Knowledge, attitude, and preventive practices of leptospirosis affected populations in South Andaman, India: A cross-sectional study

Introduction: Leptospirosis is the most common reoccurring zoonosis worldwide. Climatic conditions in tropical and subtropical regions are optimal for Leptospira survival. The pathogen thrives in flood-prone slum settlements of underprivileged areas where waste, open sewers, and standing water are present. Methods: A descriptive cross-sectional study using universal sampling methodology was conducted to determine associationsbetween sociodemographic variables and knowledge, attitudes, and practices of leptospirosis-infected individuals compared with a control group from the South Andaman population. Results: Eight hundred and one (388 cases and 413 controls) subjects were included in the study. Overall, 61.5% of the participants were male, while the main occupation of 43.94% of the subjects was farming or agricultural work. Multilogistic regression assessing the likelihood of good knowledge about leptospirosis showed that leptospirosis-positive subjects were more likely to have good knowledge (adjusted odds ratio [AOR]: 3.5 [95% CI: 2.59–4.97], p < 0.001), better attitude (AOR: 97.30 [95% CI: 41.72–226.9], p < 0.001] than leptospirosis-negative subjects, male population groups were also more likely to have a good attitude (AOR: 3.03 [95% CI: 1.94–4.73], p < 0.001), and those whose main occupation is farming were more likely to have a good attitude (AOR: 3.59 [95% CI: 2.31–5.56], p < 0.001). The leptospirosis seropositive group was more likely to have good practices (AOR: 5.80 [95% CI: 3.58–8.73], p < 0.001), rural residents were 88% less likely to have good practice levels than urban residents (AR: 0.12 [95% CI: 0.07–0.20], p < 0.01). Conclusion: The infected group had better knowledge than the control group. The integration of knowledge and attitudes to maintain good practices, along with the provision of an adequate sanitation system, waste disposal system, and availability of essential personal protective equipment is necessary for disease control in these islands

Atypical presentation of Hand foot mouth disease (HFMD) caused by enterovirus serotype Coxsackievirus A6, in India

A 27-year-old male presented in the OPD of Naval Hospital in Port Blair, Andaman Islands, India, in 2011 with a history of low-grade fever associated with malaise and a pruritic skin rash. Case 2 – A 17-year-old male student reported to the OPD at Naval Hospital, Kochi Kerala, India, in August 2015. He presented with eruptions on both the palm and soles with a history of high-grade fever for the past 3–4 days. Clinically, both the cases were diagnosed as hand, foot, and mouth disease (HFMD). Both samples were tested against measles virus and varicella-zoster IgM antibodies by enzyme immunoassay and found negative. Stool sample (case 1) and lesion swab (case 2) were processed by enterovirus reverse transcription polymerase chain reaction and phylogenetic analysis, and both were positive for enterovirus human coxsackievirus A6 (CVA6) (untranslated region [UTR]). Phylogenetic analysis also confirmed that both the CVA6 etiology belonged to the genotype F. HFMD in adults often asymptomatic and very few patients get atypical symptoms. Clinical diagnosis is often troublesome to identify HFMD in such cases. An epidemiological surveillance/vigilance is essential to document these atypical cases in near future in developing countries like India

Multilocus sequence typing method for identification and genotypic classification of pathogenic Leptospira species

BACKGROUND: Leptospira are the parasitic bacterial organisms associated with a broad range of mammalian hosts and are responsible for severe cases of human Leptospirosis. The epidemiology of leptospirosis is complex and dynamic. Multiple serovars have been identified, each adapted to one or more animal hosts. Adaptation is a dynamic process that changes the spatial and temporal distribution of serovars and clinical manifestations in different hosts. Serotyping based on repertoire of surface antigens is an ambiguous and artificial system of classification of leptospiral agents. Molecular typing methods for the identification of pathogenic leptospires up to individual genome species level have been highly sought after since the decipherment of whole genome sequences. Only a few resources exist for microbial genotypic data based on individual techniques such as Multiple Locus Sequence Typing (MLST), but unfortunately no such databases are existent for leptospires. RESULTS: We for the first time report development of a robust MLST method for genotyping of Leptospira. Genotyping based on DNA sequence identity of 4 housekeeping genes and 2 candidate genes was analyzed in a set of 120 strains including 41 reference strains representing different geographical areas and from different sources. Of the six selected genes, adk, icdA and secY were significantly more variable whereas the LipL32 and LipL41 coding genes and the rrs2 gene were moderately variable. The phylogenetic tree clustered the isolates according to the genome-based species. CONCLUSION: The main advantages of MLST over other typing methods for leptospires include reproducibility, robustness, consistency and portability. The genetic relatedness of the leptospires can be better studied by the MLST approach and can be used for molecular epidemiological and evolutionary studies and population genetics

Evaluation and comparison of native and recombinant LipL21 protein-based ELISAs for diagnosis of bovine leptospirosis

A 21-kDa leptospiral lipoprotein (LipL21) was evaluated for its diagnostic potential to detect bovine leptospirosis by ELISA. Both native LipL21 (nLipL21) and recombinant LipL21 (rLipL21) proteins were tested and compared regarding diagnostic efficiency, and no statistically significant difference was observed. The sensitivity of rLipL21 ELISA for 62 microscopic agglutination test (MAT) positive sera was 100% and the specificity with 378 MAT negative sera was 97.09%. Thus, rLipL21 protein-based ELISA could be used as an alternative to MAT for the diagnosis of bovine leptospirosis

Increasing Trends of Leptospirosis in Northern India: A Clinico-Epidemiological Study

Leptospirosis is often not suspected by physicians in patients with acute febrile illnesses reporting from supposedly “non-endemic areas,” including north India. Clinical manifestations are protean, and complications can affect most organ systems, including liver, kidneys, lungs, and the central nervous system. Timely diagnosis and specific therapy can reduce severity of illness and, in turn, mortality. In this study conducted at a tertiary care center in north India, we find how a much-neglected disease entity has emerged as a major cause of acute febrile illness in a so called “non-endemic area.” Incidence is increasing yearly. The majority of patients were from a rural background, and were farmers or farm labourers. Poor hygiene, contact with animals, rat infestation of houses, and contact with stagnant dirty water are the major determinants of disease. Apart from the usual symptoms of intermittent fever with chill and rigor, hepatosplenomegaly, renal decompensation, muscle pain and tenderness, and conjunctival suffusion, signs and symptoms indicating involvement of the respiratory and central nervous systems were also commonly observed. Severe complications resulting in mortality do occur and is especially due to late suspicion among primary level physicians, and the resulting inappropriate therapy