Dissemination kinetics and pathology of canine Leptospira icterohaemorrhagiae isolate in a guinea pig infection model.

Despite significant progress made in elucidating the mechanism of acute human leptospirosis in different organs, there is a paucity of information in organs such as the heart, pancreas, brain, and adrenal gland. This study was designed to establish leptospire dissemination kinetics and patho-morphological changes associated with these orangs in the guinea pig infection model using cultural isolation (CI), polymerase chain reaction (PCR), Warthin Starry silver stain (WSss), immunohistochemistry (IH), and transmission electron microscopy (TEM). Twenty guinea pigs were inoculated intra-peritoneally with a low dosage of 1 × 107 Leptospira interrogans serovar Icterohaemorrhagiae and 10 as control using distilled water. The guinea pigs were sacrificed at post-infection day (p.i.d.) ½, 1, 3, 5, and 7 followed by the harvest of the brain, pancreas, adrenal gland, heart, lungs, liver, kidneys, and spleen for CI, PCR, HE, WSss, IH, and TEM evaluations. The study revealed early dissemination of Leptospira organism in the brain, heart, pancreas, and adrenal gland and exerted various histopathological changes that were not explicitly elucidated in previous studies. This study revealed that the virulent pathogenic isolate of Leptospira organism obtained from clinically infected dog mimicked the same clinical manifestations, gross and histopathological changes especially in organs that were not previously evaluated.

Is the microagglutination test (MAT) good for predicting the infecting serogroup for leptospirosis in Brazil?

Leptospirosis is a zoonotic infection caused by pathogenic members of the genus Leptospira spp. Knowledge of the prevalent serovars and their maintenance hosts is essential to understand the disease. The aim of this study was to evaluate the ability of serology by the microscopic agglutination test (MAT) to predict the serogroups compared with results of identification of leptospires in São Paulo, Brazil. MAT correctly assigned the serogroup of the infecting isolate in 49/52 cases (94.23%). The serogroup Icterohaemorrhagiae was the predominant serogroup (88.46%). This study showed the usefulness of the MAT to correctly identify the infecting serogroup with a good overall agreement between the serologically-identified infecting serogroup and by identification of the isolate and can be used in epidemiological surveys in São Paulo. However, it should be complemented by the identification of Leptospira isolates.

Highly Pathogenic Leptospira Found in Urban Brown Rats (Rattus norvegicus) in the Largest Cities of Sweden.

Leptospirosis is an emerging zoonosis of global concern; however, its contemporary occurrence in Sweden, a European country partly located north of the Arctic Circle, is poorly known. Four out of 30 brown rats, captured within urban districts in Sweden, were found to be positive for antibodies to Leptospira interrogans serovar Icterohaemorrhagiae. This serovar causes Weil's disease in humans, a severe infection with jaundice, renal failure, and hemorrhage. Our study is the first finding of this highly pathogenic serovar in Swedish rats since the 1930s.

[Adrian Stokes and 'trench jaundice']. / Adrian Stokes en 'trench jaundice'.

On the day that Great Britain declared war on Germany in 1914, the Irish physician and bacteriologist Adrian Stokes travelled to London to volunteer. One week later he left for France with the first British troops as an officer with the Royal Army Medical Corps. He spent most of the First World War attached to No. 1 Mobile Bacteriological Laboratory at the Remy Siding British-Canadian field hospital in Flanders. In April 1916, he was confronted with an outbreak of trench jaundice, also known as epidemic jaundice (Weil's disease). Conditions in the trenches contributed to the hundred cases identified by Stokes in a short period. In 1917, he was the first to publish (in The Lancet) the finding that the bacterium Spirochaeta icterohaemorrhagiae, the causative agent of epidemic jaundice, could be isolated from the kidneys of rats. A subsequent rat control campaign in the trenches successfully curbed the disease.

Genotipos de cepas de Leptospira spp. aisladas de perros en Buenos Aires, Argentina / Genotypes of Leptospira spp. strains isolated from dogs in Buenos Aires, Argentina

