Outbreak Of Leptospirosis Research Articles

Extreme Weather Events and Pathogen Pollution Fuel Infectious Diseases: The 2024 Flood-Related Leptospirosis Outbreak in Southern Brazil and Other Red Lights

Extreme Weather Events and Pathogen Pollution Fuel Infectious Diseases: The 2024 Flood-Related Leptospirosis Outbreak in Southern Brazil and Other Red Lights

Identification of rodent species confirmed as the cause of leptospirosis disease, along with ecosystem distribution and environmental factors

Background: Leptospirosis outbreaks have been reported in various parts of the world, classifying it as a re-emerging infectious disease. Rats act as the main reservoir for Leptospira spp. bacteria. The Indonesian Ministry of Health reported 1,170 cases of leptospirosis with 106 deaths Case Fatality Rate (CFR 9.1%) in 2020, obtained from 8 provinces. Additionally, in 2021, there was a decrease in cases by 734, but with an increased CFR of 11.4%, with the largest contributors being Central Java and East Java. Objective: To determine the most dominant rodent species confirmed to cause leptospirosis and the distribution of ecosystems and environmental factors that are the dominant causes of leptospirosis. Method: This paper is a narrative literature review study. Articles were searched through online databases such as Google Scholar and PubMed using keywords leptospirosis, rats, ecosystem, and environmental factors, published within the last 5 years. Findings: The identification results showed that Bandicota indica was the most dominant rodent species infected with leptospirosis. This type of rat is a commensal species. Leptospirosis cases occurred in non-forest ecosystems near settlements and coastal areas near settlements. The dominant environmental factors associated with leptospirosis incidence were poor sanitation conditions, indiscriminate waste disposal behavior, and stagnant water. Conclusion: The identification results indicate that Bandicota indica is the most dominant rodent species infected with leptospirosis, being a commensal rat species in non-forest ecosystems near settlements and coastal areas near settlements. The dominant environmental factors associated with leptospirosis incidence include poor sanitation conditions, indiscriminate waste disposal behavior, and stagnant water. Novelty/Originality of this Study: The study's findings confirmed that non-forest and coastal ecosystems near settlements are significant reservoirs for Leptospira bacteria. Additionally, it highlighted the critical role of poor sanitation, indiscriminate waste disposal, and stagnant water as environmental factors contributing to the transmission of leptospirosis.

Re-Emerging, Under-Recognized Zoonotic, and Neglected Tropical Diseases in Hawai'i.

Hawai'i, the United States' most western geographic state in the Pacific, lies between the North and South American continents and the Indo-Pacific regions, including Japan. The tropical environmental conditions of the Hawaiian Islands provide favorable ecosystems for various infectious pathogens, their vectors, and reservoirs. This creates an environment conducive to the transmission of zoonotic diseases affecting both humans and animals. Hawai'i has experienced an increase in dengue, leptospirosis, and murine typhus outbreaks. Furthermore, toxoplasmosis and neuroangiostrongyliasis cases remain prevalent throughout the state, and the putative presence of autochthonous Zika cases identified in a retrospective study may be of national public health concern. Understanding the factors that affect the transmission and distribution of zoonoses is necessary to identify at-risk locations and populations. The One Health approach seeks to understand, report, and interpret these factors and requires collaboration between private and governmental institutions. One Health should focus on neglected tropical diseases (NTD) and prioritize development of interventions to control and prevent the transmission of diseases that spread between animals and humans. This review focuses on the epidemiological and clinical characteristics of under-recognized zoonotic and NTD affecting Hawai'i, including leptospirosis, murine typhus, neuroangiostrongyliasis, toxoplasmosis, dengue, and Zika.

