Review Article

Frequency of Animal Leptospirosis in the Southern United States and the Implications for Human Health

Authors: Tyann Blessington, PhD, MPH, Anna P. Schenck, PhD, MSPH, Jay F. Levine, DVM, MPH

Abstract

Leptospirosis is a zoonotic disease with symptoms in humans and animals, ranging from subclinical to serious and fatal. The disease occurs worldwide, but there is limited recognition of the public and animal health risks it poses in the southern United States. A systematic review of the frequency of animal leptospirosis in 17 states and jurisdictions covering the southern continental United States was performed to advance our understanding of the pathogen’s distribution and identify transmission patterns that could be targeted for prevention efforts. Fifty-two articles, spanning >100 years, met the analysis criteria. A wide range of techniques were used to measure seroprevalence and isolate the bacteria. The assessment identified exposure to Leptospira spp and Leptospira spp infection among a diverse range of species, spanning 22 animal families within 14 states, suggesting that the pathogen is distributed throughout the southern region. Disease frequency trends were assessed among animals in various habitats (all habitats, nonwild habitats, and wild habitats). The frequency of Leptospira spp detection in animals in wild habitats increased slightly over time (<0.2%/year). We identified reports of 11 human leptospirosis illness clusters and outbreaks in the southern United States. Exposure to potentially contaminated surface waters were documented for at least seven of the events, and interactions with infected or likely infected animals were documented for at least six of the events. This analysis highlights the need for stronger partnerships across the public and animal health fields to enhance diagnostics, surveillance, and reporting. The early identification of leptospirosis in animals may serve as an indicator of environmental contamination and trigger prevention measures, such as vaccinating companion animals and livestock, use of potable water, and the wearing of waterproof protective clothing near water that may be contaminated.

 

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References

1. Adler B, de la Pena Moctezuma A. Leptospira and leptospirosis. Vet Microbiol 2010;140:287-296.
2. Evangelista KV, Coburn J. Leptospira as an emerging pathogen: a review of its biology, pathogenesis and host immune responses. Future Microbiol 2010;5:1413-1425.
3. Heath CW, Jr Alexander AD, Galton MM. Leptospirosis in the United States. Analysis of 483 cases in man, 1949-1961. N Engl J Med 1965;273:857-864.
4. Mwachui MA, Crump L, Hartskeerl R, et al. Environmental and behavioural determinants of leptospirosis transmission: a systematic review. PLoS Negl Trop Dis 2015;9:e0003843.
5. Cacciapuoti B, Ciceroni L, Maffei C, et al. A waterborne outbreak of Leptospirosis. Am J Epidemiol 1987;126:535-545.
6. World Health Organization. Western Pacific. Leptospirosis. 2012; http://origin.wpro.who.int/mediacentre/factsheets/fs_13082012_leptospirosis/en/. Accessed January 4, 2020.
7. Durham BM. Leptospirosis (Pomona fever). South Med J 1966;59:272.
8. Bharti AR, Nally JE, Ricaldi JN, et al. Leptospirosis: a zoonotic disease of global importance. Lancet Infect Dis 2003;3:757-771.
9. Goldstein RE. Canine leptospirosis. Vet Clin North Am Small Anim Pract 2010;40:1091-1101.
10. Rentko VT, Clark N, Ross LA, et al. Canine leptospirosis. A retrospective study of 17 cases. J Vet Intern Med 1992;6:235-244.
11. Petrakovsky J, Bianchi A, Fisun H, et al. Animal leptospirosis in Latin America and the Caribbean countries: reported outbreaks and literature review (2002-2014). Int J Environ Res Public Health 2014;11:10770-10789.
12. Centers for Disease Control and Prevention. Leptospirosis (Leptospira interrogans) National notifiable time periods. https://wwwn.cdc.gov/nndss/conditions/leptospirosis/. Accessed January 4, 2020.
13. US Department of Agriculture-Animal and Plant Health Inspection Service. Voluntary NLRAD-NAHRS reportable disease list. https://www.aphis.usda.gov/aphis/ourfocus/animalhealth/monitoring-and-surveillance/sa_disease_reporting/voluntary-reportable-disease-list. Accessed January 4, 2020.
14. US Department of Agriculture-Animal and Plant Health Inspection Service. 2012; Wildlife Services informational notebook. https://www.aphis.usda.gov/aphis/ourfocus/wildlifedamage/sa_reports/sa_informational+notebook/ct_ws_informational_notebook. Accessed January 4, 2020.
