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Leptospira interrogans serovars hardjo and pomona: causes of infections in dairy cows and humans in Florida.

Leptospirosis was diagnosed in 11 milkers on 3 dairy farms in a Florida county. Serologic test results identified Leptospira interrogans serovar hardjo as the infecting organism in milkers and cows on one farm, and hardjo was isolated from two cows. On the second farm, serovars hardjo and pomona were implicated serologically in the cows and milkers, and pomona was isolated from two milkers. On the third farm, hardjo infection was identified by serologic tests in one milker, and hardjo was isolated from another.This was the first isolation of hardjo from a human being reported in the United States. Leptospiral infection is an occupational hazard for dairy milkers in some areas of the United States. Thus, the authors recommend that preventive measures should be taken. These measures should include boots and other protective clothing and protection from urine spray for the eyes and nose.

Adolescent↗

Outbreak of leptospirosis with pulmonary involvement in north Andaman.

An outbreak of acute febrile illness with haemorrhagic manifestations and pulmonary involvement occurred in Diglipur of North Andaman during October-November 1993. Investigations were carried out to see whether leptospires were responsible for this outbreak. Serum samples were collected from suspected cases and tested for presence of antibodies to leptospires by microscopic agglutination test (MAT) using a battery of 19 antigens representing 16 serogroups. 66.7 per cent of the specimens showed significant titres of antibodies against leptospires, 18 of 23 paired sera (78.3%) showed sero-conversion or four-fold rise in antibody titres. The commonest serovar involved was Leptospira grippotyphosa followed by L. canicola and L. JEZ bratislava. In 7 patients L. grippotyphosa was the sole serovar against which antibodies were detected. Clinical and epidemiological observations of this outbreak were similar with that of earlier seasonal outbreaks of acute febrile illness with haemorrhagic manifestations occurring in the same area, indicating that the past outbreaks may also have been due to leptospires. This is the first report of pulmonary leptospirosis from India.

Disease Outbreaks↗

Preliminary evaluation of antimicrobial agents for treatment of Leptospira interrogans serovar pomona infection in hamsters and swine.

OBJECTIVE: To evaluate antimicrobial agents for treatment of models of acute and persistent leptospirosis caused by Leptospira interrogans serovar pomona. DESIGN: Randomized trials comparing dosages and regimens of various antimicrobial agents for treatment of acute and persistent leptospirosis. ANIMALS: 245 Golden hamsters to model acute leptospirosis and 121 mixed-breed swine to model persistent leptospirosis. PROCEDURE: Hamsters and swine were inoculated with L interrogans serovar pomona. Antimicrobial agents were given to hamsters for 3 or 5 days after inoculation, with necropsy at 14 days after inoculation. Swine were treated for 1, 3, or 5 days beginning at 3 weeks after inoculation, and were necropsied 7 to 10 days after completion of antimicrobial agent treatment. Hamster tissue and swine tissue and urine specimens were examined by culture, fluorescent antibody testing, and histologic examination for presence of leptospires. RESULTS: All untreated control hamsters became infected and manifested clinical signs and lesions of acute leptospirosis. Leptospires were not detected in hamsters treated with dihydrostreptomycin/penicillin G (25 mg/kg of body weight). Administration of ampicillin at all dosages reduced the number of hamsters infected, as confirmed at necropsy; the other agents tested required dosages greater than label recommendations to reduce the number infected. All untreated control swine became infected and shed leptospires in urine through the time of necropsy. Leptospires were not detected in kidneys or urine of swine treated with dihydrostreptomycin/penicillin G (25 mg/kg) for 1, 3, or 5 days, or in swine treated with oxytetracycline (40 mg/kg for 3 or 5 days), tylosin (44 mg/kg for 5 days), or erythromycin (25 mg/kg for 5 days). Treatment with ceftiofur and ampicillin was not effective in elimination of L interrogans serovar pomona in swine. CONCLUSIONS: Dihydrostreptomycin/penicillin G is effective for treatment of acute and persistent leptospirosis. Differences between the effectiveness of antimicrobial agents in the acute and persistent model of leptospirosis emphasize the importance of using the appropriate model for treatment evaluation. Antimicrobial agents evaluated for treatment of persistent leptospirosis in swine required the use of dosages above those recommended by the manufacturer. CLINICAL RELEVANCE: Use of antimicrobial agents at extra-label dosages for treatment of persistent leptospirosis may cause residue problems in food animals; however, these regimens may be useful for treatment of breeding stock or animals destined for import/export.