Estimation of economic losses due to leptospirosis in dairy cattle

There are few studies that effectively quantify the economic losses resulting from problems caused by leptospirosis in naturally infected dairy cattle. Given this gap, the objective of this study was to propose and apply a method to quantify the economic losses resulting from productive and reproductive problems in a commercial dairy herd naturally infected by Leptospira spp. For this study, the zootechnical and economic indicators at a property with Jersey cattle were analyzed during the period from 2014 to 2017. The leptospirosis outbreak occurred in 2014, and the therapeutic approach was carried out between 2015 and 2017, with the latter considered the year of control of the outbreak. The adopted integrated control strategy consisted of dividing the herd according to the serological results obtained through the microscopic agglutination test, the treatment of reagents with streptomycin, and vaccination against leptospirosis of non-reagent heifers and cows. The method used to evaluate the economic indicators of the property was the calculation of the gross margin by taking into account the implicit and explicit cost parameters associated with the manifestation of leptospirosis. The prevalence rate of leptospirosis decreased from 49.4 % in 2015 to 21.6 % in 2017. There was a reduction in the abortion rate (from 40.00 % in 2014 to 9.00 % in 2017), in the stillborn rate (from 2.63 % in 2014 to 1.69 % in 2017) and an increase in the calving rate (from 65.00 % in 2014 to 86.00 % in 2017). In addition, there were increases in the number of lactating cows (from 38 in 2014–57 in 2017) and the mean times of lactation duration, which increased from 275 days in 2014–295 days in 2017. As a result, the average annual production of milk increased from 164,655 liters in 2014–248,521 liters in 2017. In 2014, when treatment hadn’t yet started, the gross margin per liter of milk sold, considering implicit and explicit costs, was US$0.00. In 2015 and 2016, US$0.27 and US$0.30 were obtained, respectively, for this variable. In 2017, with the disease under control on the property, the gross margin per liter of milk reached US$0.36. The gross margin per liter of milk sold was higher in the period when the disease was controlled, showing losses of up to 84 % of the gross margin during the outbreak. Immediate treatment of positive cows and preventive measures had a significant impact on improving the productive and economic efficiency of the property.

Analysing the outbreaks of leptospirosis after floods in Kerala, India

A growing number of studies have linked the incidence of leptospirosis with the occurrence of flood events. Nevertheless, the interaction between flood and leptospirosis has not been extensively studied to understand the influence of flood attributes in inducing new cases. This study reviews leptospirosis cases in relation to multiple flood occurrences in Kerala, India. Leptospirosis data were obtained for three years: 2017 (non-flood year) and two years with flooding—2018 (heavy flooding) and 2019 (moderate flooding). We considered the severity of flood events using the discharge, duration and extent of each flooding event and compared them with the leptospirosis cases. The distribution of cases regarding flood discharge and duration was assessed through descriptive and spatiotemporal analyses, respectively. Furthermore, cluster analyses and spatial regression were completed to ascertain the relationship between flood extent and the postflood cases. This study found that postflood cases of leptospirosis can be associated with flood events in space and time. The total cases in both 2018 and 2019 increased in the post-flood phase, with the increase in 2018 being more evident. Unlike the 2019 flood, the flood of 2018 is a significant spatial indicator for postflood cases. Our study shows that flooding leads to an increase in leptospirosis cases, and there is stronger evidence for increased leptospirosis cases after a heavy flood event than after a moderate flooding event. Flood duration may be the most important factor in determining the increase in leptospirosis infections.

Bacterial community profiles within the water samples of leptospirosis outbreak areas.