15. US Census Bureau. Census regions and divisions of the United States. https://www2.census.gov/geo/pdfs/maps-data/maps/reference/us_regdiv.pdf. Accessed January 4, 2020.
16. Hampy B, Pence DB, Simpson CD. Serological studies on sympatric barbary sheep and mule deer from Palo Duro Canyon, Texas. J Wildl Dis 1979;15:443-446.
17. Byrne RJ, Chambers CF, Jr. A serological survey for leptospiral antibodies in Maryland cattle. J Am Vet Med Assoc 1959;134:498-502.
18. Roth EE, Galton MM. Isolation and identification of Leptospira hardjo from cattle in Louisiana. Am J Vet Res 1960;21:422-427.
19. Rubin HL. Serological incidence of leptospirosis in Florida cattle. Proc Annu Meet US Anim Health Assoc 1977;81:197-200.
20. White FH, Sulzer KR, Engel RW. Isolations of Leptospira interrogans serovars Hardjo, Balcanica, and Pomona from cattle at slaughter. Am J Vet Res 1982;43:1172-1173.
21. New JC, Jr Wathen WG, Dlutkowski S. Prevalence of Leptospira antibodies in white-tailed deer, Cades Cove, Great Smoky Mountains National Park, Tennessee, USA. J Wildl Dis 1993;29:561-567.
22. Miller DA, Wilson MA, Beran GW. Relationships between prevalence of Leptospira interrogans in cattle, and regional, climatic, and seasonal factors. Am J Vet Res 1991;52:1766-1768.
23. Trainer DO, Knowlton FF. Serologic evidence of diseases in Texas coyotes. J Wildl Manage 1968;32:981-983.
24. Miller DL, Schrecengost J, Merrill A, et al. Hematology, parasitology, and serology of free-ranging coyotes (Canis latrans) from South Carolina. J Wildl Dis 2009;45:863-869.
25. Chitwood MC, Swingen MB, Lashley MA, et al. Parasitology and serology of free-ranging coyotes (Canis Latrans) in North Carolina, USA. J Wildl Dis 2015;51:664-669.
26. Holzman S, Conroy MJ, Davidson WR. Diseases, parasites and survival of coyotes in south-central Georgia. J Wildl Dis 1992;28:572-580.
27. Alexander AD, Gleiser CA, Malnati P, et al. Observations on the prevalence of leptospirosis in canine populations of the United States. Am J Hyg 1957;65:43-56.
28. White FH, Stoliker HE, Galton MM. Detection of leptospires in naturally infected dogs, using fluorescein-labeled antibody. Am J Vet Res 1961;22:650-654.
29. McKeever S, Gorman GW, Chapman JF, et al. Incidence of leptospirosis in wild mammals from southwestern Georgia, with a report of new hosts for six serotypes of leptospires. Am J Trop Med Hyg 1958;7:646-655.
30. Gorman GW, Mckeever S, Grimes RD. Leptospirosis in wild mammals from Southwestern Georgia. Am J Trop Med Hyg 1962;11:518-524.
31. Corn JL, Cartwright ME, Alexy KJ, et al. Surveys for disease agents in introduced elk in Arkansas and Kentucky. J Wildl Dis 2010;46:186-194.
32. Davidson WR, Crum JM, Blue JL, et al. Parasites, diseases, and health status of sympatric populations of fallow deer and white-tailed deer in Kentucky. J Wildl Dis 1985;21:153-159.
33. Roth EE, Adams WV, Sanford GE, et al. Isolation of Leptospira pomona from white-tailed deer in Louisiana. Am J Vet Res 1964;25:259-261.
34. Shotts EB, Greer WE, Hayes FA. A preliminary survey of the incidence of brucellosis and leptospirosis among white-tailed deer (Odocoileus virginianus) of the southeast. J Am Vet Med Assoc 1958;133:359-361.
35. Shotts EB, Jr Hayes FA. Leptospiral antibodies in white-tailed deer of the southeastern United States. J Wildl Dis 1970;6:295-298.
36. Shotts EB, Jr Andrews CL, Harvey TW. Leptospirosis in selected wild mammals of the Florida Panhandle and southwestern Georgia. J Am Vet Med Assoc 1975;167:587-589.
37. Sherrill BL, Snider AG, Kennedy-Stoskopf S, et al. Survey of zoonotic pathogens in white-tailed deer on Bald Head Island, North Carolina. Southeast Nat 2012;11:529-533.
38. Motie A, Myers DM, Storrs EE. A serologic survey for leptospires in nine-banded armadillos (Dasypus novemcinctus L.) in Florida. J Wildl Dis 1986;22:423-424.