La leptospirosis es una enfermedad infecciosa de amplia distribución global; endémica en Argentina. El objetivo de este estudio fue obtener los perfiles genéticos de las cepas de Leptospira spp. aisladas de casos clínicos de perros provenientes de la provincia de Buenos Aires, empleando el análisis de repeticiones en tándem de número variable en múltiples locus [multiple-locus variable-number tandem repeats analysis (MLVA)]. Fueron genotipificadas por MLVA ocho cepas aisladas de perros. Se obtuvo un perfil idéntico al de Leptospira interrogans serovar Canicola Hond Utrecht IV en las cepas denominadas Dogy y Mayo. Las cepas denominadas Bel, Sarmiento, La Plata 4581 y La Plata 5478 mostraron un perfil idéntico al genotipo de L. interrogans serovar Portlandvere MY 1039. La cepa denominada Avellaneda presentó un perfil idéntico al genotipo L. interrogans serovar Icterohaemorrhagiae RGA, y la cepa denominada SB mostró un perfil idéntico al genotipo de L. interrogans serovar Pomona Baires y similar al serovar Pomona Pomona. Sería de gran utilidad incluir un mayor número de cepas provenientes de distintas poblaciones caninas de diversas provincias de Argentina a fin de conocer los perfiles de las cepas circulantes en el país. La información así obtenida contribuirá al control de la leptospirosis en la población canina

Leptospirosis is an infectious disease of wide global distribution, which is endemic in Argentina. The objective of this study was to obtain the genetic profiles of Leptospira spp. strains isolated from clinical cases of dogs in the province of Buenos Aires by the multiple-locus variable-number tandem repeat analysis (MLVA). Eight isolated canine strains were genotyped by MLVA, obtaining the identical profile of Leptospira interrogans serovar Canicola Hond Utrecht IV in the strains named Dogy and Mayo. The strains named Bel, Sarmiento, La Plata 4581 and La Plata 5478 were identical to the profile of the genotype of L. interrogans serovar Portlandvere MY 1039.The strain named Avellaneda was identical to the genotype profile of L. interrogans serovar Icterohaemorrhagiae RGA and the strain named SB had the same profile as the L. interrogans serovar Pomona Baires genotype and was similar to the profile of serovar Pomona Pomona genotype. It would be useful to include a larger number of isolates from different dog populations in various provinces of Argentina and to characterize the genetic profiles of the strains circulating in the country. The information obtained will be useful for the control of leptospirosis in the dog population

Weil's disease (leptospirosis) manifesting as fulminant hepatic failure: report of an autopsy case.

We report an autopsy case of a 60-year-old man with Weil's disease who died of fulminant hepatic failure. Ante-mortem blood culture yielded the growth of Leptospira interrogans (serovar icterohaemorrhagiae). At autopsy, the liver weighed 1210 g and showed a typical appearance of "acute yellow liver atrophy". Zone 3 (centrilobular region) showed submassive necrosis of hepatocytes accompanied by marked hemorrhage. Hepatocytes in zones 1 and 2 were well preserved, and the leptospira antigen was immunohistochemically demonstrated in several hepatocytes. Dissociation of liver cell plates was not observed. An immunohistochemical study demonstrated that CD31-positive, sinusoidal endothelial cells had almost completely disappeared in zone 3. This finding suggested that severe and selective damage to endothelial cells in zone 3 was the main cause of the submassive hepatocellular necrosis, which led to fulminant hepatic failure in the present case.

A importância de Leptospira interrogans sorovariedades Icterohaemorrhagiae e Canicola na zona litorânea e nos campos sulinos do Rio Grande do Sul / The importance of Leptospira interrogans serovars Icterohaemorrhagiae and Canicola in coastal zone and in southern fields of Rio Grande do Sul, Brazil

This study aimed to describe the occurrence of Leptospira interrogans serovars Icterohaemorrhagiae and Canicola, in coastal zone and in southern grasslands of Rio Grande do Sul, Brazil. In each one of the four analyzed farms blood samples were collected from free-living wild animals, domestic animals and humans to perform serological testing for leptospirosis. The presence of antibodies was verified by microscopic agglutination test (MAT). The criterion adopted to consider a serum as agglutination reactant was at least 50% of leptospira for a microscopic field of 100x. From 17 blood samples collected at Chuí, five (29.41%) were positive, three (60.00%) for serovar Icterohaemorrhagiae and two (40.00%) for Canicola. From 21 samples collected in the County of Santana da Boa Vista, six (28.57%) were positive, four (66.67%) for serovar Canicola and two (33.33%) for serovar Icterohaemorrhagiae. From 32 samples collected at Alegrete, 10 (31.25%) were positive, seven (70.00%) for serovar Icterohaemorrhagiae and three (30.00%) foro serovar Canicola. From 17 blood samples collected in Cruz Alta, three (17.64%) were positive, two (66.67%) for serovar Icterohaemorrhagiae and one (33.33%) for Canicola. It is necessary to improve sanitary practices on farms in the state of Rio Grande do Sul, in order to achieve success in leptospirosis control programs.