Leptospirosis is a water-related zoonotic disease. The disease is primarily transmitted from animals to humans through pathogenic Leptospira bacteria in contaminated water and soil. Rivers have a critical role in Leptospira transmissions, while co-infection potentials with other waterborne bacteria might increase the severity and death risk of the disease. The water samples evaluated in this study were collected from four recreational forest rivers, Sungai Congkak, Sungai Lopo, Hulu Perdik, and Gunung Nuang. The samples were subjected to next-generation sequencing (NGS) for the 16S rRNA and in-depth metagenomic analysis of the bacterial communities. The water samples recorded various bacterial diversity. The samples from the Hulu Perdik and Sungai Lopo downstream sampling sites had a more significant diversity, followed by Sungai Congkak. Conversely, the upstream samples from Gunung Nuang exhibited the lowest bacterial diversity. Proteobacteria, Firmicutes, and Acidobacteria were the dominant phyla detected in downstream areas. Potential pathogenic bacteria belonging to the genera Burkholderiales and Serratia were also identified, raising concerns about co-infection possibilities. Nevertheless, Leptospira pathogenic bacteria were absent from all sites, which is attributable to its limited persistence. The bacteria might also be washed to other locations, contributing to the reduced environmental bacterial load. The present study established the presence of pathogenic bacteria in the river ecosystems assessed. The findings offer valuable insights for designing strategies for preventing pathogenic bacteria environmental contamination and managing leptospirosis co-infections with other human diseases. Furthermore, closely monitoring water sample compositions with diverse approaches, including sentinel programs, wastewater-based epidemiology, and clinical surveillance, enables disease transmission and outbreak early detections. The data also provides valuable information for suitable treatments and long-term strategies for combating infectious diseases.

Climate-driven models of leptospirosis dynamics in tropical islands from three oceanic basins.

Leptospirosis is a neglected zoonosis which remains poorly known despite its epidemic potential, especially in tropical islands where outdoor lifestyle, vulnerability to invasive reservoir species and hot and rainy climate constitute higher risks for infections. Burden remains poorly documented while outbreaks can easily overflow health systems of these isolated and poorly populated areas. Identification of generic patterns driving leptospirosis dynamics across tropical islands would help understand its epidemiology for better preparedness of communities. In this study, we aim to model leptospirosis seasonality and outbreaks in tropical islands based on precipitation and temperature indicators. We adjusted machine learning models on leptospirosis surveillance data from seven tropical islands (Guadeloupe, Reunion Island, Fiji, Futuna, New Caledonia, and Tahiti) to investigate 1) the effect of climate on the disease's seasonal dynamic, i.e., the centered seasonal profile and 2) inter-annual anomalies, i.e., the incidence deviations from the seasonal profile. The model was then used to estimate seasonal dynamics of leptospirosis in Vanuatu and Puerto Rico where disease incidence data were not available. A robust model, validated across different islands with leave-island-out cross-validation and based on current and 2-month lagged precipitation and current and 1-month lagged temperature, can be constructed to estimate the seasonal dynamic of leptospirosis. In opposition, climate determinants and their importance in estimating inter-annual anomalies highly differed across islands. Climate appears as a strong determinant of leptospirosis seasonality in tropical islands regardless of the diversity of the considered environments and the different lifestyles across the islands. However, predictive and expandable abilities from climate indicators weaken when estimating inter-annual outbreaks and emphasize the importance of these local characteristics in the occurrence of outbreaks.

Risk of human leptospirosis in Colombia: spatiotemporal analysis and related hydroclimatic factors.

Leptospirosis is an endemic zoonosis in tropical areas that is mainly related to rural activities; nevertheless, human leptospirosis (HL) outbreaks differ among regions. In Colombia, HL notifications are mandatory. Our objective was to determine the spatiotemporal distribution of HL in Colombia during 2007-2018 and its relationship with the main hydroclimatic variables. We determined the estimated incidence and lethality of HL according to department and year. The Bayesian spatiotemporal analysis of an autoregressive model (STAR) model included HL cases and hydroclimatic factors (average temperature, rainfall and relative humidity) for quarterly periods. During the study period, 10 586 HL cases were registered (estimated incidence: 1.75 cases x 105) and 243 deaths by HL (lethality 2.3%). The STAR model found association of HL risk with temperature (RR:6.80; 95% CI 3.57 to 12.48) and space. Quindío and three other Amazonian departments (Guainía, Guaviare and Putumayo) had a positive relationship with a significant number of HL cases, adjusted for quarterly precipitation and humidity. Spatial analysis showed a high risk of HL in departments of the western Andean Colombian regions. By contrast, in the spatiotemporal model, a higher HL risk was associated with temperature and departments of the North Colombian Amazon regions and Quindío in the Colombian Andean region.