39. Stuart BP, Crowell WA, Adams WV, et al. Spontaneous renal disease in Louisiana armadillos (Dasypus novemcinctus). J Wildl Dis 1977;13:240-244.
40. Evans LB, Wood GE, Flyger V, et al. Natural occurrence of Leptospira icterohaemorrhagiae in an opossum. Proc Soc Exp Biol Med 1962;110:113-115.
41. Alexander AD, Flyger V, Herman YF, et al. Survey of wild mammals in a Chesapeake Bay area for selected zoonoses. J Wildl Dis 1972;8:119-126.
42. Cole JR, Jr Pursell AR. Serologic incidence of leptospirosis in Georgia horses. Proc Annu Meet US Anim Health Assoc 1973;77:632-637.
43. Heidt GA, Rucker RA, Kennedy ML, et al. Hematology, intestinal parasites, and selected disease antibodies from a population of bobcats ( Felis rufus ) in central Arkansas. J Wildl Dis 1988;24:180-183.
44. Shotts EB, Jr Andrews CL, Sulzer C, et al. Leptospirosis in cottontail and swamp rabbits of the Mississippi Delta. J Wildl Dis 1971;7:115-117.
45. Ferguson DV, Heidt GA. Survey for rabies, leptospirosis, toxoplasmosis and tularemia in striped skunks (Mephitis mephitis) from three public use areas in northwestern Arkansas. J Wildl Dis 1981;17:515-519.
46. Roth EE, Adams WV, Sanford GE, Jr et al. The bacteriologic and serologic incidence of leptospirosis among striped skunks in Louisiana. Zoonoses Res 1963;2:13-39.
47. Jenkins EM, Harrington R, Jr Gbadamosi SG, et al. Survey of leptospiral agglutinins in the sera of swine of southeastern Alabama. Am J Vet Res 1979;40:1019-1021.
48. Corn JL, Swiderek PK, Blackburn BO, et al. Survey of selected diseases in wild swine in Texas. J Am Vet Med Assoc 1986;189:1029-1032.
49. New JC, Jr Delozier K, Barton CE, et al. A serologic survey of selected viral and bacterial diseases of European wild hogs, Great Smoky Mountains National Park, USA. J Wildl Dis 1994;30:103-106.
50. Saliki JT, Rodgers SJ, Eskew G. Serosurvey of selected viral and bacterial diseases in wild swine from Oklahoma. J Wildl Dis 1998;34:834-838.
51. Chatfield J, Milleson M, Stoddard R, et al. Serosurvey of leptospirosis in feral hogs ( Sus scrofa ) in Florida. J Zoo Wildl Med 2013;44:404-407.
52. Pedersen K, Pabilonia KL, Anderson TD, et al. Widespread detection of antibodies to Leptospira in feral swine in the United States. Epidemiol Infect 2015;143:2131-2136.
53. Pedersen K, Anderson TD, Bevins SN, et al. Evidence of leptospirosis in the kidneys and serum of feral swine (Sus scrofa) in the United States. Epidemiol Infect 2017;145:87-94.
54. Pedersen K, Bauer NE, Rodgers S, et al. Antibodies to various zoonotic pathogens detected in feral swine (Sus scrofa) at abattoirs in Texas, USA. J Food Prot 2017;80:1239-1242.
55. Bronson E, Spiker H, Driscoll CP. Serosurvey for selected pathogens in free-ranging American black bears (Ursus americanus) in Maryland, USA. J Wildl Dis 2014;50:829-836.
56. Sasmal I, Gould NP, Schuler KL, et al. Leptospirosis in urban and suburban American Black Bears in Western North Carolina. J Wildl Dis 2019;55:74-83.
57. Stuart BP, Crowell WA, Adams WV, et al. Spontaneous renal disease in beaver in Louisiana. J Wildl Dis 1978;14:250-253.
58. Brown RZ, Gorman GW. The occurrence of leptospiral infections in feral rodents in southwestern Georgia. Am J Public Health Nations Health 1960;50:682-688.
59. Redetzke KA, McCann MJ. Isolation of Leptospira from desert rodents of west Texas. J Wildl Dis 1980;16:333-337.
60. Roth EE, Adams WV, Sanfordge et al. Leptospira paidjan (bataviae serogroup) isolated from nutria in Louisiana. Public Health Rep 1962;77:583-587.
61. Howerth EW, Reeves AJ, McElveen MR, et al. Survey for selected diseases in nutria (Myocastor coypus) from Louisiana. J Wildl Dis 1994;30:450-453.
