que ha permitido identificar al serogrupo Australis como el de mayor circulación.  doi: http://dx.doi.org/10.7705/biomedica.v33i0.1608 385. Randomized controlled trial of pulse methyl prednisolone × placebo in treatment of pulmonary involvement associated with severe leptospirosis. [ISRCTN74625030 Leite Alfredo 2011-06-01 Full Text Available Abstract Background The lungs are involved in up to 70% of cases of leptospirosis. In the more severe forms-bleeding from the lungs and acute respiratory distress syndrome-the lethality is high. The treatment proposed for leptospirotic pneumonitis includes just care for patients in critical condition. Clinical and experimental studies point to the involvement of immunological mechanisms in the physiopathology of lung damage caused by leptospirosis. The aim of this study is to evaluate pulse treatment with methylprednisolone × placebo for leptospirotic pneumonitis. Study design This is a randomized double-blind clinical trial to test the efficacy of pulse treatment with methylprednisolone in patients with leptospirotic pneumonitis, compared with a placebo. The patients are recruited from three hospitals in the city of Recife, in the Brazilian State of Pernambuco. The exclusion criteria include patients aged under 15 years, a history of hypersensitivity to the use of corticosteroids, the presence of active infection of fungal, tuberculous or bacterial origin apart from the infection by leptospira itself, the presence of hemoconcentration or atypical lymphocyte count on admission to hospital, the presence of co-morbidities that could be responsible for the radiological and gasometric alterations used to diagnose leptospirotic pneumonitis, evidence of recent cranial trauma, neurosurgery, peptic ulcer, and participation in another clinical trial. The patients are followed until they are discharged from hospital or die. The intervention consists of endovenous pulse treatment with 1 g methylprednisolone for three consecutive days in the study group and a placebo in the control group. The primary end-point is mortality from leptospirotic pneumonitis. The secondary end-points are: evolution of lung disease; the occurrence of nosocomial respiratory infection; duration of mechanical ventilation; duration of intensive care unit (ICU stay; duration of 386. Leptospirosis en camélidos sudamericanos. Estudio de prevalencia serológica en distintas regiones de la Argentina Leptospirosis in south-american camelids. A study on the serological prevalence in different regions of Argentina P Llorente; Leoni, L.; M. MARTINEZ VIVOT 2002-01-01 Se evaluó la seroprevalencia en Camélidos Sudamericanos de Leptospirosis, zoonosis de distribución mundial, producida por espiroquetas patógenas del género Leptospira. Se examinaron 494 animales (llamas, guanacos y vicuñas), clÃnicamente sanos sin vacunar, de diferentes regiones geográficas de la República Argentina. Se utilizó la técnica, serovar especÃfica, de microaglutinación (MAT). El estudio reveló prevalencias entre 47.3 y 96.2% en llamas, entre 0 y 13% en guanacos y entre 9 y 62.8% en... 387. Leptospirosis humana en la atención primaria de salud: pautas para su prevención y control Human leptospirosis in health primary care: guidelines for its prevention and control Denis Berdasquera Corcho 2007-09-01 Full Text Available Durante las dos últimas décadas se ha observado a nivel mundial un alza en el número de casos de leptospirosis humana, frecuentemente asociada a desastres naturales. En Cuba, esta enfermedad tiene un comportamiento endemo epidémico, y estacional. Las caracterÃsticas tropicales del paÃs, el clima, la orografÃa, la red fluvial natural y la artificial, las extensas áreas agrÃcolas, y los regÃmenes lluviosos en determinadas épocas del año, han propiciado un aumento en el número de casos de esta enfermedad. En el presente artÃculo se hace una revisión documental del tema y se propone una guÃa para el control y prevención de esta zoonosis en la atención primaria de salud, y asà brindarle al Médico de Familia elementos importantes para su trabajo diario en la comunidad.For two last decades it was observed a rise in cases of human leptospirosis frequently associated to natural disasters. In Cuba, this condition has a endemic, epidemic, and seasonal behaviour. Tropical features of our country, climate, orography, natural and artificial fluvial network, extensive agricultural areas, and rainy regimes en determined times of year, have propitiate a increase in case-number of this disease. In present paper a documentary review of this topic was made and we propose a guide for control and prevention of this zoonosis in health primary care, and thus provide to Family Physician with significant components for his daily practice in community. 388. Primer reporte en Cuba de Leptospira interrogans serovar Tarassovi y caracterización clÃnica epizootiologica en focos de Leptospirosis porcina Dra. Dania Feraud Tercilla; 2005-04-01 Full Text Available La leptospirosis es una enfermedad zoonótica de focalidad natural que teniendo en cuenta el tipo de explotación, manejo, medidas protectivas y vigilancia epidemiológica podemos controlarla. De ahà que el objetivo de nuestro trabajo halla sido el determinar las caracterÃsticas clÃnico-epizootiologicas en focos activos de leptospirosis en cerdos e identificar los serovares presentes a través del aislamiento. Para lograrlo nos propusimos dos experimentos, uno relacionado con la caracterización epizoótica de dos focos de leptospirosis porcina, en los que se presentaron Ãndices de aborto de 5 y 6 % respectivamente. El otro experimento abordó el aislamiento e identificación de cepas de leptospira encontrada en los focos, la caracterización general de las unidades, investigación serológica relacionada con la enfermedad y diagnostico diferencial fueron actividades contempladas en el experimento, asà como las descripciones de aislamiento y circulación del serovar Tarassovi por primera vez en Cuba en animales autóctonos, esto ocurrió sin grandes alteraciones de los indicadores productivos y reproductivos.Leptospirosis is a zoonotic disease occurring in natural foci, and could be controlled, taking into consideration: type of exploitation, protective measures and epidemiologic surveillance. The objective of this work is to determine the clinical and epidemiological characteristics of swine leptospirosis in disease active foci, and identify the serological varieties by means of isolation. Two experiments were developed, one related with the epidemiological characterization of swine leptospirosis foci, in which abortion occurred on 5 and 6% respectively; the second experiment was about the isolation and identification of Leptospira strains from the foci, general characterization of the piggeries: serological research related with the disease and its differential diagnosis, were activities within this experiment. Descriptions of isolation 389. Diagnosis and Treatment of Canine Leptospirosis%犬钩端螺旋体病的诊æ–与防治 王å‹ä»¤; å¼ èƒœ; å¼ æ¶› 2005-01-01 钩端螺旋体病(leptospirosis)是一ç§çŠ¬å’Œå¤šç§åŠ¨ç‰©å‡å¯æ„ŸæŸ“自然疫æºæ€§ç–¾ç—…。犬在感染åŽå¼•èµ·æ€¥æ€§è‚¾ç‚Žå¹¶å¸¸ä¼´æœ ‰è‚è¡°ç«æˆ–å‡è¡€ä¸è‰¯ã€‚在感染人åŽå¼•èµ·èžºæ—‹ä½“性黄疸，称为Weilæ°ç—…ã€‚çŠ¬è¾ƒæ˜“æ„ŸæŸ“æœ¬ç—…ï¼ŒçŒ«çš„é’©ç«¯èžºæ—‹ä½“ç—…å °‘è§ã€‚我国从犬分离到的钩端螺旋体主è¦æ˜¯çŠ¬ç¾¤å’Œæµæ„Ÿé»„疸出血群。 390. Seroprevalencia y factores asociados con leptospirosis en pacientes con sÃndrome febril en Ayacucho, Perú 2005 Félix Vargas-Cuba 2008-04-01 Full Text Available Objetivos. Estimar la prevalencia de leptospirosis y factores asociados en pacientes febriles que acuden al Hospital de Apoyo San Francisco en Ayna, Ayacucho. Materiales y métodos. Estudio transversal realizado con 209 pacientes febriles con descarte de malaria, hepatitis B y tifoidea. Se les realizó una encuesta epidemiológica y se tomaron muestras de sangre que fueron analizadas por ELISA IgM y microaglutinación (MAT para la determinación de serovares de leptospira. Se calcularon la prevalencia y los factores de riesgo usando un modelo de regresión logÃstica múltiple. Resultados. La seroprevalencia fue de 30,6 (IC95%: 24,1-37,1%, 39% de las amas de casa, 33% de los agricultores y 30% de los profesionales de la salud examinados fueron positivos a leptospiras. Se detectaron 15 serovares, cinco de ellos (Autumnalis, Wolffi, Tarassovi, Patoc y Hardjo nuevos para la zona de estudio. Sólo 18% de los casos tuvo el clásico dolor en pantorrillas. Lavar la ropa en el rÃo (ORa: 2,7; IC95% 1,4-5,2, la presencia de ratas en la vivienda (ORa: 2,2; IC95%: 1,1-4,5 y el uso de sandalias para las actividades diarias (ORa: 2,2; IC95%: 1,1-4,5 son factores de riesgo para la positividad de anticuerpos contra leptospira en pacientes febriles independientemente de los otros factores evaluados. Conclusiones. La leptospirosis es una etiologÃa frecuente del sÃndrome febril en pacientes que acudieron al Hospital de San Francisco, los signos y sÃntomas de la enfermedad no son especÃficos y los factores de riesgo están relacionados con saneamiento básico deficiente y costumbres de la población. 391. Sensitivity and Specificity of a New Vertical Flow Rapid Diagnostic Test for the Serodiagnosis of Human Leptospirosis. Cyrille Goarant 2013-06-01 Full Text Available Background : Leptospirosis is a growing public health concern in many tropical and subtropical countries. However, its diagnosis is difficult because of nonspecific symptoms and concurrent other endemic febrile diseases. In many regions, the laboratory diagnosis is not available due to a lack of preparedness and simple diagnostic assay or difficult access to reference laboratories. Yet, an early antibiotic treatment is decisive to the outcome. The need for Rapid Diagnostic Tests (RDTs for bedside diagnosis of leptospirosis has been recognized. We developed a vertical flow immunochromatography strip RDT detecting anti-Leptospira human IgM and evaluated it in patients from New Caledonia, France, and French West Indies. Methodology/Principal Findings : Whole killed Leptospira fainei cells were used as antigen for the test line and purified human IgM as the control line. The mobile phase was made of gold particles conjugated with goat anti-human IgM. Standards for Reporting of Diagnostic Accuracy criteria were used to assess the performance of this RDT. The Microscopic Agglutination Test (MAT was used as the gold standard with a cut-off titer of ≥400. The sensitivity was 89.8% and the specificity 93.7%. Positive and negative Likelihood Ratios of 14.18 and 0.108 respectively, and a Diagnostic Odds Ratio of 130.737 confirmed its usefulness. This RDT had satisfactory reproducibility, repeatability, thermal tolerance and shelf-life. The comparison with MAT evidenced the earliness of the RDT to detect seroconversion. When compared with other RDT, the Vertical Flow RDT developed displayed good diagnostic performances.This RDT might be used as a point of care diagnostic tool in limited resources countries. An evaluation in field conditions and in other epidemiological contexts should be considered to assess its validity over a wider range of serogroups or when facing different endemic pathogens. It might prove useful in endemic contexts or outbreak 392. Diagnostic Accuracy of Real-Time PCR Assays Targeting 16S rRNA and lipl32 Genes for Human Leptospirosis in Thailand: A Case-Control Study