Risk Factors for Leptospirosis in Rural Communities of Bungoma County, Kenya: A Cross Sectional Survey

Leptospirosis is an important re-emerging zoonosis of worldwide public health concern. Leptospirosis is caused by a bacteria of the genus Leptospira. There was an outbreak of leptospirosis in humans in Bungoma County in 2004 with severe consequences. Leptospirosis is enzootic in cattle in Bungoma County. This study was conducted to determine the risk factors for leptospirosis in humans in Bungoma County. The risk factors considered in this study were; rainfall patterns, livestock management practices (grazing and watering system), home slaughter of livestock, consumption of un-inspected meat, rodent infestation in homes, and frequency of contact of livestock keepers with veterinary extension staff. A cross-sectional survey was carried out in Kimilili and Mt Elgon sub-counties of Bungoma County, Kenya. The study was conducted between April and July of 2017. The locations were then sampled, and 400 households selected using a systematic random sampling technique. Questionnaires were administered to heads of the identified households. Descriptive statistics and the chi-square test were used to analyze the data. Secondary data from medical records in Kimilili and Webuye health facilities were taken to show the disease trends in the year 2004. The study reveals the risk factors for leptospirosis in Bungoma County which include the close association of the community and their livestock (87.9%, n=400), rodent infestation in homes (92.3%, n=400), slaughter of animals in non-designated areas (83.8%, n=400), consumption of un-inspected meat (83.0%, n=400) and low contact of the population with veterinary extension staff (63.7%, n=400). The risk factors under consideration in this study were observed in over 80% of the study population. The study recommends that knowledge of leptospirosis and its risk factors be enhanced for effective control and prevention program.

Fatal leptospirosis in endangered Barbary macaques (Macaca sylvanus) kept in captivity: Assessing the role of sympatric rodents

Between December 2020 and January 2021, an outbreak of acute mortality in endangered Barbary macaques (Macaca sylvanus) kept in captivity was detected in a zoo in Spain. The main findings observed in the two fatally affected animals at post-mortem evaluation were jaundice, renal tubular necrosis and interstitial nephritis. Leptospira spp. infection was confirmed by real time PCR (qPCR) in different tissues in both individuals. Analyses of secY gene from a positive individual showed 100% homology with a previously published sequence corresponding to Leptospira interrogans serovar Copenhageni. Free-living sympatric brown rats (Rattus norvegicus) from the affected zoo were also analyzed, and showed a prevalence and seroprevalence of Leptospira spp. of 18.2% (4/22; 95% CI: 2.1–34.3) and 41.9% (26/62; 95% CI: 29.7–54.2), respectively. We detected seropositive sera to five different serovars of Leptospira spp. (Copenhageni, Grippotyphosa, Pomona, Canicola and Hardjo) in the rodent population, with L. Copenhageni being the predominant one. This study describes for first time an outbreak of fatal leptospirosis in captive non-human primates in Europe. Our results show that Barbary macaques, an endangered species, are highly susceptible to Leptospira spp. infection, with sympatric wild rodents being the most likely reservoir animals involved in transmission in this outbreak. Our results suggest that rodent control could be an effective measure for minimizing exposure to Leptospira spp. in zoological collections. Given the potential implications for conservation, animal and public health, non-human primates and rodents should be included in surveillance programs for Leptospira spp. in zoos.

Drivers of human Leptospira infection in the Pacific Islands: A systematic review.

