Vigilância epidemiológica hospitalar de Goiás: 1ª coletânea de boletins dos núcleos hospitalares de epidemiologia / Hospital epidemiological surveillance in Goiás: 1st collection of bulletins from hospital epidemiology centers

Coletânea de 13 boletins publicados no site da Secretaria de Estado da Saúde de Goiás, que se destacaram por descrever o perfil de morbimortalidade da unidade e apresentar temas relevantes para a população do Estado de Goiás. Trata-se de um estudo descritivo, realizado com dados do período de janeiro a março de 2023, com informações provenientes das declarações de óbitos e prontuário eletrônico do paciente

Collection of 13 bulletins published on the Goiás State Department of Health website, which stood out for describing the unit's morbidity and mortality profile and presenting relevant themes for the population of the State of Goiás. This is a descriptive study, carried out with data from January to March 2023, with information from death certificates and the patient's electronic medical record

Tendência temporal da leptospirose e sua associação com variáveis climáticas e ambientais em Santa Catarina, Brasil / Temporal trends in leptospirosis incidence and association with climatic and environmental factors in the state of Santa Catarina, Brazil

Resumo A leptospirose é uma zoonose que apresenta potencial epidêmico, principalmente após fortes chuvas que acarretam inundações, alagamentos e enxurradas. Algumas características da região costeira de Santa Catarina, localizada no Sul do Brasil, influenciam nesses processos. Portanto, a partir do estudo da leptospirose nos seis municípios do estado com as maiores incidências e picos epidêmicos de 2000 a 2015, buscou-se conhecer a tendência dessa doença e as variáveis climáticas e ambientais associadas à sua ocorrência, ajustando dois modelos com resposta binomial negativa. As maiores incidências foram encontradas em 2008 e 2011, com picos no mesmo mês ou no posterior aos eventos de desastres. A incidência apresentou forte comportamento sazonal, sendo maior nos meses do verão. Observou-se tendência de queda na incidência dos municípios estudados, estimada em 3,21% ao ano. Os fatores climáticos e ambientais mais fortemente associados foram o número de dias de chuva, a temperatura máxima e a presença de enxurrada e de inundação, com diferentes impactos entre os municípios. Houve interações significativas, indicando que o efeito de inundações na incidência não é o mesmo em todos os municípios e que as diferenças nas incidências entre os municípios dependem da ocorrência ou não de inundações.

Abstract Leptospirosis is a zoonosis with epidemic potential, especially after heavy rainfall causing river, urban and flash floods. Certain features of Santa Catarina's coastal region influence these processes. Using negative binomial regression, we investigated trends in the incidence of leptospirosis in the six municipalities with the highest epidemic peaks between 2000 and 2015 and the climatic and environmental variables associated with the occurrence of the disease. Incidence was highest in 2008 and 2011, and peaks occurred in the same month or month after disasters. Incidence showed a strong seasonal trend, being higher in summer months. There was a decrease trend in incidence across the six municipalities (3.21% per year). The climatic and environmental factors that showed the strongest associations were number of rainy days, maximum temperature, presence of flash floods, and river flooding. The impact of these variables varied across the municipalities. Significant interactions were found, indicating that the effect of river flooding on incidence is not the same across all municipalities and differences in incidence between municipalities depend on the occurrence of river flooding.

Incidence of leptospirosis in Fujian province, 2015-2020 / 中华流行病学杂志

Objective: To analyze the incidence of leptospirosis in Fujian province from 2015 to 2020 and provide the scientific evidences for the risk assessment, prevention and control of leptospirosis. Methods: The incidence data of leptospirosis in Fujian during 2015-2020 were collected from China Information System for Disease Control and Prevention for a descriptive analysis, and software ArcGIS 10.3.1 was used for spatial autocorrelation analysis, and rats were captured in 17 surveillance areas during the same period, and the rat organs were collected for pathogen culture, the level of Leptospira antibody was detected in serum samples of rats, healthy population and the serum samples of patients sent by the hospitals. The infection status of Leptospira in human and rats were analyzed. Results: The incidence of leptospirosis in Fujian showed a downward trend from 2015 to 2020. A total of 176 cases of leptospirosis were reported. There were obvious seasonality and bimodal distribution. The majority of cases were farmers, accounting for 49.43% (87/176). Most cases were aged 30-69 years (85.80%, 151/176). The male to female ratio of the cases was 3.51∶1 (137∶39). Spatial autocorrelation analysis showed that leptospirosis had high or low clustering areas. From 2015 to 2020, the average capture rate of rats in 17 surveillance areas was 6.96% (1 519/21 838), Rattus losea, Rattus flavipectus and Niviventer fulvescens were the main species. The average positive rate of Leptospira antibody in rats was 28.64% (252/880). Java and Autumnalis were the predominant serogroups, accounting for 56.75% (143/252) and 17.46% (44/252), respectively. The average positive rate of Leptospira antibody in healthy population was 16.13% (254/1 575), and Autumnalis and Australis were the predominant serogroups, accounting for 71.65% (182/254). The confirmation rate of leptospirosis in patient serum samples sent by the hospitals was 2.23% (188/8 431), Autumnalis (56.38%, 106/188) and Hebdomadis (19.68%, 37/188) were the major serogroups. Conclusions: The incidence of leptospirosis in Fujian showed a downward trend from 2015 to 2020, there were obvious area clustering and seasonality. The high clustering areas were mainly distributed in northern, western and central Fujian. Java and Autumnalis were the predominant serogroups in rats. The infection rate in healthy population decreased year by year. Autumnalis and Hebdomadis were the main serogroups in population in Fujian.

First report of pathogenic Leptospira spp. in Tadaridabrasiliensis bats (family Molossidae) and Eptesicus furinalis (family Vespertilionidae) of Argentina. New host species in this country? / Primer reporte de Leptospira spp. patógena en murciélagos Tadaridabrasiliensis (familia: Molossidae) y Eptesicusfurinalis (familia: Vespertilionidae) en Argentina. ¿Nuevas especies hospedadoras en el país?