O presente estudo teve como objetivo descrever a ocorrência de Leptospira interrogans sorovariedades Icterohaemorrhagiae e Canicola, na zona litorânea e nos campos sulinos do Estado do Rio Grande do Sul. Em cada uma das quatro propriedades foram realizadas colheitas de sangue de animais selvagens de vida livre, de animais domésticos e de seres humanos para realização de sorologia para leptospirose. A presença de anticorpos foi verificada pela técnica de Soroaglutinação Microscópica (SAM). O critério adotado para considerar um soro como reagente foi aglutinação de pelo menos 50% das leptospiras no campo microscópico no aumento de 100x. Das 17 amostras de sangue colhidas na propriedade pertencente ao Município de Chuí, cinco (29,41%) foram positivas, três (60,00%) à sorovariedade Icterohaemorrhagiae e duas (40,00%) à Canicola. Das 21 amostras colhidas em Santana da Boa Vista, seis (28,57%) foram positivas, quatro (66,67%) à Canicola e duas (33,33%) à Icterohaemorrhagiae. Das 32 amostras colhidas em Alegrete, 10 (31,25%) foram positivas, sete (70,00%) à Icterohaemorrhagiae e três (30,00%) à Canicola. Das 17 amostras colhidas em Cruz Alta, três (17,64%) foram positivas, duas (66,67%) à Icterohaemorrhagiae e uma (33,33%) à Canicola. É necessário melhorias nas práticas sanitárias em propriedades rurais do Estado do Rio Grande do Sul, a fim de se obter sucesso em programas locais de controle da leptospirose.

[Fever and jaundice... and if it was a leptospirosis. About a case of L. interrogans icterohaemorrhagiae in Northern France]. / Ictère fébrile et si c'était une leptospirose. À propos d'un cas de L. interrogans Icterohaemorrhagiae dans le Nord de la France.

Leptospirosis is an anthropozoonose, an animal disease transmissible to humans, caused by a spirochete of the genus Leptospira that lives mainly among rodents but also in wetlands. It occurs worldwide, particularly in Asia, Latin America and Africa. In Europe, the incidence is small (except in France and Great Britain, where its frequency has increased in recent years) but the frequency may be underestimated. Some areas overseas are particularly affected. In France, the potential epidemic of leptospirosis is subject to climatic variations, justifying a constant monitoring of the disease provided by the National Reference Centre (CNR) of leptospires. Transmission to humans primarily occurs through contact with environments contaminated by the urine of infected animals. The disease can affect the liver and kidneys (hepatonephritis) as cytolysis, cholestasis and renal failure associated with fever. A coagulopathy usually accompanies the clinical table. Its diagnosis is difficult because of the clinical polymorphism. Early diagnosis of leptospirosis allows effective medical care, improving patient outcomes. This is currently based on gene amplification (PCR) or serology positive by the microscopic agglutination test (MAT), which is the reference method. Its evolution is usually favorable with appropriate antibiotic treatment (aminopenicillin). However 5-10% of symptomatic patients have a severe multisystem defaillance. Nearly a century after the discovery of the causative agent, this zoonosis remains a public health problem, zoonosis priority in terms of virulence, its reporting is mandatory in our country. We report the case of a severe form of hepatonephritis due to water contaminated with Leptospira observed in Northern France.

Anticorpos revelados pelo teste de inibição do crescimento de leptospiras in vitro (TICL) contra os sorovares Canicola, Icterohaemorrhagiae e Copenhageni em cães adultos revacinados anualmente com vacina comercial contendo bacterinas dos sorovares Canicola, Icterohaemorrhagiae, Grippotyphosa e Pomona / Antibody revealed by growth inhibition test the of leptospires in vitro (GIT) against serovars Canicola, Icterohaemorrhagiae and Copenhageni in adult dogs revaccinated annually with commercial vaccine containing serovars Canicola, Icterohaemorrhagiae, Grippotyphosa and Pomona bacterins

