Abstract
BackgroundLeptospirosis is a major zoonotic disease with widespread distribution and a large impact on human health. Carrier animals excrete pathogenic Leptospira primarily in their urine. Infection occurs when the pathogen enters a host through mucosa or small skin abrasions. Humans and other animals are exposed to the pathogen by direct contact with urine, contaminated soil or water. While many factors influence environmental cycling and the transmission of Leptospira to humans, the load of pathogenic Leptospira in the environment is likely to play a major role. Peridomestic rats are often implicated as a potential source of human disease; however exposure to other animals is a risk factor as well. The aim of this report is to highlight the importance of various carrier animals in terms of the quantity of Leptospira shed into the environment. For this, we performed a systematic literature review and a meta-analysis of the amount of pathogen that various animal species shed in their urine.ResultsThe quantity of pathogen has been reported for cows, deer, dogs, humans, mice, and rats, in a total of 14 research articles. We estimated the average Leptospira per unit volume shed by each animal species, and the daily environmental contribution by considering the total volume of urine excreted by each carrier animal. Rats excrete the highest quantity of Leptospira per millilitre of urine (median = 5.7 × 106 cells), but large mammals excrete much more urine and thus shed significantly more Leptospira per day (5.1 × 108 to 1.3 × 109 cells).ConclusionsHere we illustrate how, in a low-income rural Ecuadorian community, host population demographics, and prevalence of Leptospira infection can be integrated with estimates of shed Leptospira to suggest that peridomestic cattle may be more important than rats in environmental cycling and ultimately, transmission to humans.
Highlights
Leptospirosis is a major zoonotic disease with widespread distribution and a large impact on human health
We focus on species-specific estimates of the amount of Leptospira shed in urine
Estimation of Leptospira quantity shed by cattle in an endemic rural community In a previous study [41] we found that 35.4% of cows living in Abdon Calderon Parish in Manabi province (Ecuador) were shedding Leptospira DNA in their urine
Summary
Leptospirosis is a major zoonotic disease with widespread distribution and a large impact on human health. Humans and other animals are exposed to the pathogen by direct contact with urine, contaminated soil or water. Peridomestic rats are often implicated as a potential source of human disease; exposure to other animals is a risk factor as well. Contact with other animals, such as livestock, is commonly regarded as an occupational, rather than peridomestic risk factor [26, 27]. Up to 65% of humans live in rural areas [30], and despite the likely importance of a diverse array of potential animal hosts and the impact of the environment, the role of rats is perhaps overrepresented in the peer-reviewed and public health literature
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