Thaipadunpanit, Janjira; Chierakul, Wirongrong; Wuthiekanun, Vanaporn; Limmathurotsakul, Direk; Amornchai, Premjit; Boonslip, Siriphan; Smythe, Lee D.; Limpaiboon, Roongrueng; Hoffmaster, Alex R.; Day, Nicholas P. J.; Peacock, Sharon J. 2011-01-01 Background Rapid PCR-based tests for the diagnosis of leptospirosis can provide information that contributes towards early patient management, but these have not been adopted in Thailand. Here, we compare the diagnostic sensitivity and specificity of two real-time PCR assays targeting rrs or lipL32 for the diagnosis of leptospirosis in northeast Thailand. Methods/Principal Findings A case-control study of 266 patients (133 cases of leptospirosis and 133 controls) was constructed to evaluate the diagnostic sensitivity and specificity (DSe & DSp) of both PCR assays. The median duration of illness prior to admission of cases was 4 days (IQR 2–5 days; range 1–12 days). DSe and DSp were determined using positive culture and/or microscopic agglutination test (MAT) as the gold standard. The DSe was higher for the rrs assay than the lipL32 assay (56%, (95% CI 47–64%) versus 43%, (95% CI 34–52%), p 7 years was found 12.50% and 18 75% of reactive serum. The results observed in this study demonstrated that the island of Maiandeua, state of Pará, there is the presence of Leptospira spp, with the most frequent serovar autumnalis and possible exposure of animals to brucella smooth, suggesting low risk of infection in the population of horses examined. 409. A Comparative Study of the Epidemiology of Human Leptospirosis in Korea and Japan between 2006 and 2012. Lee, Myeong-Jin; Miki, Shinichiro; Kitagawa, Masahiro; Lee, Won-Chang 2016-05-20 We undertook a comparative analysis of the epidemiology of reported human leptospirosis (HL) cases in Korea and Japan. Between 2006 and 2012, the cumulative incidence of HL in Korea was higher than that in Japan (1.26 vs. 0.14 per 100,000 population, respectively), and the total reported cases were 632 and 196, respectively. Significantly more men were infected than women in both Korea (63.0% men, P Japan (87.8% men, P Japan). However, Japan exhibited a significantly higher proportion of male cases, a younger age distribution, and less prominent seasonality. A significant difference was observed in the incidence of HL between the capital city and rural areas in Korea, but not in Japan. The differences in agricultural and forestry practices, and the efficacy or wastewater treatment infrastructure might influence the incidence level in rural areas in both countries. The differences between the 2 countries might be because of their unique geographical characteristics and variations in their levels of industrialization. 410. ProteÃnas recombinantes útiles para el diagnóstico, prevención y estudios patogénicos de la leptospirosis : Estudio de mecanismos patogénicos involucrados Prêtre, Gabriela 2011-01-01 Objetivo general El propósito general de este trabajo es: 1. Generar herramientas moleculares que sean útiles contra la leptospirosis, ya sea para su diagnóstico, prevención o un mejor conocimiento de su patogénesis. 2. Estudiar mecanismos patogénicos involucrados en la leptospirosis. Objetivos especÃficos 1. Clonado, expresión y purificación de proteÃnas recombinantes. 2. Producción de antisuero contra las proteÃnas recombinantes.... 411. Estudo do lavado broncoalveolar em pacientes com comprometimento pulmonar na leptospirose Study of bronchoalveolar lavage in leptospirosis patients with pulmonary involvement Jorge Eduardo Manhães de Carvalho 2004-04-01 Full Text Available INTRODUÇÃO: O comprometimento pulmonar é freqüente na leptospirose e caracteriza-se por hemoptise, dispnéia e infiltrados pulmonares bilaterais no radiograma de tórax. Esses achados podem ser compatÃveis com hemorragia alveolar, previamente descrita por alguns autores em autópsias e em lavado broncoalveolar. OBJETIVO: Avaliar a presença de hemorragia alveolar, diagnosticada por meio do lavado broncoalveolar, em pacientes portadores de leptospirose com alterações pulmonares, enfatizando-se a importância do método para o diagnóstico precoce da complicação. MÉTODO: Sete pacientes com leptospirose foram submetidos à broncoscopia com lavado broncoalveolar. Todos apresentavam sinais e/ou sintomas respiratórios, e/ou infiltrados no radiograma de tórax, e/ou hipoxemia. A hemorragia alveolar foi definida pelos seguintes achados no lavado: porcentagem de siderófagos e"20%, escore de Golde > 100, e/ou presença de lÃquido hemorrágico. Foram realizados exame direto e cultura para Leptospiras, com o uso de meios especÃficos. O diagnóstico da doença foi confirmado por soroaglutinação microscópica para leptospirose. RESULTADOS: O aspecto da broncoscopia foi normal em 5 pacientes, mostrou sangramento na árvore brônquica em 1 caso e sinais inflamatórios em outro. O aspecto do lavado foi hemorrágico em todos os pacientes, configurando o quadro de hemorragia alveolar. A pesquisa direta e a cultura para Leptospiras foram negativas. CONCLUSÃO: A leptospirose deve ser considerada no diagnóstico diferencial das hemorragias alveolares.O lavado broncoalveolar mostrou-se um método eficaz para a detecção de hemorragia alveolar na leptospirose, servindo para orientar a terapêutica imediata, com a finalidade de prevenir sua evolução, caracterizada pela presença de hemoptises maciças e insuficiência respiratória.BACKGROUND: Pulmonary involvement is common in leptospirosis and usually characterized by hemoptysis, dyspnea and 412. NeumonÃa aguda de la comunidad y hemorragia pulmonar por leptospirosis en el área metropolitana Buenos Aires Alfredo Seijo 2011-04-01 Full Text Available El objetivo del trabajo es comunicar los hallazgos epidemiológicos, clÃnicos y de diagnóstico de la neumonÃa y hemorragia pulmonar por leptospirosis, en el perÃodo enero 2007 a octubre 2009. Un 64% (20/31 de pacientes con diagnóstico de leptospirosis tuvieron neumonÃa. Quince de ellos (75% presentaron neumonÃa grave, de los cuales siete (35% desarrollaron hemorragia pulmonar. En diez enfermos (32% el motivo de consulta e inicio del cuadro clÃnico fue una gastroenteritis secretoria con fiebre y dolor abdominal. La ictericia sólo se manifestó en once pacientes (35%. La técnica de reacción en cadena de la polimerasa (PCR fue útil para el diagnóstico en muestra obtenida post mortem. De un hemocultivo se aisló una cepa clasificada dentro del serogrupo canicola. Se clasificaron las neumonÃas en tres tipos: neumonÃas de curso no grave con escasa repercusión general; neumonÃas graves asociadas a formas clÃnicas sistémicas con ictericia, insuficiencia renal, trombocitopenia y hemorragia pulmonar; también de curso grave, no asociada a ictericia, insuficiencia renal o trombocitopenia grave. El tratamiento antibiótico iniciado en los primeros dÃas de enfermedad (promedio 3.2 dÃas no tuvo influencia en la evolución de las neumonÃas graves. Se plantea además considerar tres formas clÃnicas de leptospirosis: anictérica, ictérica (con sus variantes evolutivas y hemorragia pulmonar. 413. Prueba de Elisa indirecta para la detección de anticuerpos IgM para el diagnóstico de Leptospirosis humana Manuel Céspedes Z; Martha Glenny A; Vidal Felices A; Lourdes Balda J; VÃctor Suárez M 2002-01-01 Para el diagnóstico temprano de enfermedades con cuadro clÃnico inespecÃfico como la leptospirosis, es necesario la confirmación laboratorial mediante pruebas especÃficas, con la finalidad de que el diagnóstico sea más acertado y rápido. Objetivo: se realizó un estudio comparativo entre la prueba de microaglutinacion (MAT) y la prueba de ELISA indirecta estandarizada con un "pool" de antÃgenos de Leptospira interrogans, para la detección de anticuerpos IgM, en muestras de suero de fase aguda ... 414. Leptospirosis en la población de la Región Huetar Norte durante el periodo comprendido entre 1997 y 2000 Ana Catalina Sáenz -Zamora 2004-10-01 Full Text Available Justificación y objetivo: Determinar el comportamiento epidemiológico de la leptospirosis en la población de la Región Huetar Norte, durante el periodo comprendido entre 1997 y 2000, según la información biomédica de la sede regional del Ministerio de Salud y del Hospital San Carlos. Método: Se pidió a INCIENSA una lista de los casos con serologÃa positiva por leptospirosis de la Región Huetar Norte, vistos de 1997 al 2000; se solicitaron los expedientes clÃnicos de estos pacientes a la oficina de BioestadÃstica del Hospital San Carlos y de allà se obtuvieron los datos requeridos por una hoja previamente confeccionada. Resultados: Se encontró un total de 58 pacientes diagnosticados con leptospirosis en dicha región, en el periodo en estudio; predominó el género masculino, en una relación de 13:1. La población más afectada fue la de los adultos jóvenes, entre los 15 y los 30 años. El cantón de donde provinieron más personas con la enfermedad fue San Carlos. Más de la tercera parte de estas personas se ocupaban de labores agrÃcolas o ganaderÃa. Los serotipos encontrados de manera más frecuente fueron pyrogenes, seguido de sejroe, tarassovi y hebdomadis. Las principales manifestaciones fueron: fiebre, cefalea, mialgias, sangrados, alteración en las pruebas de función renal y hepática, trombocitopenia y aumento de la creatinin fosfoquinasa. Conclusiones: En casi la totalidad de los pacientes fue posible determinar factores de riesgo, y en la mayorÃa el principal factor fue la exposición ocupacional. El hallazgo de leucopenia es tres veces más frecuente que el de leucocitosis, por lo que se puede afirmar que existe un comportamiento clÃnico diferente de la leptospirosis descrito en la bibliografÃa 415. COMPARISON OF 16S rRNA-PCR-RFLP, LipL32-PCR AND OmpL1-PCR METHODS IN THE DIAGNOSIS OF LEPTOSPIROSIS Tülin GÃœVEN GÖKMEN Full Text Available SUMMARY Leptospirosis is still one of the most important health problems in developing countries located in humid tropical and subtropical regions. Human infections are generally caused by exposure to water, soil or food contaminated with the urine of infected wild and domestic animals such as rodents and dogs. The clinical course of leptospirosis is variable and may be difficult to distinguish from many other infectious diseases. The dark-field microscopy (DFM, serology and nucleic acid amplification techniques are used to diagnose leptospirosis, however, a distinctive standard reference method is still lacking. Therefore, in this study, we aimed to determine the presence of Leptospira spp., to differentiate the pathogenic L. interrogans and the non-pathogenic L. biflexa, and also to determine the sensitivity and specificity values of molecular methods as an alternative to conventional ones. A total of 133 serum samples, from 47 humans and 86 cattle were evaluated by two conventional tests: the Microagglutination Test (MAT and the DFM, as well as three molecular methods, the 16S rRNA-PCR followed by Restriction Fragment Lenght Polymorphism (RFLP of the amplification products 16S rRNA-PCR-RFLP, LipL32PCR and OmpL1-PCR. In this study, for L. interrogans, the specificity and sensitivity rates of the 16S rRNA-PCR and the LipL32-PCR were considered similar (100% versus 98.25% and 100% versus 98.68%, respectively. The OmpL1-PCR was able to classify L. interrogans into two intergroups, but this PCR was less sensitive (87.01% than the other two PCR methods. The 16S rRNA-PCR-RFLP could detect L. biflexa DNA, but LipL32-PCR and OmpL1-PCR could not. The 16S rRNA-PCR-RFLP provided an early and accurate diagnosis and was able to distinguish pathogenic and non-pathogenic Leptospira species, hence it may be used as an alternative method to the conventional gold standard techniques for the rapid disgnosis of leptospirosis. 416. Prozone effects in microscopic agglutination tests for leptospirosis in the sera of mice infected with the pathogenic Leptospira interrogans serovar Canicola Fabio Hiroto Shimabukuro 2013-08-01 Full Text Available Mice experimentally infected with a pathogenic strain of Leptospira interrogans serovar Canicola produced false negative results (prozone effect in a microscopic agglutination test (MAT. This prozone effect occurred in several serum samples collected at different post-infection times, but it was more prominent in samples collected from seven42 days post-infection and for 1:50 and 1:100 sample dilutions. This phenomenon was correlated with increased antibody titres in the early post-infection phase. While prozone effects are often observed in serological agglutination assays for the diagnosis of animal brucellosis and human syphilis, they are not widely reported in leptospirosis MATs. 417. COMPARISON OF 16S rRNA-PCR-RFLP, LipL32-PCR AND OmpL1-PCR METHODS IN THE DIAGNOSIS OF LEPTOSPIROSIS GÖKMEN, Tülin GÃœVEN; SOYAL, Ayben; KALAYCI, Yıldız; ÖNLEN, Cansu; KÖKSAL, Fatih 2016-01-01 SUMMARY Leptospirosis is still one of the most important health problems in developing countries located in humid tropical and subtropical regions. Human infections are generally caused by exposure to water, soil or food contaminated with the urine of infected wild and domestic animals such as rodents and dogs. The clinical course of leptospirosis is variable and may be difficult to distinguish from many other infectious diseases. The dark-field microscopy (DFM), serology and nucleic acid amplification techniques are used to diagnose leptospirosis, however, a distinctive standard reference method is still lacking. Therefore, in this study, we aimed to determine the presence of Leptospira spp., to differentiate the pathogenic L. interrogans and the non-pathogenic L. biflexa, and also to determine the sensitivity and specificity values of molecular methods as an alternative to conventional ones. A total of 133 serum samples, from 47 humans and 86 cattle were evaluated by two conventional tests: the Microagglutination Test (MAT) and the DFM, as well as three molecular methods, the 16S rRNA-PCR followed by Restriction Fragment Lenght Polymorphism (RFLP) of the amplification products 16S rRNA-PCR-RFLP, LipL32PCR and OmpL1-PCR. In this study, for L. interrogans, the specificity and sensitivity rates of the 16S rRNA-PCR and the LipL32-PCR were considered similar (100% versus 98.25% and 100% versus 98.68%, respectively). The OmpL1-PCR was able to classify L. interrogans into two intergroups, but this PCR was less sensitive (87.01%) than the other two PCR