Detection of pathogenic Leptospira spp. in herpetofauna in Central Appalachia.

Leptospirosis is a water borne zoonotic disease of global significance that is caused by pathogenic species of the genus Leptospira. Pathogenic leptospires live in the kidneys of reservoir or infected animals and are shed in their urine contaminating water, soil, etc. Rodents are considered the primary reservoir of leptospirosis, but little is known about the role of herpetofauna (non-avian reptiles and amphibians) in the epidemiology of the disease. To address this, various species of amphibians and reptiles in the Cumberland Gap Region of the Central Appalachia were screened for the presence of Leptospira spp. Kidneys harvested from of a total of 116 amphibians and reptiles belonging to seven species of snakes, seven species of salamanders, seven species of frogs/toads, seven species of turtles and one species of lizards were tested using a highly specific TaqMan based qPCR that targets lipl32 gene of pathogenic Leptospira spp. Overall, 15 of the tested 116 amphibians and reptiles were positive (12.9%; 95% CI: 7.4%-20.4%). Of the 101 amphibians, 11 were positive (10.9%; 95% CI: 5.6%-18.7%), and 4 of the 15 reptiles tested positive (26.7%; 95% CI: 7.8%-55.1%). The amplified gene fragments of lipl32 from qPCR positive kidneys were sequenced and found to be identical with known pathogenic Leptospira spp. These results suggest that although the proportion of reptiles and amphibians transmitting pathogenic Leptospira spp. within the environment may be low as compared to rodents, they pose a risk to other susceptible hosts that share their habitats and may have role in maintaining a baseline infection in the environment.

Surviving SARS and living through COVID-19: Healthcare worker mental health outcomes and insights for coping.

OBJECTIVE: Explore how previous work during the 2003 Severe Acute Respiratory Syndrome (SARS) outbreak affects the psychological response of clinical and non-clinical healthcare workers (HCWs) to the current COVID-19 pandemic. METHODS: A cross-sectional, multi-centered hospital online survey of HCWs in the Greater Toronto Area, Canada. Mental health outcomes of HCWs who worked during the COVID-19 pandemic and the SARS outbreak were assessed using Impact of Events-Revised scale (IES-R), Generalized Anxiety Disorder scale (GAD-7), and Patient Health Questionnaire (PHQ-9). RESULTS: Among 3852 participants, moderate/severe scores for symptoms of post- traumatic stress disorder (PTSD) (50.2%), anxiety (24.6%), and depression (31.5%) were observed among HCWs. Work during the 2003 SARS outbreak was reported by 1116 respondents (29.1%), who had lower scores for symptoms of PTSD (P = .002), anxiety (P < .001), and depression (P < .001) compared to those who had not worked during the SARS outbreak. Multivariable logistic regression analysis showed non-clinical HCWs during this pandemic were at higher risk of anxiety (OR, 1.68; 95% CI, 1.19-2.15, P = .01) and depressive symptoms (OR, 2.03; 95% CI, 1.34-3.07, P < .001). HCWs using sedatives (OR, 2.55; 95% CI, 1.61-4.03, P < .001), those who cared for only 2-5 patients with COVID-19 (OR, 1.59; 95% CI, 1.06-2.38, P = .01), and those who had been in isolation for COVID-19 (OR, 1.36; 95% CI, 0.96-1.93, P = .05), were at higher risk of moderate/severe symptoms of PTSD. In addition, deterioration in sleep was associated with symptoms of PTSD (OR, 4.68, 95% CI, 3.74-6.30, P < .001), anxiety (OR, 3.09, 95% CI, 2.11-4.53, P < .001), and depression (OR 5.07, 95% CI, 3.48-7.39, P < .001). CONCLUSION: Psychological distress was observed in both clinical and non-clinical HCWs, with no impact from previous SARS work experience. As the pandemic continues, increasing psychological and team support may decrease the mental health impacts.