Na atualidade, o sorovar Copenhageni é o representante do sorogrupo Icterohaemorrhagiae, mantido por roedores sinantrópicos, que tem prevalecido nos cães e seres humanos das grandes metrópoles brasileiras. A despeito de alguns autores sugerirem a existência de proteção cruzada entre sorovares incluídos em um mesmo sorogrupo esta condição ainda não foi suficientemente esclarecida para os sorovares Icterohaemorrhagiae e Copenhageni. No presente trabalho cães adultos com dois a seis anos de idade primo-vacinados com três doses intervaladas de 30 dias a partir dos 60 dias de idade e revacinados anualmente com vacina anti-leptospirose polivalente contendo os sorovares Canicola, Icterohaemorrhagiae, Grippotyphosa e Pomona foram revacinados com a mesma vacina e aos 30 dias da revacinação foram submetidos aos testes de soroaglutinação microscópica (SAM) e de inibição do crescimento de leptospiras in vitro (TICL), para avaliação comparativa dos níveis de anticorpos produzidos para os sorovares Canicola, Icterohaemorrhagiae e Copenhageni. Os resultados obtidos indicaram que a imunidade conferida pela vacina para o sorovar Icterohaemorrhagiae é mais duradoura que a observada para o sorovar Canicola, já que títulos de anticorpos neutralizantes >1,0 log10 foram observados antes do reforço vacinal não havendo substancial aumento após a revacinação. Quanto ao sorovar Canicola, a revacinação resultou em considerável aumento do título de anticorpos neutralizantes quando comparado ao momento anterior a revacinação (p=0,001). A análise dos valores encontrados após a revacinação demonstrou claramente que cães revacinados com bacterina produzida com o sorovar Icterohaermorrhagiae não apresentam aumento do título de anticorpos inibidores do crescimento contra o sorovar Copenhageni, em nível suficiente para inibir o crescimento de leptospiras. Apesar disso, os títulos de anticorpos inibidores de crescimento anti-Copenhageni encontrados antes e após a revacinação demonstraram que, pelo menos certo grau de proteção contra a infecção por esse sorovar pode ser esperado para os cães vacinados com bacterinas do sorovar Icterohaemorrhagiae, não sendo, no entanto, uma proteção cruzada completa.

Currently, the serovar Copenhageni is the representative of serogroup Icterohaemorrhagiae maintained in synanthropic rodents found most frequently in dogs and humans in metropolitan areas of Brazil. Despite some authors have suggested the existence of cross-protection between serovars included in the same serogroup, this condition has not yet been sufficiently clarified for serovars Icterohaemorrhagiae and Copenhageni. In the present work, 2 to 6-year-old dogs, vaccinated at 60, 90 and 120 days of age and thereafter, revaccinated annually with commercial vaccine containing Canicola, Icterohaemorrhagiae, Grippotyphosa and Pomona bacterins were evaluated as to the immune status against leptospirosis before and 30 days after revaccination. Mycroscopic agglutination test (MAT) and in vitro growth inhibition test (GIT) were performed to search for agglutinating anti-Leptospira antibodies and neutralizing anti-Leptospira antibodies, respectively for serovars Canicola and Icterohaemorrhagiae, and additionally, for serovar Copenhageni, not included in the vaccine. The results showed that the immunity conferred by the vaccine to serovar Icterohaemorrhagiae is more lasting than that observed for serovar Canicola, since neutralizing antibody titers >1.0 log10 were observed before the booster vaccination with no substantial increase after revaccination. As for the serovar Canicola, revaccination resulted in a considerable increase in neutralizing antibody titer when compared to the one observed previously to the revaccination (p=0.001). The analysis of the data obtained by GIT allowed us to conclude that dogs given vaccine containing Icterohaemorrhagiae bacterin did not produce neutralizing antibodies against serovar Copenhageni enough to inhibit leptopiral growth at the same level as occurred for the homologous serovar. Despite this, the GIT titer found for serovar Copenhageni before and after revaccination showed that at least, some level of protection could be expected for dogs vaccinated with serovar Icterohaemorrhagiae bacterin, not a complete cross protection.

Molecular characterization of virulent Leptospira interrogans serogroup icterohaemorrhagiae isolated from Cavia aperea.

Leptospirosis is a worldwide zoonotic infection caused by pathogenic Leptospira. Synanthropic rodents are recognized carriers of leptospires; however, the role of wild rodents in the epidemiology of the disease is still incipient. In this work, we describe Leptospira strain isolated from Cavia aperea (Brazilian guinea pig). The isolated strain was characterized by partial rpoB gene sequencing, variable-number tandem-repeats and histopathological analysis. The strain was identified as Leptospira interrogans, serogroup Icterohaemorrhagiae and caused clinical signs of leptospirosis in the hamster model, attesting to its virulence. In conclusion, these findings could be useful for elucidating the epidemiological role of C. aperea in leptospirosis.

Characterization of a virulent Leptospira interrogans strain isolated from an abandoned swimming pool

Pathogenic Leptospira spp. are the etiological agents of leptospirosis, an important disease of both humans and animals. In urban settings, L. interrogans serovars are the predominant cause of disease in humans. The purpose of this study was to characterize a novel Leptospira isolate recovered from an abandoned swimming pool. Molecular characterization through sequencing of the rpoB gene revealed 100% identity with L. interrogans and variable-number tandem-repeat (VNTR) analysis resulted in a banding pattern identical to L. interrogans serogroup Icterohaemorrhagiae, serovar Copenhageni or Icterohaemorrhagiae. The virulence of the strain was determined in a hamster model of lethal leptospirosis. The lethal dose 50% (LD50) was calculated to be two leptospires in female hamsters and a histopathological examination of infected animals found typical lesions associated with severe leptospirosis, including renal epithelium degeneration, hepatic karyomegaly, liver-plate disarray and lymphocyte infiltration. This highly virulent strain is now available for use in further studies, especially evaluation of vaccine candidates.

