Investigation and response to a large outbreak of leptospirosis in field workers in Lower Saxony, Germany.

Between June and August 2014, 45 cases of leptospirosis were notified among workers on two strawberry farms in North-West Germany. We describe the characteristics of the outbreak and the actions taken to prevent further cases. The activities of the local, federal and national public health and veterinary authorities included collection of case data, laboratory testing of human specimens and of small mammals trapped on the fields, investigation of weather data, as well as information provided to farmers, field workers, physicians and to the authorities in Poland and Romania. Of the 45 identified cases (median age 22, 60% male), 47% were hospitalized. Characteristic symptoms were fever ≥38.5°C, generalized muscle pain and an increase in renal or liver enzymes. Thirteen cases were laboratory confirmed by serological and/or molecular methods. ELISA tests for Leptospira IgG and IgM-antibodies were positive in those samples taken >5 days after hospitalization. The probable causative agent was identified as Leptospira kirschneri serovar Grippotyphosa. Leptospira-specific DNA was found in kidneys of 67% of 64 trapped small mammals and was further identified as Leptospira kirschneri multi locus sequence type 110. During the estimated time period of human infections, the affected region faced warm weather with heavy rainfalls. The results of this investigation are in accordance with the theory of a chain of infection from mice to field workers during warm and humid weather. In 2015, a campaign was initiated to inform physicians, farmers and workers to enhance prevention measures, such as the use of personal protective equipment and early consultation of physicians in case of illness. Since then, no further outbreak occurred.

An Assessment and Comparison of the Efficacy of Two Licensed Tetravalent Leptospira Vaccines for Dogs Using an Improved Challenge Model.

An objective of the present studies was to compare the protective effects of two European licensed canine tetravalent leptospirosis vaccines, Nobivac L4 and Versican Plus L4. Four similar challenge studies in beagle dogs were performed. In each study the dogs were assigned to one of three treatment groups as follows: group 1, Nobivac L4; group 2, Versican Plus L4; group 3, non-vaccinated control group. Two vaccinations were followed by a Leptospira challenge. Strains of the following serogroups were used for challenge: study 1, Grippotyphosa; study 2, Icterohaemorrhagiae; study 3, Canicola; study 4, Australis. Parameters of efficacy were antibody titres; body temperature; clinical signs; cultures of Leptospira bacteria from the blood, urine, kidney and liver; rapid urinalysis; macroscopic and histopathological examination at necropsy. It was concluded that compared to vaccination with Versican Plus L4, vaccination with Nobivac L4 resulted in generally better control of leptospirosis disease parameters after the challenge including a complete prevention of the clinical signs following a Grippotyphosa and Icterohaemorrhagiae challenge. In contrast, vaccination with Versican Plus L4 only prevented infection by Australis and shedding by Grippotyphosa and Australis but it did not lead to any statistically significant reduction of either infection or shedding following an Icterohaemorrhagiae challenge.

Comparison of Two Leptospira Type Strains of Serovar Grippotyphosa in Microscopic Agglutination Test (MAT) Diagnostics for the Detection of Infections with Leptospires in Horses, Dogs and Pigs.

The MAT test is of great importance in the diagnosis of leptospiral infections. Based on various differences, the serovar Grippotyphosa has been divided into two types, Moskva V and Duyster. Differences or similarities of the two type strains in the context of leptospiral diagnostics have not yet been elucidated in more detail; therefore both strains were analysed in MAT diagnostics for the detection of leptospiral infections in pigs, dogs and horses. Serum samples from 2996 pigs, 55 dogs and 35 horses, as well as vitreous and/or aqueous fluid samples from these and 13 additional horses were analysed by MAT; available supplementary samples were tested for leptospires by PCR. In pigs, 92.6% of the samples with both strains received an identical titre result in the MAT test, whereas in dogs and horses only 53.0% and 43.6% had concordant results. Since infections with the serovar Grippotyphosa occur more frequently in dogs and horses overall, more differences were observed here. In the case of discrepant serological results, supplementary samples and PCR examinations were not able to add information on the true status. Further analyses of follow-up studies or at least serum pairs from dogs and horses infected with the serovar Grippotyphosa are necessary.