methods. The 16S rRNA-PCR-RFLP could detect L. biflexa DNA, but LipL32-PCR and OmpL1-PCR could not. The 16S rRNA-PCR-RFLP provided an early and accurate diagnosis and was able to distinguish pathogenic and non-pathogenic Leptospira species, hence it may be used as an alternative method to the conventional gold standard techniques for the rapid disgnosis of leptospirosis. PMID:27680169 418. Multiple-locus variable-number tandem repeat analysis of reference strains used for the diagnosis of leptospirosis in Argentina Multiple-locus variable-number tandem repeat analysis de cepas de referencia usadas para el diagnóstico de leptospirosis en Argentina MarÃa E Pavan 2011-12-01 Full Text Available Leptospirosis is a worldwide zoonosis caused by a spirochete that belongs to the genus Leptospira. In the last years, new methods, such as the PCR-based multiple-locus variable-number tandem repeat analysis (MLVA, have been developed for the genotyping of leptospires. In the present work, the MLVA patterns for all reference strains used in Argentina for bovine, ovine, porcine, equine, caprine and canine leptospirosis diagnosis, as well as in human and wild animal diagnosis, were obtained. MLVA results are presented in such a way that they can be readily used for the identifcation of these strains by the simple and direct comparison of agarose gels. Making the use and interpretation of the MLVA for leptospires typing easier will help increase the use of this method as a routine procedure for human and animal diagnosis, for epidemiological studies, vaccine control and other applications.La leptospirosis es una zoonosis de distribución global causada por una espiroqueta perteneciente al género Leptospira. En los últimos años se han desarrollado nuevos métodos para la genotipifcación de las leptospiras, entre ellos el denominado multiple-locus variable-number tandem repeat analysis (MLVA. En este trabajo se obtuvieron los patrones de MLVA de todas las cepas de referencia utilizadas en la Argentina para el diagnóstico de leptospirosis en bovinos, ovinos, porcinos, equinos, caprinos y perros, y que también son utilizadas en el diagnóstico de leptospirosis en humanos y en animales salvajes. Los resultados del MLVA se muestran de manera tal que pueden ser fácilmente utilizados para la identifcación de estas cepas por simple comparación visual de geles de agarosa. Al facilitar el uso y la interpretación del MLVA para la tipifcación de leptospiras, se ayudará a difundir la utilización rutinaria de este método en el diagnóstico humano y animal, en estudios epidemiológicos y para el control de vacunas, entre otras aplicaciones. 419. PRODUCCIÓN Y EVALUACIÓN SEROLÓGICA DE UNA BACTERINA CONTRA LA LEPTOSPIROSIS BOVINA Edna Sánchez C 2007-12-01 Full Text Available Objetivo. Producir una bacterina contra leptospirosis bovina. Materiales y métodos. La producción de la bacterina se realizó a partir de cultivos de L. pomona, L. grippotyphosa, L. hardjobovis, L. hardjoprajitno, L. icterohaemorrhagiae y L. canicola con concentraciones entre 1x108 y 1x1010 células/ml. Las leptospiras se inactivaron con formol y se adsorbieron en hidróxido de aluminio para formular la vacuna. La concentración final de cada serovar fue de 1x108 Leptospiras/ml. Para realizar la evaluación serológica del producto biológico, se inmunizó una población de 20 ternerossanos los cuales fueron sangrados antes y después de la vacunación para realizar titulaciones de los sueros por medio de la técnica de microaglutinación y de esta forma determinar la producción de anticuerpos generada a causa de la bacterina. Resultados. El serovar que mayor tÃtulo de anticuerpos produjo fue L. icterohaemorrhagiae, seguido por L. canicola. La serologÃa realizada 15 dÃas despuésde la revacunación fueron los que presentaron mayor número de anticuerpos para todos los serovares, excepto para L. grippotyphosa que fue el único que no estimuló la producción de anticuerpos en los animales vacunados. Conclusiones. La bacterina fue capaz de inducir una respuesta inmune humoral en los bovinos, sin embargo, la cepa L. grippotyphosa no fue inmunógena comparada con los demás serovares quehicieron parte de la vacuna 420. Evaluation of recombinant LigB antigen-based indirect ELISA and latex agglutination test for the serodiagnosis of bovine leptospirosis in India. Deneke, Yosef; Sabarinath, T; Gogia, Neha; Lalsiamthara, Jonathan; Viswas, K N; Chaudhuri, Pallab 2014-08-01 Leptospirosis is a zoonotic disease caused by pathogenic spirochetes of the genus Leptospira, causing febrile infection characterized by multi-organ failure in humans and animals. Leptospiral Ig-like protein B (LigB) is a surface-expressed antigen that mediates host cell invasion or attachment. In this study, N-terminal conserved region of LigB protein (46 kDa) was evaluated for its diagnostic potential to detect anti-leptospiral antibodies in the sera of various animal species. Dot blot analysis revealed immunoreactivity of Leptospira-positive sera of cattle, buffalo, dog, sheep and goat to purified LigB protein. We have analyzed 1126 bovine serum samples, collected from Northern and Eastern part of India, by microscopic agglutination test (MAT) and recombinant LigB (rLigB) based ELISA and latex agglutination test (LAT). The sensitivity of rLigB based ELISA for 554 MAT positive sera was 96.9% and the specificity with 572 MAT negative sera was 91.08% whereas LAT showed sensitivity and specificity of 93.68% and 92.31%, respectively. Kappa values of 0.879 and 0.860 for recombinant antigen based ELISA and LAT indicate excellent agreement with the gold standard serological test, MAT, for the detection of anti-leptospiral antibodies in sera. Further, LAT based on rLigB antigen is a simple and rapid test, suitable for serodiagnosis of leptospirosis under field conditions, owing to its portability and longer shelf life. « 19 20 21 22 23 » « 20 21 22 23 24 » 421. Development of the leptospirosis by experimental infection in hamsters (Mesocricetus auratus with Leptospira interrogans serovar Canicola, strain LO4, by intact and scratched skin exposures Carolina de Sousa Américo Batista 2010-10-01 Full Text Available The establishment and evolution of leptospirosis in hamster (Mesocricetus auratus by experimental infection with Leptospira interrogans serovar Canicola, LO4 strain, by intact and scratched skin exposures, having as control the intraperitoneal route, were evaluated. Hundred-twenty female hamsters distributed in two groups according to inoculation route (intact and scratched skin were used. Infectious inoculum was constituted by a pure culture of L. interrogans serovar Canicola (strain LO4, isolated from liver from a slaughtered swine in Londrina, Paraná state and typified by agglutinins adsortion technique with monoclonal antibody kit at the Royal Tropical Institute, Amsterdam, the Netherlands. The animals were observed twice a day during 21 days. Animals that died were necropsied and kidneys, liver, genital tract (uterus and ovaries and brain were aseptically collected. On the 21st post-inoculation day, surviving animals were euthanized. In these animals, serum samples were also collected by cardiac puncture to antileptospires agglutinins research using microscopic agglutination test (MAT. Fresh direct microscopy and microbiological culture were used for the detection of leptospires. Scratched skin route induced larger lethality when compared to intact skin route, with establishment and evolution of leptospirosis. On the other hand, intact skin route induced renal and/or genital carrier state more frequently. LO4 strain presented low immunogenic power, characterized by soroconversion at the MAT in only one inoculated animal. 422. Isolation of Leptospira from a phocid: acute renal failure and mortality from Leptospirosis in rehabilitated northern elephant seals (Mirounga angustirostris), California, USA. Delaney, Martha A; Colegrove, Kathleen M; Spraker, Terry R; Zuerner, Richard L; Galloway, Renee L; Gulland, Frances M D 2014-07-01 During rehabilitation, acute renal failure due to leptospirosis occurred in eight male northern elephant seals (Mirounga angustirostris) that stranded along the central California coast in 2011. Characteristic histologic lesions including renal tubular degeneration, necrosis, and mineralization, and mild lymphoplasmacytic interstitial nephritis were noted in the six animals examined. Immunohistochemistry, bacterial culture, and PCR were positive in 2/3, 2/3, and 3/4 seals, respectively, and 6/8 had high serum antibody titers to Leptospira interrogans serovar pomona. Pulsed-field gel electrophoresis confirmed one isolate as serovar pomona. Variable number tandem repeat (VNTR) analysis showed both elephant seal isolates were identical to each other but distinct from those isolated from California sea lions (Zalophus californianus). The time from stranding to onset of azotemia was 1 to 38 (median=24) days, suggesting some seals were infected at the rehabilitation facility. Based on temporal and spatial incidence of infection, transmission among elephant seals likely occurred during rehabilitation. Molecular (VNTR) analysis of the two isolates indicates there is a unique L. interrogans serovar pomona genotype in elephant seals, and sea lions were not the source of infection prior to or during rehabilitation. This study confirms the susceptibility of northern elephant seals to leptospirosis, indicates intraspecies transmission during rehabilitation, and reports the first isolation and preliminary characterization of leptospires from elephant seals. 423. Diagnostic accuracy of an IgM enzyme-linked immunosorbent assay and comparison with 2 polymerase chain reactions for early diagnosis of human leptospirosis. Vanasco, N B; Jacob, P; Landolt, N; Chiani, Y; Schmeling, M F; Cudos, C; Tarabla, H; Lottersberger, J 2016-04-01 Enzyme-linked immunosorbent assay (ELISA) tests and polymerase chain reaction (PCR) may play a key role for early detection and treatment of human leptospirosis in developing countries. The aims of this study were to develop and validate an IgM ELISA under field conditions and to compare the diagnostic accuracy among IgG, IgM ELISAs, conventional PCR (cPCR), and real-time PCR (rtPCR) for early detection of human leptospirosis. Overall accuracy of IgM ELISA was sensitivity of 87.9%, specificity of 97.0%, and area under the curve of 0.940. When the 4 methods were compared, IgM ELISA showed the greatest diagnostic accuracy (J=0.6) followed by rtPCR (J=0.4), cPCR (J=0.2) and IgG ELISA (J=0.1). Our results support the use of IgM ELISA and rtPCR for early diagnosis of the disease. Moreover, due to their high specificity, they could be also useful to replace or supplement microscopic agglutination test as a confirmatory test, allowing more confirmations. 424. ç¦å»ºçœé’©ç«¯èžºæ—‹ä½“ç—…æµè¡Œæ–°ç‰¹ç‚¹åˆ†æž%Analysis on New Features of Epidemiology of Leptospirosis in Fujian Province 潘æ•æ¥ ; å¾å›½è‹±; 陈阳; 林代åŽ; æŽè¿°æ¨; 何似; é‚“è‰³ç´ 2012-01-01 Objective To analyze the epidemiological features of leptospirosis in Fujian Province, and to provide the scientific evidence for disease control and prevention. Methods The data of two outbreaks of leptospirosis in Fujian Province from 2000 to 2009 were statistically analyzed using epidemiological investigation. Results The outbreak of leptospirosis in the southern part of Fujian Province was caused by immigrators' contacting with infectious water in rafting, with the morbidity of 44.11% . The serum positive rate of patients was 100% , and antibody titers had a four- fold rise in early and late stages. The serum positive rate of healthy population was 26.63% . The major infectious source was trie rats. The outbreak in Xiapu County was triggered by susceptible group's farming in desert field, with the morbidity of 61'. 70% . Rattus losea which brought Autum-nalis serogroup was the source of infection. The serum positive rate of patients was 89.66% . The maximum antibody titer was 1:25,600. The antibody titers of 26 patients in early and late stages were increased at least fourfold. The serogroup was Autum-nalis serogroup which was the same as the ones brought by Rattus losea. Conclusions Non - farming infections of leptospirosis, such as rafting and travelling as well as infection caused by farming in desert land are the new trend of leptospirosis local outbreak in Fujian Province in the early 21st century.%目的 分æžç¦å»ºçœé’©ç«¯èžºæ—‹ä½“ç—…(钩体病)æµè¡Œç‰¹ç‚¹,为防制æ供科å¦ä¾æ®. 方法 è¿ç”¨æµè¡Œç—…å¦è°ƒæŸ¥æ–¹æ³•å¯¹2000 -2009å¹´ç¦å»ºçœä¸¤æ¬¡é’©ä½“ç —…æš´å‘疫情进行统计分æž. 结果 é—½å—æŸåœ°é’©ä½“ç—…æš´å‘疫情是由外æ¥äººç¾¤å› 漂æµæŽ¥è§¦ç–«æ°´å‘病引起的,å‘ç—… 率44.11ï¼….病人血清阳性率为100ï¼…,且早晚期抗体å‡4å€ä»¥ä¸Šå¢žé•¿.å¥åº·äººç¾¤è¡€æ¸…抗体阳性率为26.63ï¼….é¼ ç ±»æ˜¯ä¸»è¦ä¼ 染æº.霞浦æŸåœ°é’©ä½“ç—…æš´å‘疫情是由易感人群清ç†è’芜稻田引å‘çš„,å‘病率61.70ï¼…,é»„æ¯›é¼ æ˜¯ä¼ æ 425. Association of Toll-like receptor 2 Arg753Gln and Toll-like receptor 1 Ile602Ser single-nucleotide polymorphisms with leptospirosis in an Argentine population. Cédola, Maia; Chiani, Yosena; Pretre, Gabriela; Alberdi, Lucrecia; Vanasco, Bibiana; Gómez, Ricardo M 2015-06-01 Toll-like receptor 2 (TLR2), a member of the Toll-like receptor family, plays an important role in the recognition of and subsequent immune response activation against leptospirosis in humans. The genetic polymorphism in TLR2 of an arginine to glutamine substitution at residue 753 (Arg753Gln) has been associated with a negative influence on TLR2 function, which may, in turn, determine the innate host response to Leptospira spp. This bacterium signals through TLR2/TLR1 heterodimers in human cells. The aim of the present study was

