Building an African Leptospirosis Network

Although leptospirosis is a disease of global importance, local context is crucial to formulating effective intervention strategies. Factors including reservoir host species, pathogen type, environmental, and social settings generate context-specific epidemiologies. Diverse climatic zones, agricultural systems, urbanization patterns, and cultural practices in Africa are likely to drive considerable variation in leptospirosis epidemiology. There is growing evidence of a substantial burden of human leptospirosis in Africa that is difficult to quantify in part due to lack of surveillance and clinical awareness of leptospirosis. Leptospirosis is therefore rarely considered as a differential diagnosis for acute febrile illness, and there is little access to diagnostic services for leptospirosis on the continent. In 2016, a virtual network was founded focussing on improving awareness and understanding leptospirosis in Africa. We currently have 40 members from academia, clinical practice, government and non-governmental agencies and others. Current members are based predominantly in institutions outside the continent but increasingly colleagues based in public health, laboratories, veterinary, and academic institutions within Africa are joining. We will share our experiences of developing this network, and our plans for capacity building through identifying and addressing knowledge gaps in our understanding of leptospirosis in Africa

Update on the status of leptospirosis in New Zealand

Leptospirosis is a zoonotic disease that poses public health and ecological threats worldwide. In New Zealand (NZ), incidence of the disease is relatively high compared to other developed countries. The aim of this review was to describe the epidemiological status, ecological risk of leptospirosis and prevention in NZ. Disease notification data for leptospirosis in humans in NZ from 2010 to 2015 were collected from the Institute of Environmental Science and Research database. These data were supported by a literature review of epidemiological studies in human and animal populations. During this six-year period, exotic serovars of Leptospira interrogans sv Australis and Leptospira kirschneri sv Grippotyphosa were identified in patients who had travelled abroad to Samoa (Pacific Ocean) and Thailand, respectively. Most cases of leptospirosis were recorded in New Zealanders of European ethnicity, followed by Māori people. Males had a nine-fold increased risk compared to females mostly due to occupation. The risk of leptospirosis increased gradually with the age, with a peak in the 40 to 49-year-old age group, after which it decreased. Workers in meat-processing and farming industries appeared at highest-risk of occupational exposure compared with other risky occupations such as hunters, veterinarians, technicians, stock truck drivers and lake workers. Other cases were also attributed to outdoor exposures or travelling overseas. Highest disease notification rates occurred in the West Coast region of the South Island (average annual incidence 9.7 per 100,000 people), followed by Whanganui region (8.2 per 100,000) and Hawke's Bay region (8 per 100,000) in the North Island. Vaccines currently available for animals are specific for cattle, sheep, deer and dogs and do protect against all serovars present in NZ. The development and use of molecular diagnostics is crucial for specific identification of Leptospira isolates and informing deployment of efficient vaccines

A multifaceted risk model for brucellosis at the human–animal interface in Egypt

Brucellosis is a highly contagious zoonosis affecting humans and a wide range of domesticated and wild animal species. An important element for effective disease containment is to improve knowledge, attitudes and practices (KAP) of afflicted communities. This study aimed to assess the KAP related to brucellosis at the human–animal interface in an endemic area of Egypt and to identify the risk factors for human infection. A matched case–control study was conducted at the central fever hospitals located in six governorates in northern Egypt. Face‐to‐face interviews with cases and controls were conducted using a structured questionnaire. In total, 40.7% of the participants owned farm animals in their households. The overall mean practice score regarding animal husbandry, processing and consumption of milk and dairy products were significantly lower among cases compared with controls (−12.7 ± 18.1 vs. 0.68 ± 14.2, respectively; p < .001). Perceived barriers for notification of animal infection/abortion were predominate among cases and positively correlated with participants’ education. The predictors of having brucellosis infection were consumption of unpasteurized milk or raw dairy products and practicing animal husbandry. Applying protective measures against infection significantly reduced its risk. A model predicting risk factors for brucellosis among those who own animal showed that frequent abortions per animal increased the chance for brucellosis infection among human cases by 50‐fold (95% CI: 8.8–276.9), whereas the use of protective measures in animal care reduced the odds (OR = 0.11 [95% CI: 0.03–0.45]). In conclusion, consumption of unprocessed dairy products was equally important as contact with infected/aborted animals as major risk factors for Brucella spp. infection among humans in Egypt. There is poor knowledge, negative attitudes and risky behaviours among villagers which can perpetuate the risk of brucellosis transmission at the human–animal interface. This supports the need for integrating health education into the national brucellosis control programme