Leptospirosis is a bacterial zoonosis that poses an increasing global public health risk. Pacific Island communities are highly vulnerable to leptospirosis outbreaks, yet the local drivers of infection remain poorly understood. We conducted a systematic review to identify the drivers of human Leptospira infection in the Pacific Islands. There were 42 included studies from which findings were synthesized descriptively. In tropical Pacific Islands, infections were a product of sociodemographic factors such as male gender/sex, age 20 to 60 years, Indigenous ethnicity, and poverty; lifestyle factors such as swimming, gardening, and open skin wounds; and environmental factors, including seasonality, heavy rainfall, and exposure to rodents, cattle, and pigs. Possible mitigation strategies in these islands include strengthening disease reporting standards at a regional level; improving water security, rodent control, and piggery management at a community level; and information campaigns to target individual-level drivers of infection. By contrast, in New Zealand, exposures were predominantly occupational, with infections occurring in meat and farm workers. Accordingly, interventions could include adjustments to occupational practices and promoting the uptake of animal vaccinations. Given the complexity of disease transmission and future challenges posed by climate change, further action is required for leptospirosis control in the Pacific Islands.

Genomics data of L. borgpetersenii strain HP364 and L. weilii strain SC295 isolated from rodents captured from human leptospirosis outbreak areas in Selangor, Malaysia.

We report complete genome sequences of two Leptospira isolates, Leptospira borgpetersenii strain HP364 and Leptospira weilii strain SC295. The genome sizes of L. borgpetersenii strain HP364 and L. weilii strain SC295 were 3,874,738 bp and 4,063,712 bp, respectively. Both genomes have been deposited in NCBI GenBank.

An investigation of geographical clusters of leptospirosis during the outbreak in Pangandaran, West Java, Indonesia.

Leptospirosis is neglected in many tropical developing countries, including Indonesia. Our research on this zoonotic disease aimed to investigate epidemiological features and spatial clustering of recent leptospirosis outbreaks in Pangandaran, West Java. The study analysed data on leptospirosis notifications between September 2022 and May 2023. Global Moran I and local indicator for spatial association (LISA) were applied. Comparative analysis was performed to characterise the identified hotspots of leptospirosis relative to its neighbourhoods. A total of 172 reported leptospirosis in 40 villages from 9 sub-districts in Pangandaran District were analysed. Of these, 132 cases (76.7%) were male. The median age was 49 years (interquartile range [IQR]: 34-59 years). Severe outcomes including renal failure, lung failure, and hepatic necrosis were reported in up to 5% of the cases. A total of 30 patients died, resulting in the case fatality rate (CFR) of 17.4%. Moran's I analysis showed significant spatial autocorrelation (I=0.293; p=0.002) and LISA results identified 7 High-High clusters (hotspots) in the Southwest, with the total population at risk at 26,184 people. The hotspots had more cases among older individuals (median age: 51, IQR: 36-61 years; p<0.001), more farmers (79%, p=0.001) and more evidence of the presence of rats (p=0.02). A comprehensive One Health intervention should be targeted towards these high-risk areas to control the transmission of leptospirosis. More empirical evidence is needed to understand the role of climate, animals and sociodemographic characteristics on the transmission of leptospirosis in the area studied.

Analysis of Leptospirosis transmission dynamics with environmental effects and bifurcation using fractional-order derivative

Mathematical formulations are essential tool to show the dynamics that how various diseases spread in the community. Differential equations with fractional or integer order can be utilized to see the effect of the dynamics direct or indirect Leptospirosis transmission, which are analyzed with different aspects. A mathematical description and dynamical sketch of Leptospirosis with environmental effects have been studied as a result of the successful efforts of various writers. In this study, we analyzed the Leptospirosis model described using a nonlinear fractional-order differential equation that takes the environmental effects into consideration. The proposed fractional order system is investigated qualitatively as well as quantitatively to identify its stable position. Local stability of the Leptospirosis system is verified and test the system with flip bifurcation. Also system is investigated for global stability using Lyapunov first and second derivative functions. The existence, boundedness and positivity of the Leptospirosis is checked, which are the key properties for such of type of epidemic problem to identify reliable findings. Effect of global derivative is demonstrated to verify its rate of effects according to their sub-compartments. Solutions for fractional order system are derived with the help of advanced tool fractal fractional operator for different fractional values. Simulation are carried out to see symptomatic as well as a asymptomatic effects of Leptospirosis in the world wide, also show the actual behavior of Leptospirosis which will be helpful to understand the outbreak of Leptospirosis with environmental effects as well as for future prediction and control strategies.