to investigate the Arg753Gln single-nucleotide polymorphism (SNP) of the TLR2 gene, and the isoleucine to serine transversion at position 602 (Ile602Ser) of the TLR1 gene (previously associated with Lyme disease), in leptospirosis patients compared to healthy controls, carrying out a retrospective case/control study. The TLR2 polymorphism adenine (A) allele was observed in 7.3% of leptospirosis patients but was not found in the control group, whereas the guanine (G) allele of the TLR1 polymorphism was found in 63.6% of patients and 41.6% of controls. Susceptibility to leptospirosis disease was increased 10.57-fold for carriers of the TLR2 G/A genotype (P=0.0493) and 3.85-fold for carriers of the TLR1 G/G genotype (P=0.0428). Furthermore, the risk of developing hepatic insufficiency and jaundice was increased 18.86- and 27.60-fold for TLR2 G/A carriers, respectively. Similarly, the risk of developing jaundice was increased 12.67-fold for TLR1 G allele carriers (G/G and T/G genotypes). In conclusion, the present data suggest that the TLR2 Arg753Gln and TLR1 Ile602Ser SNPs influence the risk of developing leptospirosis and its severity. 426. Spatiotemporal Determinants of Urban Leptospirosis Transmission: Four-Year Prospective Cohort Study of Slum Residents in Brazil. José E Hagan 2016-01-01 Full Text Available Rat-borne leptospirosis is an emerging zoonotic disease in urban slum settlements for which there are no adequate control measures. The challenge in elucidating risk factors and informing approaches for prevention is the complex and heterogeneous environment within slums, which vary at fine spatial scales and influence transmission of the bacterial agent.We performed a prospective study of 2,003 slum residents in the city of Salvador, Brazil during a four-year period (2003-2007 and used a spatiotemporal modelling approach to delineate the dynamics of leptospiral transmission. Household interviews and Geographical Information System surveys were performed annually to evaluate risk exposures and environmental transmission sources. We completed annual serosurveys to ascertain leptospiral infection based on serological evidence. Among the 1,730 (86% individuals who completed at least one year of follow-up, the infection rate was 35.4 (95% CI, 30.7-40.6 per 1,000 annual follow-up events. Male gender, illiteracy, and age were independently associated with infection risk. Environmental risk factors included rat infestation (OR 1.46, 95% CI, 1.00-2.16, contact with mud (OR 1.57, 95% CI 1.17-2.17 and lower household elevation (OR 0.92 per 10m increase in elevation, 95% CI 0.82-1.04. The spatial distribution of infection risk was highly heterogeneous and varied across small scales. Fixed effects in the spatiotemporal model accounted for the majority of the spatial variation in risk, but there was a significant residual component that was best explained by the spatial random effect. Although infection risk varied between years, the spatial distribution of risk associated with fixed and random effects did not vary temporally. Specific "hotspots" consistently had higher transmission risk during study years.The risk for leptospiral infection in urban slums is determined in large part by structural features, both social and environmental. Our findings 427. SEROLOGICAL AND MOLECULAR SURVEY OF Leptospira spp. AMONG CART HORSES FROM AN ENDEMIC AREA OF HUMAN LEPTOSPIROSIS IN CURITIBA, SOUTHERN BRAZIL Mariane Angélica Finger 2014-12-01 Full Text Available Introduction: Cart horses are a re-emerging population employed to carry recyclable material in cities. Methods: Sixty-two horses were sampled in an endemic area of human leptospirosis. The microscopic agglutination test (MAT and real-time polymerase chain reaction (qPCR were performed. Results: A seropositivity of 75.8% with serovar Icterohaemorrhagiae in 80.8% of the horses was observed. Blood and urine were qPCR negative. MAT showed positive correlations with rainfall (p = 0.02 and flooding (p = 0.03. Conclusions: Although horses may be constantly exposed to Leptospira spp. in the environment mostly because of rainfall and flooding, no leptospiremia or leptospiruria were observed in this study. 428. Decreased erytrocyte osmotic fragility during canine leptospirosis Diminuição da fragilidade osmótica eritrocitária na leptospirose canina Marcelo L. Santoro 1994-02-01 Full Text Available Erythrocyte osmotic fragility (EOF was carried out in nineteen dogs naturally infected by Leptospira interrogans serovar icterohaemorrhagiae/copenhagi. A decreased EOF was observed, suggesting a modification of erythrocyte components secondary to disturbances that occur during canine leptospirosis, such as renal damage and hepatic disease.A fragilidade osmótica eritrocitária foi estudada em dezenove cães infectados naturalmente pela Leptospira interrogans serovar icterohaemorrhagiae/copenhagi. Observou-se uma redução da fragilidade osmótica eritrocitária, sem a presença de anemia, possivelmente relacionada aos distúrbios hepato-renais que ocorrem nesta patologia. 429. SeroepidemiologÃa de la leptospirosis en bovinos con trastornos reproductivos en el municipio de MonterÃa, Colombia César Betancur Hurtado 2013-12-01 Full Text Available Se realizó un estudio descriptivo para determinar la prevalencia de leptospirosis en bovinos con trastornos reproductivos de zonas rurales de MonterÃa, Colombia. Se colectaron muestras de suero de 26 toros y 137 vacas procedentes de 28 fincas con antecedentes de problemas reproductivos, los cuales fueron analizados mediante técnica de microaglutinación (MAT para detección de anticuerpos contra Leptospira. Se utilizaron antÃgenos de los serovares pomona, hardjo, canicola, grippotyphosa e icterohaemorrhagiae. El 41 % de los sueros fue positivo a Leptospira a punto de corte 1:20. Los serovares prevalentes fueron grippotyphosa (29,85 % hardjo e icterohaemorrhagiae (20,8 y 16,41 %. Se realizó una prueba de chi cuadrado (χ2 para establecer relación entre la seropositividad a Leptospira y las variables de sexo, edad, antecedentes de abortos y repetición de servicios de cada animal, asà como zona de muestreo y sistema de producción de las fincas. La seropositividad a Leptospira fue de 26,86 % y 29,85 % en los grupos de edad de 3-4 años y de 5-6 años, y del 43,2 % en bovinos ≥ 7 años. La seroprevalencia en vacas abortadas y no abortadas fue similar (35 y 34 %; asimismo, la seropositividad en vacas con y sin repeticiones de servicio fue de 34 y 35 %, respectivamente. El 41,7 % de las fincas con sistema de producción de carne y el 58,2 % con doble propósito fueron positivas a diferentes serovares. Sin embargo, no se encontró dependencia entre la seropositividad a Leptospira y las variables mencionadas (p > 0,05. Los resultados indican una alta seroprevalencia de leptospirosis en bovinos con trastornos reproductivos del municipio de MonterÃa. 430. Prueba de Elisa indirecta para la detección de anticuerpos IgM para el diagnóstico de Leptospirosis humana Manuel Céspedes Z 2002-01-01 Full Text Available Para el diagnóstico temprano de enfermedades con cuadro clÃnico inespecÃfico como la leptospirosis, es necesario la confirmación laboratorial mediante pruebas especÃficas, con la finalidad de que el diagnóstico sea más acertado y rápido. Objetivo: se realizó un estudio comparativo entre la prueba de microaglutinacion (MAT y la prueba de ELISA indirecta estandarizada con un "pool" de antÃgenos de Leptospira interrogans, para la detección de anticuerpos IgM, en muestras de suero de fase aguda de leptospirosis humana. Materiales y métodos: 40 muestras de pacientes con sospecha clÃnica y con tÃtulos de 1:100-1:12800 por la prueba de MAT, 80 muestras negativas de pacientes aparentemente sanos con enfermedades como Brucelosis, SÃfilis, Tifus murino, Hepatitis B, Fiebre Amarilla, Dengue y Enfermedad de Carrión fueron evaluados por ELISA IgM. Resultados: se obtuvo una sensibilidad de 97,5% y especificidad de 98,75%, no observándose reacción cruzada con otras enfermedades. Conclusión: ELISA IgM validado en el laboratorio es suficiente sensible, especÃfico y de fácil aplicación para el uso como prueba de tamizaje en una infección por Leptospiras con la subsecuente confirmación por MAT. 431. Seroprevalencia de leptospirosis y caracterÃsticas asociadas en agricultores de arroz de una región tropical del Perú Jorge O Alarcón-Villaverde Full Text Available Objetivos . Estimar la seroprevalencia de leptospirosis en agricultores dedicados al cultivo de arroz del valle del Alto Mayo, región San MartÃn e identificar anticuerpos para los serovares circulantes y los factores asociados a la infección. Materiales y métodos. Se realizó un estudio transversal entre octubre y noviembre de 2010 en una muestra de 254 agricultores procedentes de las once comisiones de regantes del valle de Alto Mayo. Se recolectó una muestra de sangre y se aplicó un cuestionario que incluyó variables sociodemográficas, y caracterÃsticas del hogar y del trabajo. Se determinó la presencia de anticuerpos contra leptospira usando la prueba de microaglutinación y ELISA IgM. Resultados. La seroprevalencia determinada por microaglutinación fue del 64,6% (IC 95%: 58,6-70,6. La prueba ELISA IgM fue reactiva en 15,0% (IC 95%: 10,519,5. Los tipos de serovar más frecuentes fueron Icterohaemorrhagiae, Autumnalis, Australis , Panama y Grippotyphosa. Los factores asociados independientemente fueron la manipulación de roedores (OR ajustado [ORa] de 7,9, IC 95%: 1,6-37,9, trabajar descalzo (ORa de 2,9, IC 95%: 1,2-6,8 y el sexo masculino (ORa de 4,5, IC 95%: 1,3-15,3. Conclusiones . El valle del Alto Mayo es un área hiperendémica de leptospirosis. Los factores asociados más importantes fueron la práctica de trabajar descalzo y la de manipular roedores en los campos de cultivo. En consecuencia, se recomienda implementar intervenciones que incidan en estos dos factores a fin de reducir el riesgo de infección en los cultivadores de arroz. 432. Fever, thrombocytopenia, and AKI-A profile of malaria, dengue, and leptospirosis with renal failure in a South Indian tertiary-care hospital. Prabhu, Mayoor V; S, Arun; Ramesh, Venkat In the tropics, the triad of fever, thrombocytopenia, and AKI portends a grim prognosis with high mortality and a severe strain on already-stretched resources. Malaria, dengue, and leptospirosis account for most cases. We undertook a review of cases to determine factors accounting for adverse prognosis. All patients presenting to the emergency room (ER) with a history of fever, thrombocytopenia, and renal failure were included in the study. Patients were followed until discharge or death, and end points looked at were 1-week and 30-day mortality, and renal function upon discharge. Parameters like liver function test (LFT), renal function, and platelet count upon discharge were also documented. A total of 43 patients was included in the study. Mean age was 42.5 years with 86% males. Mean APACHE and SOFA scores on admission were 23.89 and 15.42, respectively. Mean admission platelet counts were 41,000. Mean serum creatinine was 4.1, and bilirubin was 9.94. A platelet count of  4, albumin of > 2.3, SOFA score of > 20, and APACHE score of > 32.2 were significantly predictive of 1 week mortality. Need for mechanical ventilation, oliguria on admission, and need for dialysis all were highly predictive of 30-day mortality. In addition, a serum bicarbonate of  1.5, hemoglobin of 1/1.600. Los resultados obtenidos en el presente trabajo no muestran diferencias significativas en relación al sexo, procedencia (rural/urbano, raza, animales vacunados y no vacunados. Sà se presentó relación entre el estado de perro vago y la probabilidad de contraer la enfermedad, y entre los valores obtenidos para los perros vacunados con respecto a la infección por el serovar ballum, que sugerirÃan una mayor probabilidad de contraer la infección por este serovar en los perros vacunados relativo a los perros no vacunados. Se compararon, además, las técnicas MAT, aislamiento e inmunofluorescencia indirecta (IFI, a partir de tejido