62. Walch EW, Walch-Sorgdrager GB. Observations on Leptospira icterohaemorrhagiae in the wild rats of Baltimore. Am J Epidemiol 1927;7:393-406.
63. Robinson GH. Occurrence of Leptospira icterohemorrhagiae in wild rats of Baltimore. Am J Epidemiol 1924;4:327-329.
64. Packchanian A, Sonnier AB. Incidence of leptospirosis in man and rodents in Galveston. Tex Rep Biol Med 1948;6:453-460.
65. Li HY, Davis DE. The prevalence of carriers of Leptospira and Salmonella in Norway rats of Baltimore. Am J Hyg 1952;56:90-91.
66. Easterbrook JD, Kaplan JB, Vanasco NB, et al. A survey of zoonotic pathogens carried by Norway rats in Baltimore, Maryland, USA. Epidemiol Infect 2007;135:1192-1199.
67. Jobling JW, Eggstein AA. The wild rats of the southern states as carriers of Spirochaeta icterohemorrhagiae. JAMA 1917;69:1787-1787.
68. Bowdoin CD. A new disease entity (?). J Med Assoc Ga 1942;31:437-442.
69. Gochenour WS, Jr Smadel JE, Jackson EB, et al. Leptospiral etiology of Fort Bragg fever. Public Health Rep 1952;67:811-813.
70. Schaeffer M. Leptospiral meningitis. Investigation of a water-borne epidemic due to L. pomona. J Clin Invest 1951;30:670-671.
71. Williams HR, Murphy WJ, McCroan JE, et al. An epidemic of Canicola fever in man with the demonstration of Leptospira canicola infection in dogs, swine and cattle. I. Clinical and epidemiological studies. Am J Hyg 1956;64:46-58.
72. Dvoskin S, Hook EW. Canicola fever with meningitis: a report of three cases and an epidemiological study at Fort McClellan, Ala. AMA Arch Intern Med 1956;97:793-797.
73. Coggins WJ. Leptospirosis due to Leptospira pomona : an outbreak of nine cases. JAMA 1962;181:1077-1078.
74. Barkin RM, Glosser JW. Leptospirosis-an epidemic in children. Am J Epidemiol 1973;98:184-191.
75. Anderson DC, Folland DS, Fox MD, et al. Leptospirosis: a common-source outbreak due to leptospires of the grippotyphosa serogroup. Am J Epidemiol 1978;107:538-544.
76. White FH, Sutherland GE, Raynor LE, et al. Leptospira interrogans serovars Hardjo and Pomona: causes of infections in dairy cows and humans in Florida. Public Health Rep 1981;96:250-254.
77. Stern EJ, Galloway R, Shadomy SV, et al. Outbreak of leptospirosis among adventure race participants in Florida, 2005. Clin Infect Dis 2010;50:843-849.
78. Frawley AA, Schafer IJ, Galloway R, et al. Notes from the field: postflooding leptospirosis-Louisiana, 2016. MMWR Morb Mortal Wkly Rep 2017;66:1158-1159.
79. Centers for Disease Control and Prevention. Nationally notifiable infectious diseases and conditions, United States: annual tables. https://wonder.cdc.gov/nndss/nndss_annual_tables_menu.asp. Accessed January 4, 2020.
80. Centers for Disease Control and Prevention. MMWR: Summary of notifiable infectious diseases. https://www.cdc.gov/mmwr/mmwr_nd/index.html. Accessed January 4, 2020.
81. Centers for Disease Control and Prevention. National notifiable infectious diseases and conditions: United States data tables. https://stacks.cdc.gov/gsearch?parentId=cdc%3A49375&amppid=cdc%3A49375. Accessed January 4, 2020.
82. Louisiana Department of Health, Office of Public Health. Leptospirosis annual report 2017. http://ldh.la.gov/assets/oph/Center-PHCH/Center-CH/infectious-epi/Annuals/Leptospirosis_LaIDAnnual.pdf. Accessed January 4, 2020.
83. Miller DA, Wilson MA, Beran GW. Survey to estimate prevalence of Leptospira interrogans infection in mature cattle in the United States. Am J Vet Res 1991;52:1761-1765.
84. Pedersen K, Anderson TD, Maison RM, et al. Leptospira antibodies detected in wildlife in the USA and the US Virgin Islands. J Wildl Dis 2018;54:450-459.
85. Childs JE, Schwartz BS, Ksiazek TG, et al. Risk factors associated with antibodies to leptospires in inner-city residents of Baltimore: a protective role for cats. Am J Public Health 1992;82:597-599.