ABSTRACT Leptospirosis is an endemic disease caused byLeptospiraspp., a bacterium that affects animals and humans. In recent years, the number of reports of leptospirosis in wild animals has increased, which highlights the need to study the infectious agents in these animals. In this study, a duplex PCR for the detection of leptospiral DNA was performed on 50 kidney samples from bats, and a MAT (Microscopic Agglutination Test) for serological detection of anti-leptospiral antibodies was applied to 47 serum samples from bats from different regions of Buenos Aires Province, Argentina. DNA was extracted using Chelex-100 and duplex PCR was performed by targeting the detection of genessecYandflaB, of pathogenicLeptospiraspp. Of the 50 kidney samples, 3 were positive forEumopssp. andTadaridabrasiliensisby duplex PCR. Of the 47 serum samples, 12 were positive for different serovars:Leptospira interrogansserovars Icterohaemorrhagiae, Cynopteri and Bataviae, andLeptospira borgpeterseniiserovar Ballum. This is the first report of the detection of pathogenic leptospires by serology in bats belonging to theT. brasiliensisandEptesicus furinalisspecies in Argentina. In addition, this is the first report of the detection of pathogenic leptospiral DNA by PCR inT. brasiliensisspecies. The detection ofLeptospiraspp. in these wild animals shows that they may play an important role as wildlife reservoirs of leptospires.

RESUMEN La leptospirosis es una enfermedad endémica causada porLeptospiraspp., una bacteria que afecta a animales y a humanos. En los últimos años, el número de reportes de leptospirosis en animales silvestres ha aumentado, lo que resalta la necesidad de analizar los agentes infecciosos en estos animales. En este estudio, se aplicó una reacción en cadena de la polimerasa (PCR) dúplex para la identificación del ADN leptospiral en 50 muestras de riñones de murciélagos y la prueba de aglutinación microscópica (MAT) para la detección serológica de anticuerpos antileptospira en 47 muestras de suero de murciélagos de diferentes regiones de la provincia de Buenos Aires, Argentina. El ADN fue extraído usando Chelex-100 y la PCR dúplex estuvo dirigida a la detección de los genessecYyflaBdeLeptospiraspp. patógena. De las 50 muestras de riñón, tres resultaron positivas por PCR dúplex paraEumopssp. yTadaridabrasiliensis. De las 47 muestras de suero, 12 fueron positivas a diferentes serovares:LeptospirainterrogansserovaresIcterohaemorrhagiae, Cynopteri y Bataviae, yLeptospiraborgpeterseniiserovarBallum. Este es el primer reporte de detección de leptospiras patógenas por serología en murciélagos pertenecientes a las especiesT. brasiliensisyEptesicusfurinalisen Argentina. Además, también es el primero en la localización de ADN leptospiral por PCR en la especieT. brasiliensis.La identificación deLeptospiraspp. en estos animales silvestres muestra que pueden desempeñar un papel importante como reservorios de leptospiras en la fauna silvestre.

Seroprevalencia de Leptospira spp. en equinos de tiro de comunidades indígenas mapuche de la Región de la Araucanía Chile / Seroprevalence of Leptospira spp. in draft horses from indigenous communities in the Araucanía Region, Chile

Resumen En la Región de la Araucanía no existen estudios sobre seroprevalencia de leptospirosis en equinos. Se analizaron muestras serológicas provenientes de 100 equinos de tiro de comunidades mapuche de cuatro comunas de la región mediante la técnica de microMAT. La seroprevalencia fue de 35% para al menos un serovar de Leptospira spp., siendo los serovares más frecuentes canicola (22%), grippotyphosa (21%), hardjo (13%) y pomona (10%). Se evidenció que las poblaciones equinas estudiadas están expuestas a la infección por Leptospira spp. y revelan un riesgo potencial de transmisión a sus propietarios.

Abstract In the Araucanía Region there are no studies on the seroprevalence of leptospirosis in horses. Serological samples from 100 draft horses from Mapuche communities of four communes in the region were analyzed using the microMAT technique. The seroprevalence was 35% for at least one serovar of Leptospira spp. being the most frequent serovars canicola (22%), grippotyphosa (21%), hardjo (13%) and pomona (10%). It was evident that the equine populations studied are exposed to infection by Leptospira spp. and reveal a potential risk of transmission to their owners.

Epidemiología de la Leptospirosis en el departamento del Huila, Colombia. 2011- 2017 / Epidemiology of leptospirosis in the department of Huila. 2011 to 2017

Resumen Objetivo: Describir la epidemiología de la Leptospirosis en el departamento del Huila durante el período 2011 -2017. Materiales y métodos: Estudio descriptivo de corte transversal, retrospectivo. La población analizada fueron pacientes de los diferentes municipios del departamento del Huila que se reportaron como casos probables o confirmados de leptospirosis. Se estructuraron registros por cada año en bases de datos recopiladas por el área de epidemiología de la Secretaría de Salud del Huila, basadas en las fichas de notificación de vigilancia en salud pública para leptospirosis y generadas por cada Unidad Primaria Generadora de Datos (UPGD) ante la presencia del evento. Los datos fueron discriminados de acuerdo a las variables de interés para el estudio en una nueva base de datos en Excel; tabuladas con el programa estadístico R - Studio 3.3.3 y Epidat 4.2, para luego ser procesados con estadísticos descriptivos y finalmente ser expresados en porcentajes y en tasas de incidencia. Resultados: Se reportaron 268 casos, de los cuales 61 (23%) fueron confirmados por laboratorio y 207 (77%) sospechosos o probables. El 69% de los pacientes presentaron fiebre, mialgias y cefalea como síntomas representativos. El grupo etario más afectado tenía entre 27 y 59 años de edad (44%). La población se caracterizó por ser del área urbana (65%), con mayor frecuencia en hombres (72%). En relación a la ocupación laboral, se encontró mayor frecuencia en agricultores (20%) y en el personal de aseo (17%). Los factores de riesgo evidenciados fueron la presencia de animales domésticos en un 67% de los casos, así como la presencia de ratas en el hogar (51%) y el posible mal manejo del agua. Conclusiones: El incremento en el número de casos de Leptospirosis probablemente está asociado a la mala manipulación del agua y a la presencia de animales en el domicilio.