Animals↗

Leptospirosis as an animal and public health problem in Latin America and the Caribbean area.

As a major livestock disease, leptospirosis cuts significantly into the world's supply of animal protein through its consequences of abortion and calf mortality, retarded growth, and reduced milk production. Evidently, such losses have severe economic implications as well. The disease's impact has been somewhat diminished in the developed countries thanks to mechanization of rural activities, improved personal and environmental hygiene, and broad application of preventive measures, including the administration of bacterins, in domestic animals. Still, even in these circumstances it remains a serious problem. In the developing countries, in which large percentages of the population live in close contact with animals, the spread of infection is much greater. Moreover, the ecology of tropical and subtropical America--with its abundant rainfall, natural water courses, and high temperatures--is particularly favorable for the transmission of leptospires. In such conditions the human disease is a growing threat as well. The spread of leptospirosis, both in animals and man, is facilitated by the fact that inefection from many of the serotypes can exist without presenting serious clinical manifestations. Hence the importance of laboratory diagnosis. Systematic studies over time of serotype distribution, coupled with wide and improved surveillance, will be a key factor in bringing the disease under control. According to the limited seroepidemiologic data available, 3 to 18 per cent of the general human population, 2 to 32 per cent of those belonging to exposed occupational groups, and 10 to 50 per cent of patients with fever of unknown origin have leptospiral antibody. The most predominant serogroups are Icterohaemorrhagiae, Canicola, Pomona, Hebdomadis, and Bataviae. So far more than 50 serotypes, from 15 serogroups, have been isolated from man and animals in Latin America and the Caribbean area.

Animals↗

[Review of the incidence of antibodies to various serological groups of the species Leptospira interrogans in a number of farm animals in the Netherlands (author's transl)].

Report on the results of serological studies on the species Leptospira interrogans in cattle (19,607), swine (6,348), dogs (182) and horses (88) from the Netherlands during the period from 1969 to 1974. Living cultures of the serotypes of pomona, icterohaemorrhagiae, canicola, guidae (Tarassovi serological group), grippotyphosa and sejroe were used as antigen in the micro-agglutination test. The numerical findings showed that antibodies to serotypes of the species Leptospira interrogans were present in 7.67 per cent of the cattle, 22.21 per cent of the pigs, 36.81 per cent of the dogs and 92.05 per cent of the horses studied. Infection with the serotypes of icterohaemorrhagiae and grippotyphosa was most common in cattle and horses, icterohaemorrhagiae and tarassovi were most common in swine and icterohaemorrhagiae and canicola were most common in dogs. The presence of pomona is not a factor in the Netherlands. In view of statistical findings, grippotyphosa infections in cattle may be assumed to result in abortion.

Abortion, Septic↗

[Icteric Fort Bragg fever: a case report with nosological discussion].

INTRODUCTION: Ictero-hemorrhagic leptospirosis is an endemic disease in France. Weil's disease, a form of leptospirosis, is well known. Fort Bragg fever is characterized by a constant pretibial papular lesion. First described in the USA, this non icteric form of leptospirosis is usually benign. We report the first French case of a mixed form of leptospirosis. EXEGESIS: A 52-year-old man living in South East France suffered from fever and myalgias associated with a pretibial papular lesion. A severe icterus appeared and permitted a diagnosis of leptospirosis. CONCLUSION: Our case recalls the clinical presentation of Fort Bragg fever, which is recognized through its inflammatory pretibial lesion associated or not with icterus.

Anti-Bacterial Agents↗

[LEPTOSPIROSIS].

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Humans↗

Risk factors for death and changing patterns in leptospirosis acute renal failure.

The risk factors for death and changes in clinical patterns in leptospirosis (Weil's disease) have not been well studied. We retrospectively studied 110 patients with Weil's disease hospitalized in Brazil between 1985 and 1996. Univariate statistical analysis showed that nonsurvivors were older than survivors, and had higher frequency of oliguria, cardiac arrhythmia, dyspnea, and pulmonary rales. Logistic regression showed that the only independent factor associated with death was oliguria (odds ratio [OR] = 8.98). The presence of arthralgia (OR = 4.71), dehydration (OR = 6.26), dyspnea (OR = 17.7), and pulmonary rales (OR = 9.91) increased after 1994. These data suggest that in Weil's disease the clinical patterns have changed and the presence of oliguria is a risk factor for death.

Acute Kidney Injury↗