Isolation of Leptospira kirschneri serovar Grippotyphosa from a red panda (Ailurus fulgens) after antimicrobial therapy: Case report.

A 1-year-old female red panda started showing symptoms of illness, including lethargy, anorexia, abdominal discomfort, and vomiting, shortly after transfer to a new zoo. Serum was tested for leptospirosis using the microscopic agglutination test, and a titer of 1:25,600 to serogroup Grippotyphosa was detected. Antimicrobial treatment with doxycycline was initiated. After completion of treatment and resolution of clinical symptoms, a urine sample was collected to ensure clearance of leptospires and cessation of urinary shedding prior to co-housing with other red pandas. A repeat serum sample taken 13 days later had a lower titer of 1:6,400 to serogroup Grippotyphosa. A sample of the animal's urine was cultured in HAN media and was culture positive for Leptospira. The recovered isolate was completely characterized by whole genome sequencing and serotyping with reference antisera, and the isolate was classified as Leptospira kirschneri serogroup Grippotyphosa serovar Grippotyphosa strain RedPanda1.

Prevalence of leptospirosis among animal herds of north eastern provinces of India.

Serum samples from 840 animals were examined for Leptospira spp. antibodies by microscopic agglutination test (MAT) to assess the risk factors and the prevalence of leptospirosis among animal herds of Assam, Meghalaya, Mizoram the north eastern (NER) provinces. They were compared with Tamilnadu (TN) the southern province of India for the serovar and risk factor inconsistency. Serovar Ballum was reported to be prevalent (28.1 %) in Assam and Grippotyphosa (16.1 %) in Tamilnadu. The overall seropositivity observed was 36.8 %(206/560) from NER and 30.7 %(86/280) from TN. In this study, the higher seroprevalence was observed in pigs (42.6 %), cattle (39.8 %) and goats (26 %) in NER. Cattle (36.4 %) and goat (17.6 %) showed higher prevalence in TN. The presence of rodents in pig herds was found to be significant (P = 0.0088) in NER and it was for cattle in TN (P = 0.0063). We suggest that a program of rodent control should be included in the flock management practices aiming to reduce transmission of the leptospires.

Serological and molecular characterization of Leptospira kirschneri serogroup Grippotyphosa isolated from bovine in Brazil.

Leptospirosis is a zoonotic disease caused by a bacterium of the genus Leptospira that affects domestic animals, including cattle. Despite of this importance in livestock, little is known about the epidemiology of leptospirosis in cattle in Brazil and other tropical countries. In this context, the objective of this study was to perform the culture of urine and kidney (n = 372 animals) of slaughtered bovines of Minas Gerais state (Brazil), in order to obtain pure cultures of Leptospira strains and carry out its characterization by serological (microscopic agglutination test) and molecular techniques (rrs, secY sequencing and variable-number tandem-repeat genotyping). One strain, named UFU 02, was obtained from a male bovine without apparent alterations in ante-mortem examination. The strain was characterized belonging to species Leptospira kirschneri and serogroup Grippotyphosa. The serogroup Grippotyphosa is most often described in wild species, suggesting a link between domestic and wild cycles/environments. Considering the importance of the country in livestock breeding, the knowledge about leptospiral strains could help to control the disease in the herds.

Development of antibody ELISA specific of Leptospira interrogans serovar Grippotyphosa, Canicola, and Icterohaemorrhagiae to monitor vaccine immunogenicity.

The antibody response after primary vaccination and annual revaccination with a multivalent DAPPi-L vaccine was assessed respectively in SPF dogs and in client owned dogs against the Grippotyphosa (Lg), Canicola (Lc) and Icterohaemorrhagiae (Li) Leptospira serovars. To overcome limitations of the microscopic agglutination test (MAT), we developed serovar-specific and sensitive blocking ELISA assays. Serovar-specific antibodies against Lg, Lc and Li were detected in 100%, 45% and 91% of dogs, respectively, after the first dose of vaccine, and in 100% of dogs for all serovars after the second dose. In addition, mean ELISA antibody titers increased 14 days after annual revaccination with most dogs remaining ELISA antibody positive against Lg (85.3%), Lc (90%) and Li (100%). Parallel testing of sera from the annual revaccination study in the MAT and ELISA assays resulted in an overall agreement of 72%, 67%, 77% of samples for Lg, Lc and Li serovars, respectively. More sera tested positive by ELISA than by MAT, suggesting that the ELISA assay is more sensitive than the MAT. These three new antibody-based assays are the first suitable and reliable ELISA assays for the assessment of the canine antibody response following vaccination and an attractive alternative to the MAT.