Leptospiral uveitis- "Transition 'from epidemic to endemic form" difficulties in laboratory confirmations.

Leptospirosis is a waterborne zoonotic disease that primarily causes systemic illness, followed by uveitis. After heavy flooding in Madurai district, an epidemic outbreak of systemic and ocular leptospirosis occurred in 1994. Our data shows a transition to endemicity after each epidemic. The aim of this study is to report the clinical signs, epidemic outbreaks, and persistent endemicity of leptospiral uveitis, as well as the diagnostic dilemmas associated with it. A retrospective analysis of clinical signs was conducted using medical records of leptospiral uveitis patients over a period of 27 years (1994-2020) in a tertiary care eye hospital. The clinical workup of uveitis included a detailed clinical history, systemic, and ophthalmic examination. Microagglutination tests (MATs) was done at the Centers for Disease Control and Prevention (CDC) in Atlanta and later in our regional laboratory. Serum samples were collected from human systemic leptospirosis cases and a small group of animals in and around Madurai. The first epidemic outbreak resulted in 200 seropositive patients. Subsequent epidemic outbreaks occurred in 1997, 1998, 2001, 2005, and 2012, with Madurai experiencing multiple outbreaks. However, the disease remained endemic, with 25-50 patients being observed per year in between the peaks. Ocular examination revealed acute non-granulomatous uveitis (94.9%), pan uveitis (59.8%), vitreous inflammatory reaction (55.4%), retinal vasculitis (29.5%), disc hyperemia (20.9%), and hypopyon. (16.2%). New serovars emerged every year, resulting in decreased sensitivity of the MAT. Over time, the MAT started to miss diagnoses. The persistent endemicity of leptospiral uveitis emphasizes the need for accessible diagnostic tests. The low performance of the MAT can be attributable to the use of an older panel. The incorporation of new isolates in the MAT by a national laboratory will improve the accuracy of diagnosis.

Detection of Leptospira wolffii in Water and Soil on Livestock Farms in Kelantan After a Massive Flood

Pathogenic leptospires cause leptospirosis in both animals and humans around the world. Humans can be infected by leptospires through direct contact with infected animals or indirect contact with leptospires contaminated water or soil. Outbreaks of leptospirosis usually occur after heavy rainfall and flooding, particularly in endemic areas. The aim of this study was to detect the presence of leptospires in water and soil in livestock farms after a massive flood in Kelantan. Samples were collected from 28 livestock farms in Kelantan, comprising 62 water samples and 62 soil samples, respectively. The samples were filtered and inoculated into a semisolid EMJH medium containing 5-FU for the isolation of Leptospira spp. The Leptospira spp. isolates were then identified using classical methods (1M NaCl, 8-azaguanine, and 13 °C), serology (MAT), multiplex polymerase chain reaction (mPCR), and DNA sequencing. The classical identification methods showed varying results and failed to differentiate between pathogenic and non-pathogenic leptospires. MAT showed the isolates reactions against serovars Autumnalis, Hebdomadis, Pyrogenes, Bataviae, Patoc, and Wolffii. However, mPCR showed that all isolates were non-pathogenic Leptospira spp. Further identification using DNA sequencing found that all isolates were identified as Leptospira wolffii, an intermediate species of Leptospira. The presence of L. wolffii in water and soil provides evidence that this species is circulating in the environment and could potentially transmit to humans and animals.

Presence of Leptospira spp. in a Mosaic of Wetlands Used for Livestock Raising under Differing Hydroclimatic Conditions.