[Epidemiological surveillance of leptospirosis on Reunion Island in 2004-2008: possible impact of Chikungunya infection on the case fatality rate of leptospirosis]. / Surveillance épidémiologique de la leptospirose à la Réunion, 2004-2008: possible impact de l'épidémie de chikungunya sur la létalité de la leptospirose.

In 2006, increased mortality due to leptospirosis in Reunion Island had alerted the authorities and justified the conduct of this study in order to update knowledge on the epidemiology of leptospirosis, whereas the latest epidemiological data published on the disease dated back to 2003. This study followed the scheme of a descriptive retrospective survey based on data from reporting and investigation of hospitalized cases of leptospirosis that occurred in Reunion between the 1st January 2004 and 31st December 2008. Data from the National Reference Center (NRC) have also been used. The annual number of reported cases (40 to 50) was stable over the period, which contrasted with the historical decreasing trend of incidence reported by the NRC. The circumstances of exposure were those usually associated with the disease on the island: about 80% of cases were infected between January and June, during the wet season; the main exposure factor identified was the practice of agriculture, declared or not; Leptospira icterohaemorrhagiae remained the most frequently isolated serovar, although regressing. Finally, our study has shown that excess mortality observed in 2006 did not result from an increased incidence but from a rise in the case fatality rate. This could be linked to the outbreak of chikungunya, which peaked in February 2006. In endemic areas of leptospirosis, health professionals should remain aware of the risk of occurrence of fatal cases during arbovirosis outbreaks.

Isolation of Leptospira interrogans from suburban rats in Tandil, Buenos Aires, Argentina.

The main objective of this study was to investigate the role of wild rodents as Leptospira spp. reservoirs in a suburban area of Tandil city, Buenos Aires province (Argentina), where a person had died due to pulmonary leptospirosis. The specific objectives were: to estimate the rodent density near the patient's home, to determine the serological prevalence and isolation of leptospirosis from wild rodents, and to identify the isolated strains. The area examined was a suburban neighbourhood in Tandil near the Langueyú stream, where the patient's house is located. Rattus norvegicus were trapped on the stream banks during two nights and a high capture rate (70%), was obtained. All rats (42) were examined serologically by the microscopic agglutination test (MAT), and 22 of them (52.3%) reacted with Leptospira serovars castellonis, canicola, grippotyphosa, icterohaemorrhagiae and hebdomadis at a titer of 1:50. The kidneys from 25 animals were cultured, and 24 isolates of L. interrogans (96%) were obtained. The isolated strains were identified as Icterohaemorrhagiae serogroup by MAT performed with rabbit hyperimmune reference sera. These findings showed a high density of suburban rodents highly infected with pathogenic leptospira, sharing environment in close contact with humans with evidence of leptospiral disease.

Characterization of Leptospira borgpetersenii isolates from field rats (Rattus norvegicus) by 16S rRNA and lipL32 gene sequencing

The main goal of this study was to evaluate the prevalence of leptospirosis among field rodents of Tiruchirappalli district, Tamil Nadu, India. In total 35 field rats were trapped and tested for seroprevalence by the microscopic agglutination test (MAT). Isolation of leptospires was performed from blood and kidney tissues and characterized to serovar level. Genomospecies identification was carried out using 16S rRNA and lipL32 gene sequencing. The molecular phylogeny was constructed to find out species segregation. Seroprevalence was about 51.4 percent, and the predominant serovars were Autumnalis, Javanica, Icterohaemorrhagiae and Pomona. Two isolates from the kidneys were identified as serovar Javanica of Serogroup Javanica, and sequence based molecular phylogeny indicated these two isolates were Leptospira borgpetersenii.

Severe leptospirosis in hospitalized patients, Guadeloupe.

We evaluated prognostic factors for leptospirosis in 168 consecutive hospitalized patients in Guadeloupe. Factors independently associated with severity included chronic hypertension or chronic alcoholism, late initiation of antibacterial therapy, abnormal chest auscultation results, icterus, oligoanuria, disorders of consciousness, elevated aspartate aminotransferase levels, hyperamylasemia, and Leptospira interrogans serovar Icterohemorrhagiae.