Abstract Objective: Describe the epidemiology of Leptospirosis in the department of Huila during the years 2011 to 2017. Materials and methods: This article is a descriptive, cross-sectional, retrospective study. The population analyzed were patients from the different municipalities of the department of Huila who were reported as probable or confirmed cases for leptospirosis, structuring records for each year in databases compiled by the epidemiology area of ​​the department's health secretary, based on the public health surveillance notification sheets for leptospirosis, and generated by each Primary Data Generating Unit (UPGD) in the presence of the event; The data were discriminated according to the variables of interest for the study in a new database in Excel; tabulated with the statistical program R - Studio 3.3.3 and Epidat 4.2, to later be processed with descriptive statistics and finally expressed in percentages and incidence rates. Results: 268 cases were reported, which 61 (23%) were confirmed by laboratory and 207 (77%) suspicious or probable. 69% of the patients presented fever, myalgia and headache as representative symptoms. The most affected group range in ages from 27 and 59 (44%). The population was characterized for being part of the urban area (65%), and the cases were more frequent in men (72%). Regarding to employment, it was found that farmers (20%) and the cleaning staff (17%) were the most common cases. The risk factors identified were the presence of domestic animals in 67% of the cases, as well as the presence of rats at home (51%) and the possible poor water management. Conclusions: The increase in the number of cases of Leptospirosis is probably associated with the poor water management and the presence of animals at home.

A molecular survey reveals high occurrence of co-infections in intensive pork production farms with increased rates of mummified swine fetuses in Southern Brazil / [Pesquisa molecular revela alta ocorrência de coinfecções em granjas de produção intensiva de suínos com altas taxas de mumificação fetal no sul do Brasil]

Neste estudo, 308 amostras de fetos mumificados foram testadas para parvovírus suíno (PPV), circovírus suíno tipos 2 e 3 (PCV2 e PCV3) e leptospiras patogênicas. A idade gestacional no momento da perda gestacional e a frequência da mumificação fetal de acordo com a ordem de parto também foram investigadas. As amostras foram coletadas em granjas comerciais de criação de suínos da região sul do Brasil que apresentassem taxas de mumificação fetal igual ou maiores a 2,5%. Fragmentos de pulmão, rim, fígado e coração de fetos suínos mumificados foram coletados para análise molecular. Resultados da PCR foram classificados de acordo com a região de origem das amostras, tendo Santa Catarina, Paraná e Rio Grande do Sul contabilizado 87 (28,25%), 89 (28,90%) e 132 (42,86%) do total de amostras de fetos suínos mumificados, respectivamente. Coinfecções foram observadas na maioria dos casos e PCV3 foi o agente mais prevalente detectado, encontrado em 298 amostras (96,75%). A maioria das perdas gestacionais foi observada entre 50 e 70 dias de gestação (168; 54,5%) e a mumificação fetal não foi associada à ordem de parto das matrizes. Os achados sugerem que as altas taxas de fetos suínos mumificados na região Sul do Brasil podem ser explicadas pela infecção com esses agentes virais.(AU)

Antibodies against Leptospira spp. in bovine serum samples from several Brazilian states analyzed in the period from 2007 to 2015 / [Anticorpos contra Leptospira spp. em amostra de soro bovino de diversos estados brasileiros analisados no período entre 2007 e 2015]

Bovine leptospirosis assumes great economic importance since it affects several production aspects. Therefore, knowledge about the occurrence and distribution of this disease is fundamental to adopt the correct prevention measures. The present study aimed to evaluate the frequency of anti-Leptospira spp. antibodies in 24,483 bovine serum samples received between 2007 to 2015 from 21 Brazilian states. Of these, 8,643 (35.3%) were reagents in the microscopic agglutination test to one or more serovars of Leptospira spp. The most frequent serovars were Wolffi (61.47%), Tarassovi (9.62%) and Pomona (7.20%). Hardjo serovar presented a prevalence of 6.27%. Among the 21 states analyzed, the State of Pernambuco had the highest frequency with 88.24% and the State of São Paulo was the origin of the largest number of analyzed samples (13,838), with a frequency of 31.54% of reagents. The results demonstrate a high exposure to several serovars of Leptospira spp. in bovine species in Brazilian states, showing the importance of adopting prophylactic measures in order to reduce the risk of infection in this specie.(AU)

Com o objetivo de avaliar a frequência de anticorpos anti-Leptospira spp., foram analisadas 24.483 amostras de soro sanguíneo bovino, provenientes de 21 estados brasileiros, recebidas no período de 2007 a 2015. Destas, 8.643 (35,3%) foram reagentes no teste de soroaglutinação microscópica a uma ou mais sorovariedades de Leptospira spp., e as sorovariedades com maior frequência foram Wolffi (61,47%), Tarassovi (9,62%) e Pomona (7,20%). A sorovariedade Hardjo apresentou prevalência de 6,27%. Entre os 21 estados analisados, o estado de Pernambuco apresentou a maior frequência, com 88,24%, e o estado de São Paulo foi a origem do maior número de amostras para análise, 13.838, com frequência de 31,54% de reagentes.(AU)

Risk factors for leptospirosis and brucellosis in people living with human immunodeficiency virus who attended a referral hospital in southeastern Brazil

Abstract INTRODUCTION: Leptospirosis and brucellosis cause immunosuppression that worsens the clinical condition of people living with HIV/AIDS (PLWHA). We investigated the serological profile and risk factors of PLWHA. METHODS: Serum samples (n=238) were researched for Brucella spp. antibodies using Rose Bengal and tube agglutination tests and Leptospira spp. antibodies using the microscopic agglutination test. RESULTS: All samples were negative for Brucella spp. For leptospirosis, four samples (1.69%) were positive, and Andamana was the prevalent serovar. CONCLUSIONS: Low or no detection of these zoonoses does not reduce their importance in PLWHA. Vigilant, educational, and preventive measures should be adopted.

Inundações e leptospirose nos municípios brasileiros no período de 2003 a 2013: utilização de técnicas de mineração de dados / Floods and leptospirosis in Brazilian municipalities from 2003 to 2013: use of data mining techniques / Inundaciones y leptospirosis en municipios brasileños durante el período de 2003 a 2013: utilización de técnicas de mineración de datos

A leptospirose se relaciona a problemas de saneamento ambiental, com incremento de casos em períodos de inundações. Levando-se em consideração as questões relacionadas a mudanças climáticas, as inundações tendem a um aumento. As inundações não atingem as populações de maneira homogênea, em geral os menos favorecidos em termos socioeconômicos são os mais acometidos. Para saber se o número de inundações aumentaria a incidência de leptospirose e sua relação com as variáveis contextuais, utilizou-se dados socioeconômicos, ambientais e de ocorrência da doença no nível municipal. Os municípios que tinham problemas no esgotamento sanitário apresentaram maior risco para a ocorrência da leptospirose. O total de inundações adquirida a partir da decretação pela autoridade municipal constituiu um importante marcador de risco para a ocorrência de leptospirose. A modelagem de árvore de regressão mostrou-se útil para estimar a ocorrência de leptospirose no Brasil.