Knowledge about the life cycle and survival mechanisms of leptospires in the environment is scarce, particularly regarding the environmental factors associated with their presence in ecosystems subject to livestock farming, where precipitation, seasonal floods, and river overflows could act as facilitators of leptospire dispersion. This study aimed to identify and study the presence of Leptospira spp. in the Lower Delta of the Paraná River and describe the physical, chemical, and hydrometeorological conditions associated with their presence in wetland ecosystems impaired by livestock raising intensification. Here, we show that the presence of Leptospira was determined mainly by water availability. We detected the species Leptospira kmetyi, L. mayottensis, and L. fainei and successfully cultured the saprophytic species L. meyeri from bottom sediment, suggesting the association of leptospires with microbial communities of the sediment's biofilm to enhance its survival and persistence in aquatic environments and adapt to changing environmental conditions. Knowledge of Leptospira sp. diversity in wetlands and the impact of climate variability on the transmission of these organisms is crucial for predicting and preventing leptospirosis outbreaks in the context of human health. IMPORTANCE Wetlands are environments that are often conducive to the survival and transmission of Leptospira because they provide a suitable habitat for the bacteria and are often home to many animal species that can act as reservoirs for leptospirosis. Bringing humans and animals into closer contact with contaminated water and soil and increased frequency and intensity of extreme weather events may further exacerbate the risk of leptospirosis outbreaks, which is mostly relevant in the context of climate change and a widespread intensification of productive activities, particularly in the Lower Delta of the Paraná River. The detection of leptospiral species in wetland ecosystems impaired by livestock raising intensification can help to identify propitious environmental factors and potential sources of infection, develop preventive measures, and plan for appropriate responses to outbreaks, ultimately improving public health outcomes.

Towards a leptospirosis early warning system in northeastern Argentina

Leptospirosis is a zoonotic disease with a high burden in Latin America, including northeastern Argentina, where flooding events linked to El Niño are associated with leptospirosis outbreaks. The aim of this study was to evaluate the value of using hydrometeorological indicators to predict leptospirosis outbreaks in this region. We quantified the effects of El Niño, precipitation, and river height on leptospirosis risk in Santa Fe and Entre Ríos provinces between 2009 and 2020, using a Bayesian modelling framework. Based on several goodness of fit statistics, we selected candidate models using a long-lead El Niño 3.4 index and shorter lead local climate variables. We then tested predictive performance to detect leptospirosis outbreaks using a two-stage early warning approach. Three-month lagged Niño 3.4 index and one-month lagged precipitation and river height were positively associated with an increase in leptospirosis cases in both provinces. El Niño models correctly detected 89% of outbreaks, while short-lead local models gave similar detection rates with a lower number of false positives. Our results show that climatic events are strong drivers of leptospirosis incidence in northeastern Argentina. Therefore, a leptospirosis outbreak prediction tool driven by hydrometeorological indicators could form part of an early warning and response system in the region.

Outbreak of leptospirosis amidst COVID'19 in Tanzania: a new threat? Short communication.

As the world is still fighting to combat the coronavirus disease 2019 (COVID-19) virus, the United Republic of Tanzania has been confronting yet another bacterial infection called leptospirosis (LS). It is caused by the spirochete bacteria of genus Leptospira, and has been known to infect several people, already claiming a number of lives. It infects 1 million people annually with ~60000 deaths having a fatality rate of 6.85% worldwide. COVID has profusely burdened the healthcare system worldwide within the past 2 years; it has sabotaged medical management and brought down resources, which has now made it difficult for any country to withstand another pandemic. LS has overburdened the medical care system of Tanzania abjectly; it is now imperative not to overlook environmental factors, like a flood, the presence of rodents, unsatisfactory socioeconomic conditions in areas where dogs reside, substandard wastewater and garbage disposal facilities, or any other factor which might lead to further spread of LS and put Tanzania in jeopardy.

Recent leptospirosis outbreak: an urgent warning around the globe, genomic features, diagnosis, and treatment procedures-correspondence.

Recent leptospirosis outbreak: an urgent warning around the globe, genomic features, diagnosis, and treatment procedures-correspondence.