Fifteen-month duration of immunity for the serovar Grippotyphosa fraction of a tetravalent canine leptospirosis vaccine.

Forty-four specific pathogen-free beagles, median age 65 days, received two subcutaneous doses of either a commercially available, five-way combination vaccine or the same vaccine in combination with a tetravalent Leptospira bacterin (Canicola, Grippotyphosa, Icterohaemorrhagiae, Pomona). They were subsequently challenged with a pathogenic strain L kirschneri serovar Grippotyphosa 470 days following completion of the vaccination protocol. Titres of agglutinating serum antibodies were determined at various time points before and after both vaccination and challenge, along with postchallenge reisolation of the challenge organisms from blood and urine, and evaluation of renal histopathology. Clinical signs of generalised leptospirosis were not observed in any of the dogs after challenge. In order to demonstrate efficacy, leptospirosis was defined as having at least one positive urine sample and a positive renal histopathology score; or, in the absence of renal pathology, multiple positive urine samples. Leptospiremia was not demonstrated in any of the vaccinated dogs versus 27 per cent of the controls; leptospiruria was noted in 5 per cent of the vaccinates compared with 76 per cent of controls; and renal lesions were observed in 15 per cent of the vaccinates and 65 per cent controls. Using these criteria, the vaccine was able to significantly prevent leptospirosis (P=0.0001) in the vaccinated animals. This study establishes duration of immunity of at least 15 months for the prevention of disease and renal excretion of leptospires for the Leptospira serovar Grippotyphosa fraction of a quadrivalent Leptospira vaccine.

Characterization of Leptospira santarosai Serogroup Grippotyphosa Serovar Bananal Isolated from Capybara ( Hydrochaeris hydrochaeris ) in Brazil.

Leptospirosis is a widespread zoonosis caused by bacteria of the genus Leptospira. Rodents appear to be the most important reservoirs of infection. They contaminate the environment and food and can transmit the pathogen when they are consumed by carnivores. Capybara ( Hydrochaeris hydrochaeris ) are efficient reservoirs of Leptospira, and because they are in close contact with farm animals and are found in semiurban areas, they represent a risk to public health. We isolated five Leptospira strains from capybara kidneys in Sao Paulo State, Brazil, in 2001 and typed them using serologic and molecular techniques. These strains include the Leptospira santarosai serogroup Grippotyphosa serovar Bananal. Pulsed field gel electrophoresis resulted in a unique pattern distinct from the reference strains, and the isolates clustered with greater than 85% similarity. The isolates also presented higher growth rates than other Leptospira serovars, with high minimal inhibitory concentration values for most of the tested antibiotics, with the exception of penicillin and ampicillin. This isolation and characterization of the L. santarosai serogroup Grippotyphosa serovar Bananal from capybara, highlights the importance of wild and sinantropic rodents as carriers of pathogenic leptospires.

Molecular Characterization and Serology of Leptospira kirschneri (Serogroup Grippotyphosa) Isolated from Urine of a Mare Post-Abortion in Brazil.

A strain of Leptospira kirschneri (serogroup Grippotyphosa) was cultured from urine of a mare post-abortion in Brazil and characterized by serogrouping, multiple-locus variable-number tandem repeat analysis, PGFE, and sequencing of genes rrs and secY. Strains of L. kirschneri have apparently never been recovered from horses in tropical area, only in Europe and USA. Knowledge of local epidemiology is important to interpret genetic profiles of leptospires circulating in an area.

ACUTE CLINICAL LEPTOSPIROSIS (GRIPPOTYPHOSA SEROVAR) IN AN ADULT DROMEDARY CAMEL (CAMELUS DROMEDARIUS).