Leptospirosis is related to problems with environmental sanitation, and the incidence tends to increase during flood periods. Considering issues related to climate change, floods can be expected to increase. Floods do not affect populations homogeneously, and communities with worse socioeconomic conditions tend to be impacted more heavily. In order to determine whether the number of floods increases the incidence of leptospirosis and its relationship to contextual variables, the study used socioeconomic, environmental, and disease occurrence data at the municipal (county) level. Municipalities suffering problems with sewage disposal showed a higher risk of leptospirosis incidence. Total flooding since the municipality's declaration of flood emergency was an important risk marker for leptospirosis incidence. Regression tree modeling proved useful for estimating leptospirosis incidence in Brazil.

La leptospirosis se relaciona con problemas de saneamiento ambiental, así como con el incremento de casos en períodos de inundaciones. Teniendo en consideración las cuestiones relacionadas con el cambio climático, las inundaciones tienden a aumentar. Las inundaciones no afectan a las poblaciones de manera homogénea, en general, los menos favorecidos en términos socioeconómicos son los más afectados. Para saber si el número de inundaciones aumentaría la incidencia de leptospirosis, y su relación con variables contextuales, se utilizaron datos socioeconómicos, ambientales y de ocurrencia de la enfermedad en el nivel municipal. Los municipios que poseían problemas en el alcantarillado sanitario presentaron un mayor riesgo para la ocurrencia de leptospirosis. El total de inundaciones sufridas a partir de su reconocimiento oficial por parte de la autoridad municipal constituyó un importante marcador de riesgo para la ocurrencia de leptospirosis. El modelo de árbol de regresión se mostró útil para estimar la ocurrencia de leptospirosis en Brasil.

Human leptospirosis in the municipality of São Paulo, SP, Brazil: distribution and trend according to sociodemographic factors, 2007-2016 / Leptospirose humana no município de São Paulo, SP, Brasil: distribuição e tendência segundo fatores sociodemográficos, 2007-2016

ABSTRACT: Objectives: This study aimed to describe the incidence and proportional lethality of human leptospirosis in the municipality of São Paulo, between 2007 and 2016, according to sociodemographic factors and characteristics of the disease, and to assess the temporal trends of incidence, according to age group and region of residence. Methods: Proportional distributions of leptospirosis cases of residents in the municipality were built and regression models with a Binomial Negative response were adjusted. Results: 2,201 cases of leptospirosis were registered, most of them being males (82%), aged between 20 to 59 years (64.6%), white (39%) or brown (32.8%), residing in the South (27.8%), East (23.8%) and North (18.5%) regions. The overall lethality was 15.1%. The risk was higher in the 20 to 59 age group. There was a downward trend in incidence in all age groups and regions, estimated at 5.6% per year. Conclusions: Despite the downward trend in incidence, leptospirosis is a serious disease with high lethality, affecting mainly male individuals in the age groups considered economically active and living in the peripheral regions of the municipality

RESUMO: Objetivos: O presente estudo teve como objetivos descrever a incidência e a letalidade proporcional de leptospirose humana no município de São Paulo, entre 2007 e 2016, segundo fatores sociodemográficos e características da doença e, avaliar a tendência temporal da incidência, conforme a faixa etária e a região de residência. Métodos: Foram construídas distribuições proporcionais dos casos de leptospirose de residentes no município e ajustados modelos de regressão com resposta binomial negativa. Resultados: Foram registrados 2.201 casos de leptospirose, a maioria do sexo masculino (82%), com idades entre 20 e 59 anos (64,6%), de raça/cor branca (39%) ou parda (32,8%), residentes nas regiões sul (27,8%), leste (23,8%) e norte (18,5%). A letalidade geral foi de 15,1%. O risco da doença foi maior nas faixas etárias de 20 a 59 anos. Houve tendência de queda na incidência, em todas as faixas etárias e regiões, estimada em 5,6% ao ano. Conclusões: Apesar de apresentar tendência de queda na incidência, a leptospirose continua sendo uma doença grave e de alta letalidade, acometendo sobretudo indivíduos do sexo masculino, nas faixas etárias consideradas economicamente ativas e residentes nas regiões periféricas do município.

Cross-sectional survey for canine leptospirosis in an Atlantic Rainforest area of the semiarid of Paraíba state, Northeastern Brazil / Estudo transversal para leptospirose canina em área de Mata Atlântica do semiárido da Paraíba, Nordeste do Brasil

Leptospirosis is a worldwide zoonosis caused by the bacteria Leptospira spp. that affects humans, domestic and wild animals. The present work aimed to conduct a cross-sectional survey for leptospirosis in the canine population of the Brejo Paraibano microregion, semiarid of Northeastern Brazil. From May to October 2017, blood samples from 414 dogs were collected in the counties of Alagoa Grande (n=100), Areia (n=79), Bananeiras (n=72), Alagoa Nova (n=73), Serrraria (n=25), Pilões (n=25), Borborema (n=20) and Matinhas (n=20). The tutors of the sampled dogs answered an epidemiological questionnaire, obtaining information about the animals, owner, residence and breeding of the dogs. Subsequently, the serum samples were subjected to the microscopic agglutination test (MAT), using a collection of 23 serovar pathogenic antigens and using the 1:50 dilution as the cutoff point. Of the 414 dogs analyzed 52 were seroreactive, resulting in an apparent prevalence of 12.6% and a real prevalence of 12.2%. Seroreactive dogs were found in the eight counties. Dogs were reactive for the serogroups Icterohaemorrhagiae (76.9%), Autumnalis (13.55%), Pomona (3.8%), Grippotyphosa (3.8%) and Serjoe (1.9%) Antibody titers ranged from 50 to 800. The statistical analysis (robust Poisson regression) detected six factors associated with seropositivity, including the rainy season (prevalence ratio; PR=1.94, P=0.013), male dogs (PR=2.10, P=0.005), animals with age greater than five years (PR=4.21, P=0.012), consumption of untreated water (PR=1.87, P=0.043), free access of dogs to street (PR=2.15, P=0.011) and contact with wildlife (PR=3.54, P=0.050). The serogroup Icterohaemorrhagiae has a high zoonotic potential and was the most frequent in seropositive animals. The high real prevalence of Leptospira spp. in a transmission region of the semiarid region of Paraíba and the occurrence of seroreactive animals in all the counties suggest wide distribution of the infection and reinforce the need for preventive measures to avoid infection in pets and, consequently, to humans. The analysis of factors associated with the prevalence suggest greater manegment cares with the dogs.(AU)