renal. Para realizar la IFI, se obtuvo suero hiperinmune inoculando ratas con los serovares canicola e icterohaemorrhagiae. Se encontró un 14% de caninos positivos a MAT, frente a los serovares canicola, icterohaemorrhagiae y ballum. La mayorÃa de estos sueros lo hizo a tÃtulos entre 1/400 y > 1/1.600. No se pudo obtener ningún aislamiento a partir de tejido renal, a pesar de que algunos de 450. Formas graves de leptospirose: aspectos clÃnicos, demográficos e ambientais Severe forms of leptospirosis: clinical, demographic and environmental aspects Everaldo Costa 2001-06-01 Full Text Available São descritas as caracterÃsticas de 1.016 pacientes internados com leptospirose no Hospital Couto Maia, Salvador, BA, entre 1993 e 1997. Aumento na precipitação pluviométrica mostrou relação com aumento do número de internamentos no mês subsequente. Sexo masculino correspondeu a 81,1% (824/1.016; a média da idade foi 35,7±15,4 anos. Quase 94% (778/829 dos 829 com informação sobre raça eram negros ou mulatos. Para idade igual ou superior a 18 anos, quase 93% não cursaram o segundo grau. A média do perÃodo de incubação foi estimado em 6,3±3,9 dias. A duração dos sintomas foi em média 6,1±2,4 dias. Episódios hemorrágicos corresponderam a 14,3% (145/1.016. A letalidade entre 1.009 pacientes não transferidos foi de 14,2% (143/1.009. Insuficiência renal foi a causa atribuÃda de morte em 76,2% (109/143. Os dados indicam que leptospirose é estreitamente relacionada com baixos nÃveis socioeconômicos e que aumento da precipitação pluviométrica precede surtos epidêmicos.Characteristics of 1,016 patients hospitalized with leptospirosis in the Hospital Couto Maia, Salvador, BA, Brazil, between 1993 and 1997 are described. Higher pluviometric precipitation was related to an increase in the number of hospitalizations during the following month. Males corresponded to 81.1% (824/1,016 of these; mean age was 35.7±15.4 years. Almost 94% (778/829 of the 829 patients with information about race were black or mulatto (mixed race. For ages 18 years or above, almost 93% had not completed high school level. The mean incubation period was estimated as 6.3±3.9 days. Average duration of symptoms was 6.1±2.4 days. Hemorrhagic events corresponded to 14.3% (145/1,016. The case-fatality rate among 1,009 patients that were not transferred was 14.2% (143/1,009. Renal failure was the attributable cause of death in 76.2% (109/143. The data indicate that leptospirosis is closely related to lower socioeconomic levels, and that higher 451. Comparative evaluation of recombinant LigB protein and heat-killed antigen-based latex agglutination test with microscopic agglutination test for diagnosis of bovine leptospirosis. Nagalingam, Mohandoss; Thirumalesh, Sushma Rahim Assadi; Kalleshamurthy, Triveni; Niharika, Nakkala; Balamurugan, Vinayagamurthy; Shome, Rajeswari; Sengupta, Pinaki Prasad; Shome, Bibek Ranjan; Prabhudas, Krishnamsetty; Rahman, Habibur 2015-10-01 This study aimed to develop latex agglutination test (LAT) using recombinant leptospiral immunoglobulin-like protein (LigB) (rLigB) antigen and compare its diagnostic efficacy with LAT using conventional heat-killed leptospiral antigen and microscopic agglutination test (MAT) in diagnosing bovine leptospirosis. The PCR-amplified 1053-bp ligB gene sequences from Leptospira borgpetersenii Hardjo serovar were cloned in pET 32 (a) vector at EcoRI and NotI sites and expressed in BL21 E. coli cells as fusion protein with thioredoxin (-57 kDa) and characterized by SDS-PAGE and immunoblot. Out of 390 serum samples [cattle (n = 214), buffaloes (n = 176)] subjected to MAT, 115 samples showed reciprocal titre≥100 up to 1600 against one or more serovars. For recombinant LigB protein/antigen-based LAT, agglutination was observed in the positive sample, while no agglutination was observed in the negative sample. Similarly, heat-killed leptospiral antigen was prepared from and used in LAT for comparison with MAT. A twosided contingency table was used for analysis of LAT using both the antigens separately against MAT for 390 serum samples. The sensitivity, specificity and positive and negative predictive values of recombinant LigB LAT were found to be 75.65, 91.27, 78.38 and 89.96 %, respectively, and that of heat-killed antigen-based LAT were 72.17, 89.82, 74.77 and 88.53 %, respectively, in comparison with MAT. This developed test will be an alternative/complementary to the existing battery of diagnostic assays/tests for specific detection of pathogenic Leptospira infection in bovine population. 452. 2005-2011年安岳县钩体病æµè¡Œåˆ†æž%Leptospirosis in Anyue County, 2005-2011 é™ˆæ ‘è‹±; ç”°åŽ 2012-01-01 目的 分æžå®‰å²³åŽ¿2005-2011年钩端螺旋体病(leptospirosis,钩体病)疫情æµè¡Œç—…å¦ç‰¹å¾,为钩体病防控工作æ供科å¦æœ ‰æ•ˆä¾æ®.方法 对93例病例的三间分布特å¾å’Œæœ‰å…³å½±å“å› ç´ è¿›è¡Œåˆ†æž,找出å‘ç—…åŽŸå› ,æ出有效防治对ç–.结果 2005-2011å¹ ´å®‰å²³åŽ¿é’©ä½“病共报告93例,2005年报告病例最高(37例),2010年最低(5例),å¹´å‡å‘病率约为0.84/10万；å‘ç—…å£èŠ‚为610月,9月最高,å å‘病总数的83.87ï¼… (78/93)ï¼›å‘病人群以50 ～ 59å²å¹´é¾„组为主,å 病例总数的35.48ï¼… (33/93)ï¼›ç”·æ€§å¤šäºŽå¥³æ €§,æž„æˆæ¯”为2.32:1ï¼›èŒä¸šä»¥å†œæ°‘å‘病为主,å 总å‘ç—…æ•°çš„81.72ï¼….结论 æ¥2005-2011年安岳县钩体å‘病率处于较低水平,é€å¹´å‘ˆçŽ °ä¸‹é™è¶‹åŠ¿,主è¦å‘病人群为农民,农æ‘是钩体病防治的é‡ç‚¹åœ°åŒº. 453. Hiperendemicidad de leptospirosis y factores de riesgo asociados en localidades arroceras del departamento de San MartÃn - Perú¹ Rollin Cruz M 2002-01-01 Full Text Available Objetivos: Determinar la prevalencia de infección por leptospiras y los factores asociados a dicha infección en localidades dedicadas al cultivo de arroz del departamento de San MartÃn. Materiales y métodos: en este estudio transversal analÃtico se seleccionó una muestra de 457 pobladores de 73 localidades con la mayor producción de arroz de 4 provincias del departamento de San MartÃn de julio a diciembre del 2000, en quienes se evaluó la presencia de anticuerpos IgG antilesptospiras en suero por el método de ELISA, con identificación de los serovares (en muestras positivas a través de la prueba de microaglutinación (MAT. La presencia de factores de riesgo asociados a la infección por leptospiras fue evaluada por una encuesta epidemiológica. Resultados: 115 (25,2% pobladores tuvieron anticuerpos anti-leptospiras. Los factores asociados a la infección por leptospiras en los pobladores incluidos en la muestra fueron: edad mayor de 30 años (OR=1,69, p=0,018, no ser natural de San MartÃn (OR=1,59, p=0,032, ser agricultor (OR=1,71, p=0,013, habitar una vivienda con piso de tierra (OR=2,17, p=0,018, eliminación de excretas a campo abierto (OR=2,11, p=0,023 y no guardar lo comida tapada (OR=3,63, p=0,023. Conclusiones: existe una alta prevalencia de leptospirosis en áreas dedicadas al cultivo de arroz del departamento de San MartÃn. En estas zonas debe realizarse actividades educativas preventivas tomando en cuenta los factores de riesgo identificados. 454. The epidemiological characteristics of leptospirosis among police dogs and effect of vaccination%è¦çŠ¬åŸºåœ°é’©ç«¯èžºæ—‹ä½“ç—…æµè¡ŒçŠ¶å†µåŠç–«è‹—æŽ ¥ç§æ•ˆæžœè§‚察 å´æ™¯æ–‡; 陶端åŽ; 刘å æ–Œ; 胡茂红; 涂ä¸å…´ 2014-01-01 目的：通过对公安部å—昌市è¦çŠ¬åŸºåœ°åŠå…¶å¹¼çŠ¬å¯„å…»çŽ¯å¢ƒçš„é’©ç«¯èžºæ—‹ä½“ï¼ˆä»¥ä¸‹ç®€ç§°é’©ä½“ï¼‰ç—…çš„ç³»ç»Ÿç›‘æµ‹ï¼Œäº†è§£å… ¬å®‰éƒ¨å—昌市è¦çŠ¬åŸºåœ°é’©ä½“ç—…çš„æµè¡ŒçŠ¶å†µï¼Œä¸ºè¦çŠ¬åŸºåœ°æˆ–其他类型的犬场钩体病防制æä¾›ä¾æ®ã€‚方法2009～2011å¹ ´é’©ä½“ç—…æµè¡Œå£èŠ‚在è¦çŠ¬åŸºåœ°åŠå…¶å¹¼çŠ¬å¯„养环境范围内，分别在å¥åº·äººç¾¤ã€åŸºåœ°å¤–çŽ¯å¢ƒï¼ˆé¼ ã€é’蛙）ç‰å®¿ä¸»ä¸è¿›è¡Œé’©ç«¯èžºæ—‹ä½“抗体检测和病原分离，分æžè¯¥çŠ¬åœºå…»æ®–基地和幼犬寄养环境的人ã€çŠ¬åŠå…¶ä»–å®¿ä¸»åŠ¨ç‰©æ‰ €æ„ŸæŸ“钩体型别是å¦ä¸€è‡´ï¼Œäº†è§£é’©ä½“在区域范围内“人—犬—其他宿主动物â€çš„ä¼ æ’关系。结果è®çŠ¬å¸ˆï¼ˆåˆ‘è¦å¦é™¢æ– °å¦å‘˜ï¼‰æ„ŸæŸ“钩体型别与基地è¤å®¶é¼ ä¸åˆ†ç¦»çš„钩体型别基本一致，幼犬寄养环境å¥åº·äººç¾¤æ„ŸæŸ“é’©ä½“åž‹åˆ«ä¹Ÿä¸Žå½“å¹ ´åº¦å¯„å…»çš„å¹¼çŠ¬æ„ŸæŸ“çš„é’©ä½“åž‹åˆ«åŸºæœ¬ä¸€è‡´ã€‚æ ¹æ®åŸºåœ°é’©ä½“病型别定è´äº†è¦†ç›–所有感染型别的人用钩体多价疫苗 对幼犬进行疫苗接ç§ï¼Œ1个月和3个月åŽå„型抗体阳转率å‡è¾¾åˆ°100ï¼…ï¼Œè¿™æ˜¯é¦–æ¬¡æŠ¥å‘Šäººç”¨é’©ä½“å¤šä»·ç–«è‹—å¯¹çŠ¬ç±»æœ ‰æ•ˆã€‚结论公安部å—昌市è¦çŠ¬åŸºåœ°å·²æˆä¸ºé’©ä½“ç—…çš„ç–«æºåœ°ï¼Œå¹¼çŠ¬å¯„å…»åœ¨å†œæˆ·å®¶ä¼šå¯¼è‡´æ„ŸæŸ“é’©ä½“ï¼Œé’ˆå¯¹é’©ä½“åž‹åˆ«é€ ‰æ‹©åˆé€‚的疫苗分别进行人ã€çŠ¬ç–«è‹—接ç§ï¼Œç»“åˆçé¼ æŽªæ–½ï¼Œå¯¹é™ä½Žè®çŠ¬å¸ˆï¼ˆä¸»è¦æ˜¯åˆ‘è¦å¦é™¢å®žä¹ å¦å‘˜ï¼‰ã€çŠ¬åœºå‘¨å›´ç¾¤ä¼—㠀犬åŠå¤–环境钩体病的感染率，å‡å°‘基地ç»æµŽè´¢äº§æŸå¤±ï¼Œä¿æŠ¤ç–«æºåœ°å‘¨å›´äººç¾¤çš„身体å¥åº·ï¼Œæœ‰é‡è¦çš„社会æ„ä¹ ‰å’Œç»æµŽä»·å€¼ã€‚%Objective To explore the epidemiological characteristics of leptospirosis and provide scientific basis for the control and prevention of leptospirosis .Methods Leptospirosis antibody was detected from healthy people and leptospirosis was isolated from hosts ,such as rats and frogs in the police dog base and puppies foster places in regular seasons from 2009 to 2011 .Data including the disease 455. Epidemiological Analysis of Leptospirosis in Guangxi Zhuang Autonomous Region from 2007 to 2011%2007-2011年广西钩端螺旋体病æµè¡Œç—…å¦åˆ†æž æŽç§€è‹¾; æ¢æ±Ÿæ˜Ž; 黄å›; 曾竣; 蒋震羚; æ¨å…‰åŽ; å´ç§€çŽ² 2013-01-01 Objective To survey the epidemiological features of leptospirosis in Guangxi Zhuang Autonomous Region from 2007 to 2011 so as to provide a scientific basis for developing effective prevention and control measures. Methods Descriptive epidemiological and medical statistical methods were used to statistically analyze and evaluate the data about leptospirosis in Guangxi Zhuang Autonomous Region during the period of 2007 - 2011. Results Altogether, 259 cases of leptospirosis were reported during the period of 2007 2011. There were 9 cases of death, with the mortality of 3. 47% . The average annual incidence rate was 0.11/100,000. The prevalence season for leptospirosis was from June to September per year, with a peak in August and 69.11 % cases occurred in the prevalence season. In the case of occupation distribution, farmers and students were the most commonly involved, accounting for 83. 01 % of the total cases. Male cases were more than female ones, and the ratio of male to female was 2.28:1. The main infection bacterial colony in the patients was jaundice bleeding group and the type of paddy - field was the dominant infection type. Conclusions Implementing comprehensive measures, including infection source control and management, health education and immunization, is the key to leptospirosis prevention and control.%目的 了解近五年æ¥å¹¿è¥¿é’©ç«¯èžºæ —‹ä½“ç—…æµè¡Œç—…å¦ç‰¹å¾,为有效预防与控制钩端螺旋体病的å‘生和æµè¡Œæ供科å¦ä¾æ®.方法 采用æ述性æµè¡Œç—…å¦æ– ¹æ³•å’ŒåŒ»å¦ç»Ÿè®¡å¦æŠ€æœ¯å¯¹2007-2011年广西钩端螺旋体病疫情报告åŠå…¶ç›¸å…³èµ„料进行统计ã€åˆ†æžå’Œè¯„ä¼°.结果 2007-2011å¹ ´å¹¿è¥¿é’©ç«¯èžºæ—‹ä½“病共报告病例259例,æ»äº¡9例,ç—…æ»çŽ‡ä¸º3.47ï¼…,å¹´å‡å‘病率为0.11/10万.6-9月是本病æµè¡Œå£èŠ‚,å‘ç—… 人数å 全部病例的69.11ï¼…,8月是å‘病高峰.èŒä¸šåˆ†å¸ƒä»¥å†œæ°‘å’Œå¦ç”Ÿä¸ºä¸»,å…¶å‘病人数å 全部病例的83.01ï¼….ç—…ä¾‹ç”·æ€§å ¤šäºŽå¥³æ€§,性别比为2.28:11.æµè¡Œçš„主è 456. 安徽çœ2005-2009年钩端螺旋体病疫情动æ€ç›‘测分æž%Analysis on the epidemic trend and surveillence of leptospirosis in Anhui Province from 2005 to 2009 æŽé’; 刘红; 范引光; 顾黎丽 2011-01-01 目的 了解安徽çœé’©ç«¯èžºæ—‹ä½“ç—…(简称钩体病)æµè¡Œç‰¹å¾,为制定防治对ç–æ供科å¦ä¾æ®.方法 用æ述性æµè¡Œç—…å¦çš„æ– ¹æ³•å¯¹2005-2009年安徽çœé’©ä½“ç—…æµè¡Œç‰¹å¾è¿›è¡Œåˆ†æž,采用病原å¦ã€è¡€æ¸…å¦æ£€æµ‹æ–¹æ³•æŽ¢ç´¢ä¸»è¦çš„æµè¡ŒèŒç¾¤.结果 2005-2009å¹´å® ‰å¾½çœé’©ä½“ç—…å¹´å¹³å‡å‘病率为0.055/10万,å‘病率最高年份是2007å¹´(0.085/10万),èŒä¸šåˆ†å¸ƒä»¥å†œæ°‘为主,å 87.15%(156/179).å¹ ´é¾„分布以15～60å²ä¸ºä¸»,å 86.59%(155/179),男女病例数之比为2.25:1(124/55).病例主è¦åˆ†å¸ƒåœ¨æ—Œå¾·åŽ¿(57例)ã€æ™åŽ¿(52例)åŠé»„å± ±åŒº(15例).2005-2009年共检测出177æ ªæ¯’æ ª,å…¶ä¸é»„疸出血群å 93.22%(165/177).å¥åº·äººç¾¤è¡€æ¸…å¦æ£€æµ‹é˜³æ€§çŽ‡ä¸º5.64%(122/2 162),ä»¥é»„ç– ¸å‡ºè¡€ç¾¤ä¸ºä¸»,å 68.03%(83/122),é»‘çº¿å§¬é¼ ä¸ºä¼˜åŠ¿ç§,å 84.55%(1 779/2 104),带èŒçŽ‡ä¸º8.94%(159/1 779).结论 安徽çœé’©ä½“ç—…æµè¡ŒèŒç¾¤ä¸ºé»„ç– ¸å‡ºè¡€ç¾¤,主è¦å®¿ä¸»æ˜¯é»‘çº¿å§¬é¼ ,钩体病æµè¡Œè¡€æ¸…群æ£åœ¨æ”¹å˜,需长期监测åŠæ—¶æŽŒæ¡ç–«æƒ…动æ€,采å–æœ‰é’ˆå¯¹æ€§é¢ „防控制措施.%Objective To study the epidemiological characteristics of leptospirosis in Anhui Province and provide evidence for making prevention and cure strategy. Methods Descriptive analysis of leptospirosis epidemic situation in Anhui Province from 2005 to 2009 was made, the main microbial population was explored by the patients and the host animals etiological and serological detection methods. Results The average morbidity of leptospirosis in Anhui Province from 2005 to 2009 was 0. 055/100 000. The highest incidence was 0. 085/100 000 in 2007, the major patients were farmers (87.15ï¼…, 156/179). Most of the patients were from 15 years to 60 years (86.59ï¼…, 155/179), the male to female ratio was 2.25:1(124/55). Most cases were found in Jingde County (57 cases), and Shexian County (52 cases), followed by Huangshan District (15 cases). 177 strains were detected from 2005 to 2009, of which 165 strains of jaundice bleeding group (93.22ï¼…, 165 457. 2010-2012年资阳市钩体病æµè¡Œç—…å¦åˆ†æž%Epidemic Situation of Leptospirosis in Ziyang, 2010-2012 欧阳æ•; 何平; 廖安波; 贾勇 2013-01-01 目的 分æž2010-2012年资阳市钩端螺旋体病(leptospirosis,钩体病)疫情æµè¡Œç—…å¦ç‰¹å¾,为钩体病防控工作æä¾›ä¾æ®.方法 收集2010-2012年全国疾病监测信æ¯æŠ¥å‘Šç®¡ç†ç³»ç»Ÿçš„报告数æ®å’Œå››å·çœç–¾ç—…预防控制ä¸å¿ƒæ£€æµ‹æ•°æ®,利用æ述性æµè¡Œç—…å¦æ–¹æ³•è¿›è¡Œåˆ†æž.结果 2010-2012å¹´,资阳市钩体病累计报告85例,å¹´å‡å‘病率0.71/10万,åˆè®¡æ»äº¡7例,åˆè®¡ç—…æ»çŽ‡ä¸º8.24ï¼….