A 9-yr-old castrated male dromedary camel (Camelus dromedarius) presented with lethargy and partial anorexia. A diagnostic examination revealed fever, and further workup revealed a neutrophilia, hyperfibrinogenemia, renal azotemia, and a rapid onset of a high Leptospira antibody titer during the acute clinical period (Grippotyphosa serovar). The camel responded clinically to antimicrobial treatment with ceftiofur crystalline free acid injections, but renal azotemia persisted, presumably secondary to chronic renal damage. Subsequent Leptospira polymerase chain reaction testing on urine samples obtained over the following 4 mo revealed no evidence of urinary shedding, so a persistent infection was unlikely. Although often mentioned as a potential cause of reproductive loss, well-documented case reports of clinical leptospirosis in camelids are very rare. In this case, native wildlife contamination of a small watering hole is suspected to have been the source of infection. In response to this experience, the camel and two conspecifics were prescribed a vaccination regimen using an inactivated pentavalent Leptospira vaccine licensed for cattle.

Acute interstitial nephritis due to Leptospira grippotyphosa in the absence of Weil's disease.

Anicteric leptospirosis is a self-limited flu-like disease, whereas the icteric form is a severe illness characterized by multiple organ involvement or even failure. A case involving a patient with rapidly progressing renal insufficiency requiring intermittent renal replacement therapy due to Leptospira grippotyphosa in the absence of a Weil's disease is reported.

La leptospirose anictérique est une maladie pseudogrippale spontanément résolutive, tandis que sa forme ictérique est une maladie grave caractérisée par une atteinte multiorganique ou même par une insuffisance. Les auteurs présentent le cas d'un patient présentant une insuffisance rénale à évolution rapide exigeant une thérapie de substitution rénale intermittente attribuable à un Leptospira grippothyphosa en l'absence d'une maladie de Weil.

Eficácia dos tratamentos estabelecidos pelo Manual da IETS, em oócitos, expostos à Leptospira interrogans / Effectiveness of treatments established by the Manual of IETS, in oocytes, exposed to Leptospira interrogans

Avaliou-se a eficácia dos tratamentos, definidos pela International Embryo Transfer Society (IETS), de oócitos bovinos, maturados in vitro e expostos experimentalmente à Leptospira interrogans sorovar Grippotyphosa. Os oócitos foram obtidos por meio de punção folicular, selecionados e distribuídos em quatro grupos, expostos ao patógeno e submetidos aos diferentes tipos de tratamentos. Foram expostos à cepa na concentração de 4,7.10(5)/µL, virulenta e não adaptada ao meio de manutenção EMJH, e, de 6,3.10(5)/µL, avirulenta e adaptada ao meio, por 24 horas. Os grupos tratados com tripsina ou antibióticos apresentaram eficácia de 21,7 por cento, e o grupo lavado sequencialmente 33,4 por cento. Os tratamentos não foram eficazes para os contaminados com a cepa avirulenta. Concluiu-se que as normas de controle de qualidade estabelecidas pela IETS poderiam ser revisadas e, possivelmente, redefinidas, uma vez que a eficácia dos tratamentos, provavelmente, não depende somente da espécie do patógeno, pois há interferência da virulência e de ação dos tratamentos sobre o tipo de patógeno.

The research purpose was to evaluate the effectiveness of treatments established by the IETS, in bovine oocytes maturated in vitro, exposed experimentally to Leptospira interrogans serovar Grippotyphosa. The oocytes were obtained through follicular puncture, selected and randomly allotted in four groups, exposed to the pathogen and subjected to different types of treatments. They were exposed to the strain in the concentration of 4.7x10(5)/µL virulent and not adapted to the EMJH, and to 6,3x10(5)/µL, virulent and adapted to the medium, for 24 hours. The treatments presented for the groups with trypsin or antibiotics, 21.7 percent efficiency, and the group washed sequentially presented 33.4 percent efficiency. The treatments were not effective for those infected with avirulent strain. In the statistical analysis, by χ², was found significance in the results obtained. The standards of quality control established by IETS could be reviewed and possibly redefined, since the effectiveness of treatment probably depends not only on the species of the pathogen, but is also affected by its virulence and treatment effectiveness.