A leptospirose é uma zoonose mundial causada pela bactéria Leptospira spp. que afeta seres humanos, animais domésticos e selvagens. O presente trabalho teve como objetivo realizar um estudo transversal de leptospirose na população canina da microrregião Brejo Paraibano, semiárido do Nordeste do Brasil. No período de maio a outubro de 2017, amostras de sangue de 414 cães foram coletadas nas cidades de Alagoa Grande (n=100), Areia (n=79), Bananeiras (n=72), Alagoa Nova (n=73), Serraria (n=25), Pilões (n=25), Borborema (n=20) e Matinhas (n=20). Os tutores dos cães amostrados responderam a um questionário epidemiológico, sendo obtidas informações sobre os animais, proprietário, residência e criação dos cães. Posteriormente as amostras de soro foram submetidas à prova de soroaglutinação microscópica (SAM), utilizando-se uma coleção de 23 sorovares antígenos patogênicos e adotando como ponto de corte a diluição 1:50. Dos 414 cães analisados 52 foram sorreativos, resultando em uma prevalência aparente de 12.6% e uma prevalência real de 12,2%. Cães sororreativos foram encontrados nos oito municípios. Os cães foram reativos para o sorogrupo Icterohaemorrhagiae (76,9%), Autumnalis (13,55%), Pomona (3,8%), Grippotyphosa (3,8%) and Serjoe (1,9%) Os títulos de anticorpos variaram de 50 a 800. A análise estatística (regressão de Poisson robusta) detectou seis fatores associados à soropositividade, incluindo o período chuvoso (razão de prevalência - RP=1,94; P=0,013), cães machos (RP=2,10; P=0,005), animais com idade maior que cinco anos (RP=4,21; P=0,012), consumo de água não tratada (RP=1,87; P=0,043), cães com livre acesso à rua (RP=2,15; P=0,011) e contato com animais silvestres (RP=3,54; P=0,050). Os resultados desse estudo indicaram que há a exposição por Leptospira spp. em cães da microrregião do Brejo paraibano. O sorogrupo Icterohaemorrhagiae possui alto potencial zoonótico e foi o mais frequente nos animais soropositivos. A alta prevalência real de Leptospira spp. em uma região de transmissão da região semiárida da Paraíba e a ocorrência de animais sororreativos em todos os municípios sugerem uma ampla distribuição da infecção e reforçam a necessidade de medidas preventivas para evitar a infecção em animais de estimação e, consequentemente, em seres humanos. A análise dos fatores associados à prevalência sugere maior cuidado com os cães.(AU)

Epidemiological characteristics of Leptospira spp. infection in bovine herds in Mato Grosso do Sul, Brazil / Caracterização soroepidemiológica da infecção por Leptospira spp. em rebanhos bovinos de corte do estado de Mato Grosso do Sul, Brasil

The epidemiological characteristics of bovine leptospirosis in animals and herds in Mato Grosso do Sul were investigated to determine parameters such as disease frequency and the serovars reactant in beef cattle herds. A total of 4,629 beef cattle herds were examined against 33 Leptospira spp. serovars. The serum samples were submitted to the microscopic agglutination test (MAT) for the serological diagnosis of leptospirosis. The MAT results showed that 3,814 (82.39%) of the 4,629 animals evaluated were seropositive for the bacterium, with serological reactions mainly to serogroup Sejroe, serovar Wolffi (36.49%). The observed high frequency of reactive animals demonstrates the relevance of the infection. Therefore, general and specific measures should be implemented to contain and/or prevent infection of the animals in the studied region.(AU)

Foi realizado um inquérito epidemiológico da leptospirose em bovinos de rebanhos de corte do estado de Mato Grosso do Sul, de modo a determinar a frequência e as sorovariedades reagentes. Para isso, foram examinados 4.629 bovinos de corte, com uma coleção de 33 sorovariedades de Leptospira, por meio da prova de Soroaglutinação Microscópica (MAT). Dos 4.629 animais examinados, 3.814 (82,39%) foram reagentes com reações predominates para o sorogrupo Sejroe, sorovar Wolffi (36,49%). Assim, a alta frequência de animais reagentes encontrada justifica a implantação de medidas gerais e específicas para conter e/ou prevenir a infecção nos animais dessa região.(AU)

Spatial distribution of serologically reactive sheep to Leptospira spp. in the northeast region of Brazil