ä¸åŒåœ°åŒºé —´å‘病率的差异有统计å¦æ„义(x2=186.753,P＜0.01);ä»…8ã€9ã€10月份有病例报告,å‘病高峰为9月,å 病例的84.71ï¼….ç—… 例ä¸å†œæ°‘å 92.94ï¼…,35å²ä»¥ä¸Šä¸è€å¹´ç—…例å 82.35ï¼….2010å¹´ä¹è‡³åŽ¿å‘生1起钩体病疫情.85例钩体病病例å‡æœ‰ç”°é— ´åŠ³åŠ¨å’Œæ¸¸æ³³æˆæ°´å²,æµè¡Œçš„主è¦èŒç¾¤æ˜¯é»„疸出血群.结论 2010-2012年资阳市钩体病疫情维æŒåœ¨è¾ƒé«˜æ°´å¹³,æµè¡Œå› ç´ å¹¿æ³›å˜åœ¨,ç—… æ»çŽ‡è¾ƒé«˜,å¤ç§‹ä¹‹äº¤é«˜å‘,典型的稻田型钩体病æµè¡Œ,ä¸è€å¹´ä¸ºé’©ä½“病主è¦å±å®³äººç¾¤. 458. Prevalencia de Leptospirosis y su relación con la tasa de gestación en bovinos de la zona centro de Veracruz Juan Prisciliano Zárate MartÃnez 2015-01-01 Full Text Available Introducción: La reproducción bovina es afectada por varias enfermedades infecciosas, entre las que se encuentran leptospirosis, brucelosis, campilobacteriosis, diarrea viral bovina y rinotraqueitis infecciosas bovina. Estas enfermedades infecciosas causan pérdidas económicas a la industria ganadera. El objetivo fue determinar la seroprevalencia de cinco especies de Leptospira: hardjo, inifap, paloalto, tarassovi y wolffi en siete unidades de producción (UP del estado de Veracruz, asà como las razones de momios entre las seroprevalencias de las UP. Un objetivo adicional fue determinar si la presencia de Leptospira influye la tasa de gestación (TG. Método: Las UP fueron de los municipios de San Rafael, MedellÃn y Cotaxtla. Se tomaron muestras de sangre de vacas Bos taurus x Bos indicus. Los análisis serológicos para determinar la presencia de Leptospiras se realizaron con la prueba de microaglutinación en placa. Se consideraron como positivos los animales con tÃtulos mayores que 1:100. Los análisis de seroprevalencia se realizaron con el procedimiento GENMOD de SAS, considerando un diseño completamente al azar, donde el factor de riesgo fue la UP, y asumiendo la función liga logit para una distribución binomial. El análisis de TG se realizó con el mismo procedimiento, asumiendo la misma función liga, pero el modelo incluyó los efectos de estatus zoosanitario (presencia/ausencia de Leptospiras y UP. Resultados: La variable UP fue significativa (P0.05 para la de L. inifap y L. wolffi. Las seroprevalencias promedio fueron: 89.3, 67.1, 40.0, 15.9 y 10.0% para L. inifap, L. hardjo, L. paloalto, L. tarassovi y L. wolffi, respectivamente. El estatus zoosanitario y UP no afectaron (P>0.05 la TG. La TG promedio de las siete UP fue 50.5% Discusión o Conclusión: Los resultados obtenidos en el presente trabajo muestran que las cinco especies de Leptospira estudiadas se encuentran presentes en todas las unidades de producci

459. Leptospirosis: Una enfermedad zoonótica hiperendémica en la provincia de Coronel Portillo. Ucayali, Perú Manuel Céspedes Z 2004-04-01 Full Text Available Objetivo: Determinar la prevalencia de anticuerpos para leptospiras en personas asintomáticas en las localidades dedicadas al comercio y la agricultura de la provincia de Coronel Portillo, del departamento de Ucayali. Asimismo determinar la prevalencia de leptospirosis en animales domésticos. Material y Métodos: En este estudio transversal analÃtico, se tomó muestras de suero de 364 pobladores de 4 localidades, en quienes se evaluó la presencia de anticuerpos totales contra leptospiras en suero por el método de ELISA y la prueba de microaglutinación (MAT. Se realizó el análisis estadÃstico para ver el grado de asociación entre las caracterÃsticas generales de la población y la información recopilada en la encuesta con la positividad para anticuerpos para leptospiras. De la misma manera, se tomó muestras de suero de 374 animales domésticos (canes a los que se realizó MAT. Resultados: Se enrolaron 364 personas de las cuales 227 (62,4% fueron mujeres y 137 (37,6% varones, 114 (31,3% pobladores tuvieron anticuerpos contra leptospiras y los serovares más frecuentes fueron Bratislava y Georgia según MAT, los probables factores asociados a la positividad a anticuerpos para leptospiras en los pobladores fueron: guardar alimentos en el hogar (OR=2,221, ser agricultor (OR=3,418, ser obrero y agricultor (OR=2,088, eliminar basura en el campo (OR=2,348. En canes, 181 (52,2% tuvieron serologÃa positiva a leptospiras. Conclusiones: Existe una alta prevalencia de serologÃa positiva para leptospiras en población general asintomática y condiciones favorables para la presencia de leptospiras en las localidades estudiadas. En estas zonas se recomienda realizar actividades educativas preventivas frecuentes, tomando en cuenta los resultados de este estudio. 460. Characterization and immunogenicity of rLipL32/1-LipL21-OmpL1/2 fusion protein as a novel immunogen for a vaccine against Leptospirosis Zhao Xin 2015-01-01 Full Text Available Vaccination is an effective strategy to prevent leptospirosis, a global zoonotic disease caused by infection with pathogenic Leptospira species. However, the currently used multiple-valence vaccine, which is prepared with whole cells of several Leptospira serovars, has major side effects, while its cross-immunogenicity among different Leptospira serovars is weak. LipL32, LipL21 and 2 OmpL1 have been confirmed as surface-exposed antigens in all pathogenic Leptospira strains, but their immunoprotective efficiency needs to be improved. In the present study, we generated a fusion gene lipL32/1-lipL21-ompL1/2 using primer-linking PCR and an engineered E. coli strain to express the recombinant fusion protein rLipL32/1-LipL21-OmpL1/2 (rLLO. Subsequently, the expression conditions were optimized using a central composite design that increased the fusion protein yield 2.7-fold. Western blot assays confirmed that rLLO was recognized by anti-rLipL32/1, anti-rLipL21, and anti-rOmpL1/2 sera as well as 98.5% of the sera from leptospirosis patients. The microscopic agglutination test (MAT demonstrated that rLLO antiserum had a stronger ability to agglutinate the strains of different Leptospira serovars than the rLipL32/1, rLipL21, and rOmpL1/2 antisera. More importantly, tests in hamsters showed that rLLO provided higher immunoprotective rates (91.7% than rLipL32/1, rLipL21 and rOmpL1/2 (50.0-75.0%. All the data indicate that rLLO, a recombinant fusion protein incorporating three antigens, has increased antigenicity and immunoprotective effects, and so can be used as a novel immunogen to develop a universal genetically engineered vaccine against leptospirosis. « 21 22 23 24 25 » « 21 22 23 24 25 » 461. An analysis on leptospirosis surveillance of ten years in Zhejiang Province%浙江çœé’©ç«¯èžºæ—‹ä½“ç—…10å¹´ç›‘æµ‹ç»“æžœåˆ†æž æ–½æ—å…‰; 姜ç†å¹³; å™ç»§æ°‘; 龚震宇 2016-01-01 Objective To analyze surveillance and survey data in Zhejiang Province,and to learn the distribution of the leptospirosis of the host animals and the crowd,in order to provide the basis for prevention and control.Methods Descriptive epidemiology and statistical analysis were conducted.The kidneys of mouse,frog,pig,and duck were collected for pathogen isolation.The serum samples of the clinic diagnosed patients and the host animals were tested by microscopic agglutination test or antibody.Results There were 1 31 cases of leptospirosis in Zhejiang Province from 2005 to 201 4, including 3 cases died.The incidence rate,mortality rate and fatality rate were 0. 025 2/1 00 000,0. 000 6/1 00 000,and 2. 29%,respectively. The cases were reported in all the areas except Zhoushan and Huzhou. The main endemic distributions were mountain areas of southern and central Zhejiang Province.The positive rate in blood of duck was highest and the main flora was icteroheamorrhagiae.The floras in patients'serum antibody were icteroheamorrhagiae and leptospira hebdomadis.The flora in patients was incongruous with the host animals.Conclusion The incidence of leptospirosis remains at low level in recent years in Zhejiang Province.The bacterial flora distribution was stable,but the outbreak of leptospirosis due to strain changing should be prevented.%目的：分æžæµ™æ±Ÿçœ2005—2014å¹´é’©ç«¯èžºæ —‹ä½“病（钩体病）监测资料，探索浙江çœé’©ä½“ç—…æµè¡Œè§„律。方法采用æ述性æµè¡Œç—…å¦æ–¹æ³•åˆ†æžäººé—´é’©ä½“ç— …疫情数æ®ï¼›é‡‡é›†é¼ 肾ã€è›™è‚¾ã€çŒªè‚¾ã€ç‰›å°¿ã€é¸è‚¾ã€é¸è¡€å’Œè›™è¡€è¿›è¡Œç—…åŽŸä½“åˆ†ç¦»åŸ¹å…»ï¼Œä¸´åºŠç¡®è¯Šç—…ä¾‹å’Œå®¿ä¸»åŠ¨ç ‰©é‡‡ç”¨æ˜¾å¾®é•œå‡é›†å®žéªŒæ£€æµ‹æŠ—体，分æžå®¿ä¸»åŠ¨ç‰©å’Œäººç¾¤ä¸é’©ç«¯èžºæ—‹ä½“æµè¡ŒèŒç¾¤æºå¸¦å’Œå˜åŠ¨æƒ…å†µã€‚ç»“æžœæµ™æ ±Ÿçœ2005—2014年累计å‘ç—…131例，æ»äº¡3例，报告å‘病率为0.0252ï¼10万，æ»äº¡çŽ‡ä¸º0.0006ï¼10万，病æ»çŽ‡ä¸º2.29％。2007å¹´å‘ç —…率最高，为0.1084ï¼10万。除舟å 462. Distribuição espacial da leptospirose no Rio Grande do Sul, Brasil: recuperando a ecologia dos estudos ecológicos Spatial distribution of leptospirosis in Rio Grande do Sul, Brazil: recovering the ecology of ecological studies Christovam Barcellos 2003-10-01 Full Text Available A leptospirose apresenta no Estado do Rio Grande do Sul uma grande diversidade de situações de exposição, reservatórios, agentes etiológicos e quadros clÃnicos. O principal objetivo desse trabalho é identificar áreas de maior risco e possÃveis componentes ecológicos da transmissão da leptospirose por meio da agregação de dados epidemiológicos em unidades espaciais que representem a diversidade sócio-ambiental do Estado. Os 1.274 casos confirmados de leptospirose ocorridos em 2001 foram georreferenciados por municÃpio de residência. Os mapas de municÃpios foram sobrepostos aos de caracterização de uso do solo, relevo e bacias hidrográficas. Com as operações de SIG, foram calculadas as taxas de incidência para cada categoria e sua significância estatÃstica. As maiores taxas de incidência foram verificadas em áreas sedimentares litorâneas, de baixa altitude e uso do solo predominantemente agrÃcola. Nessas áreas, a maior parte dos casos está associada à lavoura irrigada. Os resultados sugerem a existência de caracterÃsticas ecológicas favoráveis à transmissão da leptospirose em locais de proliferação de roedores sinantrópicos e de produção agrÃcola intensiva. São discutidos os efeitos da agregação de dados em unidades ambientais na análise de dados epidemiológicos e estratégias de controle da endemia no Estado.Leptospirosis is an endemic disease in the State of Rio Grande do Sul, Brazil, and presents a broad diversity of exposure routes, reservoirs, etiological agents, and clinical features. The main objective of this work is to identify transmission areas and possible ecological components of leptospirosis transmission. This was accomplished through the aggregation of epidemiological data into spatial units that represent the State's socio-environmental diversity. The 1,274 confirmed leptospirosis cases that occurred in 2001 were georeferenced in the counties of residence. The county maps were 463. Is CK-MB isoenzyme useful for diagnosis of cardiac involvement in icteric leptospirosis? CK-MB: útil no diagnóstico de envolvimento cardÃaco na leptospirose ictérica Elizabeth Stankiewicz Machado 1995-10-01 Full Text Available In the absence of heart failure or cardiogenic shock, cardiac involvement diagnosis in icteric leptospirosis is possible on the basis of abnormal electrocardiograms. As metabolic and electrolytic disorders are frequently seen during acute leptospirosis infection, they may be responsible for some electrocardiograms changes. We conducted a study to assess if creatine phosphokinase isoenzyme determinations are useful in selecting patients with a high cardiac involvement suspicion. Sixty-nine patients were studied prospectively. Ten patients out of 16 with cardiac involvement and 25 without had high CK-MB levels (p>0.05, although mean values of abnormal CK-MB levels were higher in the group with cardiac involvement (pNa ausência de insuficiência cardÃaca ou choque cardiogênico, o diagnóstico de envolvimento cardÃaco na leptospirose ictérica pode ser baseado em alterações eletrocardiográficas. Devido ao frequente comprometimento multisistêmico da doença, algumas dessas alterações podem ser secundárias a distúrbios metabólicos ou eletrolÃticos. Realizou-se um estudo para avaliação do significado da enzima CK-MB elevada em casos suspeitos de envolvimento cardÃaco. Sessenta e nove pacientes com leptospirose ictérica foram estudados prospectivamente. Dez dos 16 casos com envolvimento cardÃaco e 25 dos 53 pacientes sem envolvimento cardÃaco tiveram CK-MB elevada (p>0,05. O valor médio de CK-MB foi maior no grupo com envolvimento cardÃaco (p 0.1. On the other hand, hyperK showed a significant association with increased risk of death (OR = 3.95, p = 0.021. In conclusion, in this sample of men with leptospirosis initial serum potassium was positively and independently correlated with the risk of in-hospital death.Leptospirose grave afeta predominantemente os homens e apresenta alta susceptibilidade para insuficiência renal aguda com hipocalemia. Como hipocalemia e hipercalemia induzem complicações graves, é importante avaliar se o potássio sérico é um independente fator de risco de morte na leptospirose. Foram revistos os prontuários de 1016 pacientes internados com o diagnóstico de leptospirose. A análise foi restrita a 442, obedecendo os seguintes critérios: sexo masculino, idade igual ou superior a 18 anos, informação sobre morte ou alta hospitalar e registro dos valores do potássio s 479. Study on the Epidemiological Features of Leptospirosis in North-west of the Hubei Province in 1990’S%90年代鄂西北地区钩端螺旋体病æµè¡Œç—…å¦ç ”究 程å‡ç¦; å¾ä¸–æµ·; æ¨æ™“艳 2001-01-01 Objective:Investigate the epidemic of leptospirosis in north-westof Hubei province in 1990'S.Methods:The serum of leptospirosis cases were measured using MAT and Dot-ELISA methods,health population immune level with MAT method. The investigation of the source adopt mouse-clip in the evening, cultivatet rat and pig kidney cortex, separate leptospiroal and identify leptospiroal serum groups.Results:The cases of leptospirosis were few 1990s ago and later the continued outbreaks of leptospirosis were in Zhuxi,Xiangyang and Yicheng and so on in north-west of the Hubei province. All patients (964) accounted for 88.93% in cases of 40 years. The time of outbreak mostly centred on September to October,which prolonged for about one month than that in brief precent areas of all Hubei province. The patient's clinical categories were grippotyphosa type and lung bleed type,which accounted for 70.47% and 21.12% respectively in all patients. The density of mice was 3.62% and mice carrier rate 14.37%. The positive rate of antibody was 41.50% in healthy groups. Conclusions:The leptospiral groups among leptospiral patients were mainly icterohaemorrhagiae. They carried the same groups of source of infection such as pigs and mice.