Detección de Leptospira santarosai y L. kirschneri en bovinos: nuevos aislados con potencial impacto en producción bovina y salud pública / Detection of Leptospira santarosai and L. kirschneri in cattle: new isolates with potential impact in bovine production and public health

Bovine leptospirosis causes high economic losses in cattle mainly due to reproductive failure, as well as representing public health risk. Since the last century, antibody titers against several Leptospira serovars have been detected by the microscopic agglutination test (MAT) in Mexico. With the exception of very few cases, the presence of serovars causing leptospirosis in cattle and other animal species has not been demonstrated by isolation in Mexico, and in such cases characterization had to be done abroad by complex and slow immunological approaches, by comparison with a number of reference strains. The present study was conducted to perform the molecular characterization of Leptospira isolates by multiple locus sequencing typing (MLST). A hundred and ninety seven sera and kidneys samples were collected immediately after slaughter, from grazing cattle coming from the south-eastern states of Mexico. Anti-Leptospira antibodies were detected by the MAT and kidneys were inoculated into EMJH and Fletcher's specific medium. A seropositivity of 60.4% (119 out of 197), with titers from 1:100 up to 1:3 200 was detected. Four isolates (2.03%), referred as CAL4, CAL6, CAL7 and MOCA45, were characterized by serology, ribotyping and MLST as L. kirschneri serovar Grippotyphosa; L. interrogans serovar Hardjo; L. santarosai serovar Mini and L. santarosai serovar Tarassovi, respectively. With the exception of serovar Hardjo, the three other isolates belong to serovars and species not previously isolated in Mexico. These findings make it necessary to evaluate the potential distribution of such serovars among cattle and their role on animal production and public health.

La leptospirosis bovina causa grandes pérdidas económicas a la ganadería por problemas reproductivos y también es un riesgo de salud pública. En México, desde el siglo pasado se ha registrado la presencia de anticuerpos contra serovariedades de Leptospira por la técnica de aglutinación microscópica (AM), en bovinos y otras especies animales. En muy pocos casos, la enfermedad fue demostrada por el aislamiento de Leptospira, y en tales casos, su caracterización se basó en métodos inmunológicos lentos que requirieron la comparación con cepas de referencia y que fueron realizados fuera de México. En el presente trabajo se realizó la caracterización molecular mediante la secuenciación de locus múltiples (MLST), de aislados de Leptospira obtenidos de riñones de bovinos recolectados en rastro, procedentes de las zonas Golfo y sur de México. Se obtuvieron muestras de suero y riñones de 197 bovinos para realizar la AM, y el cultivo en medios específicos EMJH y Fletcher. Se detectó una seropositividad del 60.4% (119 de 197), con títulos desde 1:100 hasta 1:3,200 y se obtuvieron cuatro aislados de Leptospira (2.03%), denominados CAL4, CAL6, CAL7 y MOCA45. Los aislados fueron caracterizados por serología, ribotipificación y MLST, como L. kirschneri serovariedad Grippotyphposa; L. interrogans serovariedad Hardjo; L. santarosai serovariedad Mini y L. santarosai serovariedad Tarassovi, respectivamente. A excepción de la serovariedad Hardjo, los aislados pertenecen a especies y serovariedades no aisladas anteriormente en la República Mexicana, esto sugiere la necesidad de evaluar su diseminación entre bovinos y su potencial efecto en la producción animal y en la salud pública.

Leptospira infections in trappers from Ontario.

BACKGROUND: Four trappers presented to the Middlesex-London Health Unit in November, 1997 with similar clinical presentations. All four complained of fever, chills and headache, and three of the four had severe muscle aches. All gave histories of trapping raccoons before the onset of illness. Three of the four men exhibited diagnostic seroconversions to Leptospira grippotyphosa. OBJECTIVE: To describe the four suspected cases of leptospira infections and to determine whether raccoons might serve as a reservoir of infection using field studies. DESIGN: Raccoon serology were undertaken using the microscopic agglutination test against eight serovars of Leptospira interrogans including L grippotyphosa. Raccoons were trapped using Tomahawk live traps, anaesthetized with intramuscular injection of ketamine and acepromazine, bled by cardiac puncture and released. RESULTS: Forty-two raccoons were trapped in Middlesex (n=36) and Kent counties (n=6) from April 25 to May 2, 1998, and 10 (23.8%) of these animals had antibodies to L grippotyphosa. CONCLUSIONS: Infections due to L grippotyphosa or a closely related serovar are a risk for trappers in Ontario, and raccoons are a likely reservoir of this bacterium.