Considering the importance of leptospirosis in sheep farming and public health and the significance of identifying which serogroups circulate in sheep within each region, the objective of this study was to determine the seroprevalence and spatial distribution of the most frequent serogroups causing infection by Leptospira sp. in ovine herds in the Northeast region of Brazil. Blood samples were collected from 4197 sheep from 229 herds in 7 Northeastern States. Sera were analyzed via microscopic agglutination test (MAT). The frequency of seroreactive sheep for Leptospira sp. was 14.06%. The states of Alagoas, Ceará, Paraíba, Piauí, Rio Grande do Norte, and Sergipe, located in the Caatinga biome, had the highest frequencies of serologically reactive sheep, and Maranhão, in the Cerrado biome, had the lowest frequency. The most frequent serogroups were Autumnalis (19.49%), Australis (15.76%) and Serjoe (14.41%). In the states of Ceará, Paraíba, Rio Grande do Norte, and Sergipe, 100% of their municipalities had at least one seroreactive animal. The highest frequencies of seropositive animals were found in the municipalities of União (50%), Passagem (49.06%), Canindé (48.89%), Igaci (28.95%), Gararu (31.2%), Pirapemas (17.5%), and Angicos (16%) located in the states of Piauí, Paraíba, Ceará, Alagoas, Sergipe, Maranhão and Rio Grande do Norte, respectively. The animal-level prevalence (14.06%) obtained in the present study is significant, especially considering the rustic nature of the species and the adverse conditions of the region for the infectious agent. In semi-arid conditions, it has been suggested that perhaps sheep do not seroconvert detectable titers on MAT with a cut-off point of 1:100. It is important to highlight that the ovine population in the Northeast region of Brazil is composed of mixed animals, which have been considered more resistant to infection by Leptospira spp. Also, environmental factors hostile to the survival of the infectious agent in the studied region should be taken into consideration, since they may have influenced the seropositive animal-level prevalence. A noteworthy variation was observed in agglutinin titers, which ranged from 100 to 1,600, where 80.2% of the positive samples had titers ≤ 200. It is important to highlight that more elevated titers (≥ 400) were obtained in all seven states, which may suggest an acute infection caused by a non-adapted serovar, indicating that preventive and control measures focused on possible infection sources for sheep should be adopted. Although some states showed the same serogroups as the most frequent, a variety of serogroups was observed in municipalities, which may indicate different sources of infection, whether interspecies, intraspecies, or via alternative routes of transmission in semi-arid conditions, such as venereal. This indicates that even though sheep are more resistant to infection, they become exposed due to the environment or management conditions. As such, identification, isolation, and treatment of the affected animals are alternative measures recommended for prevention and control of leptospirosis in sheep in the semi-arid region. It is evident that despite the lack of rain observed in the last decade in the Northeast region of Brazil, which prevented the formation of favorable environments for the presence of Leptospira, the infectious agent remains among the sheep, as well as other production and wild animals in the region. Some factors may be contributing to this scenario, such as the fact that sheep farming in the region is = characterized mainly by subsistence systems, where veterinary assistance and adequate sanitary management are absent, thus increasing the possibility of contact with Leptospira. (AU)

Presence of Pathogenic Leptospira spp. in an Urban Slum of the Colombian Caribbean: A One Health Approach

Introducción: La leptospirosis es una zoonosis que tiene alto impacto en la salud de las personas y los animales, especialmente en áreas tropicales y subtropicales. Esta enfermedad es causada por el patógeno Leptospira spp. y es transmitida principalmente por los roedores. Objetivo: Describir la presencia de Leptospira patógena y los posibles factores de riesgo de leptospirosis en un sector marginal de Colombia, con un enfoque One-Health. Métodos: Se llevó acabo un estudio exploratorio en un sector marginal de Soledad, municipio situado en la costa norte de Colombia. Se tomaron muestras de sangre de 83 sujetos. Se analizaron variables sociodemográficas, clínicas y ecológicas relacionadas con la leptospirosis. La presencia de anticuerpos IgM anti-leptospira en el suero humano fue detectado mediante la prueba ELISA. También, se tomaron muestras de tejido renal de 53 roedores sinantrópicos para identificar Leptospira spp. patógenas mediante PCR convencional a través del uso de cebadores específicos. Resultados: Se detectaron anticuerpos IgM-anti-leptospira en el 30,12 por ciento de los sujetos de estudio. La Leptospira spp. patógena fue identificada en el 7,55 por ciento de los roedores analizados. En la muestra seleccionada se encontró asociación de casos seropositivos con ser comerciantes, ama de casa y estar en contacto con cerdos. Las condiciones higiénico-sanitarias subóptimas también fueron evidentes en el área de estudio. Conclusiones: La circulación de Leptospira spp. patógena y la exposición a factores de riesgo humanos y ecológicos es elevada en el sector marginal (área de pobreza) del Caribe colombiano. Se recomienda dirigir las intervenciones en la interfaz hombre-animal-ambiente de acuerdo con el paradigma One-Health; se debe considerar la extrema pobreza como un factor determinante para la ocurrencia de la leptospirosis(AU)

Objective: This study aims to describe the presence of pathogenic Leptospira and potential risk factors for leptospirosis in a marginal sector of the Colombian Caribbean, with a One Health approach. Methods: an exploratory study was carried out in a marginal sector of Soledad, a municipality located in the north coast of Colombia. Blood samples were taken from 83 subjects, who were also questioned about sociodemographic, clinical and ecological variables related to leptospirosis. The presence of IgM Anti-Leptospira antibodies in human serum was performed by ELISA. A total 53 synanthropic rodents were also captured using Sherman traps. Renal tissue samples were taken from rodents to identify pathogen Leptospira spp. by conventional PCR using specific primers. Results: IgM-anti-Leptospira was present in 30.12 percent of study subjects and pathogenic Leptospira spp. was identified in 7.55 percent of captured rodents. In the selected sample we found an association of positive cases with being a merchant, housewife and being in contact with pigs. Suboptimal hygienic-sanitary conditions were also evident in the study area. Conclusions: Our results show the circulation of pathogenic Leptospira spp. and exposure to human and ecological risk factors in a marginal sector (slum) of the Colombian Caribbean. We suggest to direct interventions in the human-animal-environment interface according to the One Health paradigm, considering extreme poverty as a determining factor for Leptospirosis occurrence(AU)

Microscopio agglutination test: Variables that affect the time of serological confirmation of human leptospirosis cases / Test de microaglutinación: variables que afectan el tiempo de confirmación de los casos humanos de leptospirosis

Abstrac Leptospirosis is considered an endemic disease in Buenos Aires province, Argentina,with human cases reported annually from rural and urban areas. The aim of the study was todescribe the variables that influence the delay in the serological confirmation of leptospirosisin human cases (period 2006-2014) from Buenos Aires province. Sixty-four percent (64%) ofcases could be confirmed by microscopic agglutination test (MAT) with the first sample. The time of confirmation of the human leptospirosis cases was on average 21 days from the onset of the first clinical signs, and varied depending on the distance of the different sanitary regions. The geographical distribution of the confirmed leptospirosis human cases, in addition to the high number of suspected cases and probable cases (which could not be confirmed by MAT), demonstrate that leptospirosis is endemic and underreported in Buenos Aires province, and that distance and lack of resources could be determinant factors of this situation.