%目的：调查鄂西北地区90年代钩端螺旋体(简称钩体)ç—…æµè¡Œæƒ…况。方法：病人血清检测采用MATå’ŒDotELISA法，å¥åº·äººç¾¤å…疫水平检测采用MATæ³•ï¼Œä¼ æŸ“æºè°ƒæŸ¥ç”¨å¤¹å¤œæ³•æ•é¼ ï¼ŒåŸ¹å…»é¼ è‚¾å’ŒçŒªè‚¾çš®è´¨ï¼Œåˆ†ç¦»é’©ä½“å¹¶é‰ ´å®šé’©ä½“èŒç¾¤ã€‚结果：90年代å‰é„‚西北地区很少å‘生钩体病，90年代åŽï¼Œè¯¥åœ°åŒºç«¹æºªã€ç«¹å±±ã€è¥„阳ã€å®œåŸŽç‰åŽ¿å¸‚å‘生钩体病964例，å 该地区40年总å‘ç—…æ•°çš„88.93%。钩体病暴å‘时间主è¦é›†ä¸åœ¨9～10æœˆï¼Œé’©ä½“ç—…äººä¸´åºŠç ±»åž‹ä»¥æµæ„Ÿä¼¤å¯’型和肺出血型为主，分别å 调查总数的70.47%å’Œ21.12%ã€‚é¼ å¯†åº¦3.62%ï¼Œé¼ å¸¦èŒçŽ‡14.37%，å¥åº·äººç¾¤è¡€æ¸…抗 体阳性率41.50%。结论：钩体病人感染èŒç¾¤ä»¥é»„疸出血群为主ï 480. Prevalência e aspectos epidemiológicos da leptospirose bovina em rebanho leiteiro na microrregião de Goiânia - GO Prevalence and epidemiology aspects of bovine leptospirosis in dairy herd from goiânia microregion, Goiás state, Brazil Raquel Soares Juliano 2000-10-01 Full Text Available Foram colhidas 426 amostras de hemossoro bovino, provenientes de vacas em lactação na microrregião de Goiânia-GO, e testadas pelo método de soroaglutinação microscópica (SAM para detecção de aglutininas antileptospiras, para efetuar um estudo de prevalência. Paralelamente, foi realizado um questionário epidemiológico, contendo informações que pudessem fornecer dados sobre a epidemiologia da leptospirose nessa região. Os resultados obtidos revelaram uma prevalência de 81,90% de animais reagentes. Os principais sorovares envolvidos foram: wolffi (36,10%, icterohaemorrhagiae (20,50%, hardjo (5,20% e tarassovi (4,90%. A presença de ratos e suÃnos, a utilização de inseminação artificial e o tipo de fonte de água não interferiram no número de animais reagentes no teste de SAM. A leptospirose tem um comportamento enzoótico nessa região.With the aim of search the prevalence of anti-leptospiral antibodies, 426 sera samples were collected from dairy cattle in the microregion of Goiânia-GO, Brazil. Some questions were made about epidemiological and sanitary conditions characteristics of the farms to help us to understand the behavior of leptospirosis in this region. The prevalence was 81.90% and the serovars more involved were: wolffi (36.10%, icterohaemorrhagiae (20.50%, hardjo (5.20% and tarassovi (4.90%. There were pigs and rats in the farms, but they did'nt interfer on positive animals number. This afirmative is also correct to artificial insemination and water supplying. The bovine leptospirosis had enzootic characteristics in this region. « 21 22 23 24 25 » « 21 22 23 24 25 » 481. Leptospirosis en el Perú: II. Incidencia de la infección en las ratas (Rattus norvegicus de la ciudad de Lima e identificación de la cepa infectante ArÃstides Herrer 1960-01-01 Full Text Available Entre mayo de 1955 y diciembre de 1957 se ha estudiado la incidencia de la leptospirosis en las ratas (Rattus norvegicus que infestan los mercados de abastos en la ciudad de Lima, tratando al mismo tiempo de determinar el valor diagnóstico de cada uno de los métodos empleados. En tales estudios se utilizaron 600 ratas, en la mayorÃa de las cuales se efectuaron hemocultivos, cultivos del riñón, reacciones serológicas de aglutinación-lisis y observaciones al campo oscuro del triturado de riñón, Al determinar la presencia de anticuerpos en la sangre de las ratas asà como en la identificación de las cepas que se aislaran en cultivo, se emplearon las siguientes cepas serológicas de leptospiras: L. icterohaemorrhagiae AB Wijnberg, L. canicola Ruebush, L. autumnalis AB Akiyama A., L. bataviae Van Tienen, L. sejroe Mallersdorf, L. pomona S91, L. ballum S102, L. hyos, L. grippotyphosa Moscow V., L. hebdomadis y L. pyrogenes Salinem. Además, con frecuencia se usó también dos cepas (R23 y R410 aisladas por los autores durante las investigaciones e identificadas como L. icterohaemorrhagiae. Los principales resultados obtenidos son los siguientes: 1. Los hemocultivos fueron positivos en el 1.2%, entretanto que los cultivos del riñón ofrecieron una positividad de 49.0%, variando entre 38.3 y 54.5% de acuerdo con los diferentes mercados donde fueran capturadas las ratas. La observación al campo oscuro del triturado del riñón fue positiva en el 26. 0% de los casos. De acuerdo con la reacción de aglutinación-lisis, los sueros fueron positivos en el 32.8%. En 591 ratas, en las que se realizaran los estudios empleando los cuatro métodos de diagnóstico mencionados, la positividad fue de 62.4%. 2. La reacción de aglutinación-lisis fue positiva en 195 sueros, 167 (85.6% de los cuales reaccionaron únicamente con el antÃgeno de L. icterohaemorrhagiae AB Wijnberg; seis sueros también reaccionaron tan sólo con un antÃgeno, pero diferente al 482. Prevalence of leptospirosis in various risk groups Angnani R 2003-01-01 Full Text Available Two hundred and twenty seven patients were included in the study. The test group included 55 patients of pyrexia of unknown origin (PUO, 42 veterinary workers, 38 hepatitis patients and 25 village farmers. The control group comprised of 27 Syphilis controls and 40 healthy controls. Of the total study entrants, 186 were tested for Leptospira antibodies by IgM ELISA and 41 by microscopic agglutination test (MAT. ELISA results of 45 patients were further tested by MAT for comparative evaluation. Out of 160 patients of the test group 56(35.0% were positive for Leptospira antibodies. The positivity was 18(32.73% amongst PUO patients, 15(35.71% of the farm workers, 15(39.47% of hepatitis patients and 8(32.0% farmers. Leptospira antibodies were not detected in any of the controls. The antibody positivity was seen in 33(32.04% of the 103 urban patients and 23(40.35% of 57 rural patients. Out of 56 Leptospira cases, in 39(69.64% history of animal contact was present. The common clinical features in these patients included fever in 51(91.07%, myalgia 48(85.71%, headache 42(75.0%, Anorexia 31(55.35%, Jaundice 24(42.86% and nausea/vomiting in 21(37.5%. Of the 45 ELISA results compared with that of MAT, there was 86.67% agreement between the tests. 483. Leptospirosis vaccines: Past, present, and future Koizumi N 2005-01-01 Full Text Available It is well known that Leptospira vaccine prevents the disease. However specificity for serovars limits the efficacy of killed whole cell vaccines. Leptospiral antigens that induce cross-protective immunity to the various serovars are sought as new vaccine candidates. In this paper, we have summarized both past and current findings about leptospiral antigens that are conserved among pathogenic leptospires and that induce protective immunity in animal models. The full-length genome sequences of two Leptospira strains have been published and reverse vaccinology has been used to identify leptospiral vaccine candidates. Although humoral immunity is thought to be dominant in protection from leptospiral infection, a role for cell-mediated immunity is now being explored. 484. Seroepidemiology of leptospirosis in Minnesota wolves Khan, M.A.; Goyal, S.M.; Diesch, S.L.; Mech, L.D.; Fritts, S.H. 1991-01-01 Serum samples (n = 457) from wolves (Canis lupus) in northern Minnesota were collected from 1972 through 1986 and were tested for antibodies against Leptospira interrogans using a microtiter agglutination test. Twelve serovars included in the study were: australis, autumnalis, ballum, bataviae, bratislava, canicola, copenhageni, grippotyphosa, hardjo, pomona, pyrogenes, and tarassovi. Fifty-two (11%) sera had antibody titers of greater than or equal to 1:50 against one or more serovars of L. interrogans. The seroprevalence of different serovars in decreasing order was: grippotyphosa, bratislava, autumnalis, canicola, pomona, ballum, pyrogenes, hardjo, and copenhageni. No antibodies were found against australis, bataviae, and tarassovi. These results indicate that L. interrogans infection may occur in wolves of Minnesota. 485. Three cases of canine leptospirosis in Quebec. KALIN, M.; Devaux, C.; Difruscia, R; LeMay, S.; Higgins, R 1999-01-01 Three dogs from different locations with acute renal failure were hospitalized in autumn 1996 and 1997. Leptospira interrogans serovar pomona was detected by the microscopic agglutination test. All dogs recovered after antibiotic treatment. The importance of the development of vaccines adapted to emerging serovars in dogs should be addressed. 486. Variáveis climáticas, condições de vida e saúde da população: a leptospirose no municÃpio do Rio de Janeiro de 1996 a 2009 Climate variables, living conditions and the health of the population: leptospirosis in the city of Rio de Janeiro from 1996 to 2009 Teresa Vieira dos Santos de Oliveira 2012-06-01 Full Text Available Os eventos climáticos extremos têm fortes repercussões na saúde das pessoas, especialmente quando produz doenças ou mesmo quando provoca vÃtimas por acidentes. A população do Rio de Janeiro é vulnerável diante das variabilidades climáticas, principalmente pelo seu aspecto socioeconômico, pois o municÃpio tem topografia e clima que favorecem esta vulnerabilidade. Este artigo discute a evolução da leptospirose no MunicÃpio do Rio de Janeiro, pelas trinta e duas Regiões administrativas, no perÃodo de 1996 a 2009, testando a hipótese de que as variações climáticas acarretam um aumento no número de casos da doença.Os dados meteorológicos utilizados foram fornecidos pelo Instituto Nacional de Meteorologia e pela Empresa Brasileira de Infra-Estrutura Aero-Portuária Os dados referentes à morbimortalidade da leptospirose foram coletados da Secretaria Municipal de Saúde e Defesa Civil/RJ. Neste trabalho, concluiu-se que há correlação entre a incidência da leptospirose e a pluviometria. No entanto, ao final, é enfatizado que a oscilação do número de casos não é determinada apenas pelo Ãndice pluviométrico, outros fatores influenciam nessa dinâmica, tais como: saneamento, assim como fatores ambientais e sociais.Extreme climate events have major repercussions on the health of the population, especially when they cause disease or even result in victims due to accidents. The population of Rio de Janeiro is vulnerable to climate variations, mainly due to the socioeconomic factors, as the city has a topography and climate that enhance this vulnerability. This article discusses the evolution of leptospirosis in the thirty-two administrative regions of the city of Rio de Janeiro from 1996 through 2009, testing the hypothesis that climate variations lead to an increase in the number of cases of the disease. The meteorological data examined were provided by the National Meteorology Institute and the Brazilian Airport 487. Surveillance of host animals of leptospirosis in Pan'an county,Zhejiang province,2007-2009%2007-2009年浙江çœç£å®‰åŽ¿é’©ç«¯èžºæ—‹ä½“ç—…å®¿ä¸»åŠ¨ç ‰©ç›‘æµ‹åˆ†æž åº”å‡¯æ»¡; å¼ åŸç”° 2011-01-01 目的 了解浙江çœç£å®‰åŽ¿é‡Žé¼ ã€ç‰›ã€çŒªã€é¸å’Œé’蛙钩端螺旋体带èŒæƒ…况.方法 å¯¹é‡Žé¼ é¼ è‚¾ã€ç‰›ä¸æ®µå°¿ã€çŒªè‚¾ã€é¸è‚¾å’Œé’蛙肾ç‰è¿›è¡Œé’©ç«¯èžºæ—‹ä½“èŒæ ªçš„分离培养.结果 2007-2009å¹´ç£å®‰åŽ¿å…±åˆ†ç¦»åŸ¹å…»åˆ°é’©ç«¯èžºæ—‹ä½“èŒ8æ ª,ç»é‰´å®šå‡ä¸ºé»„ç– ¸å‡ºè¡€ç¾¤.é‡Žé¼ åˆ†ç¦»åŸ¹å…»åˆ°7æ ª,带èŒçŽ‡ä¸º2.13%;é’蛙分离到1æ ª,带èŒçŽ‡ä¸º0.33%;牛ä¸æ®µå°¿ã€çŒªè‚¾å’Œé¸è‚¾æœªåˆ†ç¦»å‡ºé’©ç«¯èžºæ —‹ä½“èŒ.ä¸åŒé¼ ç§çš„带èŒçŽ‡ç¤¾é¼ 8.33%ã€é»„èƒ¸é¼ 3.03%.结论 é‡Žé¼ ä¸ºç£å®‰åŽ¿é’©ç«¯èžºæ—‹ä½“病的主è¦ä¼ 染æº,é»„ç–¸å‡ºè¡€ç¾ ¤ä¸ºä¸»è¦çš„感染èŒç¾¤.