86. Levett PN. Leptospirosis. Clin Microbiol Rev 2001;14:296-326.
87. North Carolina Climate Office, NC State University. Southeast precipitation. https://climate.ncsu.edu/edu/SEPrecip. Accessed January 4, 2020.
88. Lee HS, Levine M, Guptill-Yoran C, et al. Regional and temporal variations of Leptospira seropositivity in dogs in the United States, 2000-2010. J Vet Intern Med 2014;28:779-788.
89. Siza C. Equine Leptospirosis Seroprevealence in the Central and Bluegrass Regions of Kentucky from 1993-2015. Lexington : College of Public Health, University of Kentucky 2016.
90. Ward MP. Clustering of reported cases of leptospirosis among dogs in the United States and Canada. Prev Vet Med 2002;56:215-226.
91. Major A, Schweighauser A, Francey T. Increasing incidence of canine leptospirosis in Switzerland. Int J Environ Res Public Health 2014;11:7242-7260. 92. Ward MP, Glickman LT, Guptill LE. Prevalence of and risk factors for leptospirosis among dogs in the United States and Canada: 677 cases (1970-1998). J Am Vet Med Assoc 2002;220:53-58.
93. White AM, Zambrana-Torrelio C, Allen T, et al. Hotspots of canine leptospirosis in the United States of America. Vet J 2017;222:29-35.
94. Vijayachari P, Sugunan AP, Shriram AN. Leptospirosis: an emerging global public health problem. J Biosci 2008;33:557-569.
95. Greenough G, McGeehin M, Bernard SM, et al. The potential impacts of climate variability and change on health impacts of extreme weather events in the United States. Environ Health Perspect 2001;109(suppl 2):191-198.
96. Gubler DJ, Reiter P, Ebi KL, et al. Climate variability and change in the United States: potential impacts on vector- and rodent-borne diseases. Environ Health Perspect 2001;109(suppl 2):223-233.
97. Kaku KA, Davidian MH, DeSimone ED. Leptospirosis: potential rise from hurricanes and floods. US Pharm 2018;43:HS2-HS6.
98. Schneider MC, Nájera P, Aldighieri S, et al. Leptospirosis outbreaks in Nicaragua: identifying critical areas and exploring drivers for evidence-based planning. Int J Environ Res Public Health 2012;9:3883-3910.
99. Sutter JD, Sosa Pascual O. Deaths from bacterial disease in Puerto Rico spiked after Maria. https://www.cnn.com/2018/07/03/health/sutter-leptospirosis-outbreak-puerto-rico-invs/index.html. Accessed January 4, 2020.
100. Viotti JB, Chan JC, Rivera C, et al. Sporadic leptospirosis case in Florida presenting as Weil‘ Disease. IDCases 2020;19:e00686.
101. Hamond C, Martins G, Loureiro AP, et al. Urinary PCR as an increasingly useful tool for an accurate diagnosis of leptospirosis in livestock. Vet Res Commun 2014;38:81-85.
102. Alabama Department of Public Health. Case counts. http://www.alabamapublichealth.gov/infectiousdiseases/cases.html. Updated December 16, 2019. Accessed January 4, 2020.
103. Delaware Health and Social Services. Communicable disease yearly statistics, number of Delaware cases statewide 2005-2018. https://www.dhss.delaware.gov/dhss/dph/healthdatastats.html. Accessed January 4, 2020.
104. DC Health. Zoonotic disease. 2017 animal disease surveillance system summary. https://dchealth.dc.gov/sites/default/files/dc/sites/doh/page_content/attachments/2017%20Veterinary%20Surveillance%20Summary.pdf. Published April 10, 2018. Accessed January 4, 2020.
105. Florida Department of Health. Leptospirosis, leptospirosis occurrence in Florida. http://www.floridahealth.gov/diseases-and-conditions/leptospirosis/index.html. Accessed January 4, 2020.
106. West Virginia Department of Health and Human Resources, Bureau for Public Health. Leptospirosis, data and surveillance, leptospirosis, 1997-2006. https://oeps.wv.gov/leptospirosis/Documents/data/leptospirosis_1997-2006.pdf. Accessed January 4, 2020.
107. Centers for Disease Control and Prevention. One Health. https://www.cdc.gov/onehealth/index.html. Accessed March 27, 2020.
108. American Veterinary Medical Association. Leptospirosis. https://www.avma.org/public/PetCare/Pages/Leptospirosis.aspx Accessed January 4, 2020.