Resumen La leptospirosis se considera una enfermedad endémica en la provincia de Buenos Aires, con casos humanos registrados anualmente en áreas rurales y urbanas. El objetivo de este estudio fue describir las variables que influyen en el retraso de la confirmación serológica de la leptospirosis en humanos, a partir del análisis de los casos ocurridos en el período 2006-2014 en la provincia de Buenos Aires. El 64% de los casos fue confirmado por microaglutinación (MAT) con la primera muestra clínica. El tiempo de confirmación promedio fue de 21 días desde el inicio de los primeros signos clínicos; este valor se vio afectado por la distancia entre los centros de salud y los laboratorios de referencia en las distintas regiones sanitarias. La distribución geográfica de los casos confirmados de leptospirosis en humanos, además del alto número de casos sospechosos y probables (que no pudieron ser confirmados por MAT), demuestra que esta afección es endémica y se encuentra subregistrada en la provincia de Buenos Aires, y que la distancia y la falta de recursos serían factores determinantes de estas características.

Comportamiento epidemiológico de la leptospirosis en México durante el periodo 2013-2019 / Epidemiologic behavior of leptospirosis in México during the period 2013-2019

RESUMEN Objetivo Determinar el comportamiento temporal y espacial de la leptospirosis en México durante el periodo 2013-2019. Materiales y Métodos Se utilizó la información depositada en los boletines epidemiológicos del Sistema Nacional de Vigilancia Epidemiológica de México. Para determinar el comportamiento espacial se construyeron canales endémicos y análisis de series de tiempo. Para determinar el comportamiento espacial, se utilizó el modelo estadístico espacial Scan. Resultados Se determinó que los casos de leptospirosis en México se presentan todo el año; sin embargo, los picos endémicos se observaron en los meses de agosto, septiembre y octubre. Con respecto al comportamiento espacial, no se determinó ninguna agrupación estadísticamente; no obstante, los estados con la mayor prevalencia fueron: Sinaloa, con 146.7 casos por cada millón de habitantes, y Tabasco, con 142 casos por cada millón de habitantes. Discusión La leptospirosis es una enfermedad influenciada por los hábitos y las costumbres de la población, al igual que por variables climatológicas que favorecen el contacto con el agente etiológico. Esto coincide con lo reportado por otros estudios que han determinado que la incidencia de leptospirosis aumenta durante la época de lluvia y que esta enfermedad se relaciona con actividades de recreación en zonas tropicales. Conclusiones La leptospirosis es una enfermedad zoonótica emergente de gran importancia en México, que se presenta con mayor frecuencia en época de lluvias. Los estados de Sinaloa y Tabasco son los más afectados.(AU)

ABSTRACT Objetive To determine the temporal and spatial behavior of leptospirosis in Mexico during the period 2013-2019. Materials and Methods It was used the information deposited in the epidemiological bulletins of National System of Epidemiological Surveillance of Mexico. To determine spatial behavior, endemic channels and time series analyzes were constructed. The spatial statistical model Scan was used to determine the spatial behavior. Results It was determined that leptospirosis cases in Mexico occur throughout the year, however endemic peaks were observed during the months of August, September and October. Regarding to spatial behavior, it was not statistically determined any aggrupation, nevertheless the States with the highest prevalence were Sinaloa with 146.7 cases per million of habitants and Tabasco with 142 cases per million of habitants. Discussion Leptospirosis is a disease which is affected by habits and customs of the populations, as well as by climatological events, favoring the contact with the etiological agent, which coincides with that reported in other studies, in which it was determined that leptospirosis incidence increases during the rainy season, likewise, it was reported that this disease is related to recreational activities in tropical areas. Conclusions To date leptospirosis is an important emerging zoonotic disease in Mexico, the disease occurs more frequently during rainy season, being Sinaloa and Tabasco the most affected States by this disease.(AU)

Seroprevalencia de anticuerpos anti-Leptospira spp. en estudiantes de Medicina Veterinaria y Zootecnia de la Costa Grande de Guerrero, México / Seroprevalence of anti-Leptospira spp. antibodies among Veterinary Medicine and Zootechnics students from Costa Grande of Guerrero, Mexico

Introducción: La leptospirosis humana es una enfermedad zoonótica con manifestaciones clínicas inespecíficas (cefalea y mialgia), las cuales pueden confundirse con otras enfermedades febriles como: gripe, malaria, dengue, fiebre amarilla, hepatitis vírica y rickettsiosis. Objetivo: Determinar la prevalencia de anticuerpos anti-Leptospira en estudiantes de la carrera de Medicina Veterinaria y Zootecnia de la Costa Grande de Guerrero. Métodos: Se aplicó un cuestionario a los estudiantes de la Escuela Superior de Medicina Veterinaria y Zootecnia No. 3 con la finalidad de conocer algunos factores de riesgo asociados a la presencia de anticuerpos anti-Leptospira spp. La determinación de anticuerpos anti-Leptospira y la identificación de las serovariedades se realizaron con la técnica de microaglutinación. Se consideró un suero positivo cuando se observó una aglutinación en una dilución igual o mayor a 1:100. Resultados: En el estudio la seroprevalencia de anticuerpos anti-Leptospira spp. fue de 12,1 por ciento (8/66). Se detectaron anticuerpos a 8 serovariedades de Leptospira spp. El 62,5 por ciento (5/8) de los sueros presentó más de una serovariedad. Las serovariedades y frecuencia fueron icterohaemorrhagiae 25 por ciento (4/16), hardjo 18,8 por ciento (3/16), pyrogenes 18,8 por ciento (3/16), pomona 12,5 por ciento (2/16), canicola 6,2 por ciento (1/16) wolffi 6,2 por ciento (1/16) tarassovi 6,2 por ciento (1/16) y bratislava 6,2 por ciento (1/16). Los factores de riesgo estudiados no se relacionaron con la presencia de anticuerpos anti-Leptospira. Conclusiones: En el presente estudio se encontraron anticuerpos a Leptospira spp. en estudiantes de Medicina Veterinaria y Zootecnia. Por tanto, es pertinente proporcionar información a los estudiantes para prevenir el contacto con el agente causal de la leptospirosis(AU)