%Objective To investigate the carriage of Leptospira of host animals and provide scientific evidence for the prevention and control of leptospirosis. Methods The kidney samples of rats, pigs. ducks, frogs and midstream urine of cattle were taken to isolate the pathogen. Results From 2007 to 2009 , eight strains of Leptospira were isolated; all were L. icterohaemorrhagiae. Seven strains were detected in the rats with the positive rate of 2.13ï¼… ; and 1 strain was detected in the frog with the positive rate of 0.33ï¼… . No Leptospira strain was detected in the remaining samples. The carriage rate was 8.33ï¼… for Rattus confucianus and 3.03ï¼… for Rattus flavipectus. Conclusion The field mouse was the predominant host animal of leptospirosis in Pan'an county, and L. icterohemorrhagiae was the major pathogen. 488. Avaliação da contraimunoeletroforese com antÃgenos dos sorovars icterohaemorrhagiae E patoc no diagnóstico sorológico da leptospirose humana Evaluation of counterimmunoeletrophoresis with the serovars icterohaemorrhagiae and patoc antigens in the diagnosis of human leptospirosis Paulo H. Yasuda 1991-12-01 Full Text Available Avaliou-se o desempenho da contraimunoeletroforese (CIE no diagnóstico sorológico da leptospirose humana utilizando três tipos de antÃgenos derivados da L. interrogans sorovar icterohaemorrhagiae e do sorovar patoc da L. biflexa. Comparou-se os resultados obtidos na CIE com a prova de referência a soroaglutinação microscópica (SAM. Soros pareados de 135 pacientes com leptospirose foram subdivididos em 4 grupos de acordo com os resultados da SAM. Como controle coletou-se sangue de 69 indivÃduos sadios. A concordância entre as duas técnicas variou de 92,64 a 94,11%. Os resultados obtidos pela CIE com os antÃgenos do sorovar icterohaemorrhagiae foram mais favoráveis do que aqueles derivados do patoc. Ressaltam-se as caracterÃsticas de elevada sensibilidade detectando anticorpos antileptospiras mais precocemente do que a microaglutinação. As caracterÃsticas encontradas no presente estudo credenciam o emprego da CIE como um método útil e prático para o diagnóstico da leptospirose humana na fase aguda da doença.Counterimmunoelectrophoresis (CIE was applied on paired sera from 135 pacients with leptospirosis and on 69 sera from a control group. The sera from pacients were subdivided in 4 groups according to the results obtained by the Microscopic Agglutination Test (MAT. The first samples sera from 58 pacientes were non reagent by MAT. Six monthly samples of sera were taken from 7 patients to follow-up and to determine the level of agglutinin and precipitin antibodies present using MAT and CIE. Serovars icterohaemorrhagie and patoc were used as antigens. Three types of antigens were compared, 1 Triton-X-100 extracted; 2 heat extacted and 3 a pool of them. The CIE using icterohaemorrhagiae derivated antigens types agreed with MAT in 92.64, 92.64 and 94.11% of the leptospirosis sera. The patoc antigens types reacted with the control group in 7.24, 86.95 and 84.05% of the samples, and consequently were eliminated from the present

489. Imunodiagnóstico da leptospirose humana através do teste ELISA-IgM, empregando-se diferentes preparações antigênicas a partir de sorotipos prevalentes de Leptospira interrogans Immunodiagnostic of human leptospirosis by ELISA-IgM, employing: different antigenic preparations as from prevalent serovars of Leptospira interrogans Marcos Vinicius da Silva 1990-08-01 Full Text Available Realizou-se estudo comparativo de diferentes sorotipos de Leptospira interrogans utilizados na preparação de antÃgenos empregados no teste ELISA, para a detecção de anticorpos da classe IgM, em amostras de soro na fase precoce e tardia da leptospirose humana. Foram utilizados dez sorotipos, escolhidos entre os que apresentaram maior reatividade na soroaglutinação microscópica (SAM, na cidade de São Paulo. Os cinco sorotipos que apresentaram melhores resultados individualmente no teste ELISAIgM (canicola, hebdomadis, icterohaemorrhagiae, cynopteri e brasiliensis, foram também estudados em mistura antigênica. Os antÃgenos não tratados apresentaram maior reatividade do que os antÃgenos tratados com Triton X - 100 (4% à temperatura de 50ºC, durante 4 horas. O teste ELISA-IgM empregando os sorotipos não tratados, isoladamente, e em mistura antigênica, mostrou-se altamente sensÃvel, podendo ser empregado como teste de triagem para o diagnóstico precoce da leptospirose humana. Outra aplicação do teste é permitir a detecção do inÃcio de situações epidêmicas ou de surtos, possibilitando acionar medidas de vigilância epidemiológica.A comparative study among different serovars of Leptospira interrogans was performed in order to prepare antigens to detect IgM antibodies by ELISA in early and late phase of human leptospirosis. Ten serovars were chosen among the most prevalent detected by microscopic seroagglutination (SAM in São Paulo city. Using ELISA-IgM five of them showed better results (canicola, hebdomadis, icterohaemorrhagiae, cynopteri and brasiliensis. These ones were also studied in a pool. The non-treated antigens showed higher reactivity than the Triton X-100 (4%/50ºC/4h. ELISA-IgM using individually or pool of non treated antigens proved to be reliable with high sensitivity and should be used for an earlier diagnosis of leptospirosis, as a trial test. Faster diagnostic elucidation can be useful to detect 490. 应用纯化é‡ç»„外膜脂蛋白LipL32检测钩端螺旋体病抗体%Application of purified recombinant outer membrane lipoprotein LipL32 in detecting antibodies among leptospirosis cases å¾å›½è‹±; 严延生; å¼ å¿—çŠ; æŽä¸–清; 王çµå²š; 邓艳ç´; 潘æ•æ¥ 2008-01-01 Objective To establish recombinant outer membrane lipoprotein LipL32-based antibody detection assays in identifying leptospirosis. Methods Recombinant leptospiral outer membrane protein LipL32 was obtained by genetic engineering method. This purified protein was used in the indirect and sandwich ELISA assays to test the antibodies in sera of human beings and rats, and the results were compared with those obtained by microscopy agglutination test (MAT) and imported ELISA kit. Results When the acute and convalescent phase specimens from 9 leptospiral patients were tested, the detected rates of three ELISAs were similar to the MAT. Among the 45 probable cases which MAT showed positive, 32 (71.11%) samples were positive by r32-I-ELISA, 36(80.00%) by r32-S-ELISA,while 28.89% (13/45) samples were positive and 55.56% (25/45)were suspicious by D.A.I-ELISA. The specificity of r32-I-ELISA and r32-S-ELISA were 97.10 % (67/69) for 69 specimens. 43 healthy specimens were negative by both r32-I-ELISA and r32-SELISA, 14 healthy specimens were negative by D.A.I-ELISA. Among 16 non-leptospirosis patients, two specimens were positive by r32-I-ELISA and r32-S-ELISA, D.A.I-ELISA and identified one positive specimen, while 12 specimens were suspicious by D.A.I-ELISA. For 10 syphilis specimens, data obtained through three ELISAs were in consistent with that by MAT. A sandwiched ELISA, using rLipL32 protein as the antigen was developed to detect rat sera. Considering MAT as standard test, the sensitivity and specificity were 86.75 % (131/151), 99.19 % (122/123) respectively with coincidence rate as 92.34% (253/274). Conclusion The recombinant protein LipL32 had high immunoresctivity and could be used as an antigen for the detection of panthogenic leptospirosis. In summary, the novel sandwiched ELISA with rLipL32 showed similar sensitivity and specificity to that of MAT in the antibody detection of rat leptospirosis. It was suitable for large scales field sero-epidemiological studies 491. Diagnóstico precoce da leptopirose por demonstração de antÃgenos através de exame imuno-histoquÃmico em músculo da panturrilha Early diagnosis of leptospirosis by immune histochemical examination of hamstring muscles David Everson Uip 1992-10-01 Full Text Available As dificuldades para estabelecer diagnóstico precoce e de certeza da leptospirose levaram-nos a analisar as alterações histopatológicas do músculo gastrocnêmio e avaliar, originalmente, a utilidade de método imuno-histoquÃmico, da peroxidase-antiperoxidase, quando desejada a demonstração do espiroquetÃdeo e de seus produtos no referido tecido. O estudo histopatológico de biópsias da panturrilha configurou quadro de miosite, caracterizado pela correlação entre o infiltrado inflamatório intersticial e as anormalidades degenerativo-necróticas das fibras musculares. As lesões foram consideradas mÃnimas em 69,45% dos pacientes, moderadas em 19,45% e intensas em 5,55%, estando ausentes nos demais. Por seu turno, o método imuno-histoquÃmico enzimático identificou antÃgeno leptospirótico em 94,45%, configurando resultado muito expressivo.Establishing an early and certain diagnosis of leptospirosis has been a difficult task. So, we analysed the histopathological alterations of the gastrocnemius muscle, and studied, for the first time, the usefulness of the immune histochemical method of peroxidase-antiperoxidase for the demonstration of the spirochete and of its products in this tissue. Histopathological observations have shown a picture of miositis, characterized by interstitial inflammatory infiltrate and necrotic-degenerative abnormalities of muscle fibers. The lesions were considered minimal in 69.45% of the patients, moderate in 19.45%, severe in 5.55% and absent in the remaining. On the other hand, the immune histochemical method identified the etiology in 94.45% what was considered very expressive. 492. Variação sazonal na prevalência de leptospirose em cães de rua da cidade de São Paulo, Brasil Seasonal variation in the prevalence of leptospirosis in stray dogs in the citv of S. Paulo (Brazil P. H. Yasuda 1980-12-01 Full Text Available Utilizando a técnica da soroaglutinação microscópica para o diagnóstico de leptospirose, 308 (21,6% de 1428 soros de cães errantes da cidade de Sà £o Paulo (Brasil mostraram-se reagentes. Na população canina estudada, a infecção leptospirótica sofreu influência sazonal. Verão (24,2% e outono (24,9% foram as estações do ano com maior número de soros reatores, em oposição à primavera (18,3% e inverno (18,3%. Estas diferenças foram significantes, estatisticamente. Ô sorotipo canicola é o principal causador da leptospirose na população estudada (50,7%, seguido do icterohaemorrhagiae (25,5%; grippotyphosa (7,8%; pomona (6,7% e ballum (4,4%.One thousand, four hundred and twenty-eight sera from stray dogs from the city of S. Paulo were examined using agglutination microscopic testing. Of the total of 1428 sera, 308 (21.6% showed positive. Seasonal influence was observed in the leptospiral infection of the canine population studied in that the largest number of the reagent sera was verified in the summer (24.2% and autumn (24.9%. In contrast, spring (18.3% and winter (18.3% prevalence levels were lower. These differences were considered significant from the statistical point of view. The canicola serotype was found to be the main cause of leptospirosis in the population examined (50.7%, followed by icterohaemorrhagiae (25.5%, grippetyphosa (7.8%, pomona (67%, and ballum (4.4%. 493. Alterações na bioquÃmica hepática em cães com leptospirose aguda determinada por amostras do sorogrupo Icterohaemorrhagiae Hepatic biochemistry alterations in dogs with naturally occurring acute leptospirosis determined by Icterohaemorrhagiae serogroup Isabel Maria Alexandre Freire 2008-12-01 Full Text Available Foram testadas 120 amostras séricas de cães com tÃtulos (³100 perante Leptospira spp. serovar Icterohaemorrhagiae para a determinação da atividade sérica de alanina aminotransferase (ALT, aspartato aminotransferase (AST, fosfatase alcalina (FA, gamaglutamiltransferase (GGT e dos nÃveis séricos de colesterol total, triglicerÃdeos, proteÃna total, albumina, globulinas e bilirrubinas total, direta e indireta. Um grupo de 34 animais sem qualquer sintomatologia clÃnica e idade semelhante ao grupo testado foi utilizado como controle, tendo sido submetido à s mesmas dosagens bioquÃmicas. Os animais com tÃtulos ³200 apresentaram dosagens de FA e bilirubina direta superiores ao grupo controle e também aos animais com tÃtulos menores que 200 (POne hundred and twenty serum samples obtained from dogs with specific titres (³100 against Leptospira spp. serovar Icterohaemorrhagiae were tested in order to determine the enzymatic activities of alanine aminotransferase (ALT, aspartate aminotransferase (AST, alkaline phosphatase (ALP, gamaglutamyltransferase (GGT, as well as of the total cholesterol, triglycerides, total protein, albumin, globulins and total, direct and indirect bilirubins serum concentrations. Thirty four animals free from clinical signs with the same age of the tested group were used as control group and submitted to the same biochemical tests. The animals with titres ³200 showed increased ALP activity and greater direct bilirubin concentration when compared to the control group and also to the group of dogs with titres