Introduction: Human leptospirosis is a zoonotic disease of unspecific clinical manifestations (headache and myalgia) which may be confused with those of other febrile diseases, such as influenza, malaria, dengue, yellow fever, viral hepatitis and rickettsiosis. Objective: Determine the prevalence of anti-Leptospira antibodies among Veterinary Medicine and Zootechnics students from Costa Grande de Guerrero. Methods: A questionnaire was applied to students from the Higher Education Veterinary Medicine and Zootechnics School No. 3 to obtain information about risk factors associated to the presence of anti-Leptospira spp. antibodies. Microagglutination technique was used to determine anti-Leptospira antibodies and identify serovars. A serum sample was considered positive when agglutination was observed at a dilution equal to or greater than 1:100. Results: Seroprevalence of anti-Leptospira spp. antibodies was found to be 12.1 percent (8/66). Antibodies were detected for 8 serovars of Leptospira spp. Of the serum samples analyzed, 62.5 percent (5/8) contained more than one serovar. The serovars and their frequency were the following: icterohaemorrhagiae 25 percent (4/16), hardjo 18.8 percent (3/16), pyrogenes 18.8 percent (3/16), pomona 12.5 percent (2/16), canicola 6.2 percent (1/16), wolffi 6.2 percent (1/16), tarassovi 6.2 percent (1/16) and bratislava 6.2 percent (1/16). The risk factors studied were not related to the presence of anti-Leptospira antibodies. Conclusions: Leptospira spp. antibodies were found in Veterinary Medicine and Zootechnics students. It is therefore advisable to provide students with the information required to prevent contact with the causative agent of leptospirosis(AU)

Neuroleptospirosis con pericarditis y colestasis intrahepática (Síndrome de Weil) / Neuroleptospirosis with Pericarditis and Intrahepatic Cholestasis (Weil syndrome)

Introducción: El síndrome de Weil es una forma grave de la infección bacteriana causada por la bacteria Leptospira, conocida como leptospirosis. Este se caracteriza por la disfunción de múltiples órganos, entre ellos, hígado, riñón, músculos, serosas o el sistema neurológico, en este caso denominado neuroleptospirosis, genera una mortalidad muy elevada cuando no se brinda diagnóstico y tratamiento adecuado. Objetivo: Describir las manifestaciones clínicas, paraclínicos complementarios y tratamiento de un paciente con síndrome de Weil, una condición poco frecuente. Caso clínico: Paciente de 23 años quien consulta en el contexto de síndrome febril agudo asociado con neuritis óptica, dolor torácico y paraclínicos que evidenciaron afectación hepática y cardíaca. Se confirma el diagnóstico de síndrome de Weil dado por neuroleptospirosis, pericarditis y colestasis intrahepática. Conclusiones: mediante un caso clínico de síndrome de Weil, se describe la afectación multisistémica de complicaciones asociadas con leptospirosis, con manifestaciones poco habituales como neuroleptospirosis, pericarditis y colestasis intrahepática(AU)

Introduction: Weil syndrome is a serious form of the bacterial infection caused by the Leptospira bacterium; this is known as leptospirosis. This is characterized by multiple organ dysfunction; for example, the liver, kidney, muscles, of serous type, or the neurological system, in this case called neuroleptospirosis, which produces a very high mortality when adequate diagnosis and treatment are not provided. Objective: To describe the clinical manifestations, complementary paraclinic practice and treatment of a patient with Weil syndrome, as a rare condition. Clinical case: 23-year-old patient who presents with acute febrile syndrome associated with optic neuritis, chest pain, and paraclinical symptoms obviously consistent liver and cardiac involvement. The diagnosis of Weil syndrome is confirmed, specifically defined by neuroleptospirosis, pericarditis, and intrahepatic cholestasis. Conclusions: Through a clinical case of Weil syndrome, the multisystem involvement of complications associated with leptospirosis is described, along with its unusual manifestations, such as neuroleptospirosis, pericarditis, and intrahepatic cholestasis(AU)

Seroprevalence and incidence of Leptospira spp. in domestic dogs in the Southeast region of São Paulo State, Brazil / Soroprevalência e incidência de Leptospira spp. em cães domésticos na região sudeste do estado de São Paulo, Brasil

Leptospirosis is a zoonotic disease caused by Leptospira and domestic dogs can act as host of some serovars. In order to analyze the transmission dynamics in a dog population, with and without immunization, a longitudinal study was carried out with a focus to evaluate antibody response and to identify serovars. Blood samples were collected in three consecutive years (2015 to 2017) from 331, 373 and 347 dogs respectively. The dog seroprevalence in each year was 11%, 7% and 14%, respectively, and the incidence in 2016 was 5% and in 2017, 14%. The most frequent serovars were Cynopteri and Butembo in 2015, Cynopteri, Butembo and Hardjoprajitno in 2016, and Canicola and Butembo in 2017. Dogs can play a role as sentinel animals and hosts of Leptospira serovars. The percentage of seropositive dogs due to vaccination was higher than the previous years without immunization and lower than in previous years for other serovars, which we interpret as evidence for the importance of immunization. These parameters associated with active canine population control are important for prevention and control of leptospirosis not only in dogs but alsoto inhibit the transmission between dogs and humans.(AU)

A leptospirose é uma zoonose causada pelo agente etiológico Leptospira. Cães domésticos atuam como hospedeiro de diversos sorovares deste agente. Com intuito de analisar a dinâmica da leptospirose em uma população canina, com e sem imunização, um estudo longitudinal foi realizado avaliando a resposta sorológica destes animais e identificando seus sorovares. Foram coletadas amostras de 331, 373 e 347 cães em três anos consecutivos (2015 a 2017). As soroprevalências foram de 11%, 7% e 14%, respectivamente, e a incidência em 2016 foi de 5% e em 2017 de 14%. Os sorovares mais frequentes foram Cynopteri e Butembo em 2015, Cynopteri, Butembo e Hardjoprajitno em 2016, e Canicola e Butembo em 2017. Estes cães estão atuando como bio-indicadores da presença de Leptospira na região do estudo, incluindo sorovares zoonóticos, e contribuindo com a sua manutenção no ambiente. A soropositividade para sorovares protegidos pela vacina foi mais alta do que nos anos anteriores à imunização, enquanto para os sorovares não protegidos pela vacina diminuiu, demonstrando a importância da imunização para essa população de cães. Medidas de prevenção e controle para a leptospirose, como imunização e controle populacional canino, são recomendadas no local para inibir a transmissão do agente entre as populações de cães e humanos envolvidas.(AU)