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Human leptospirosis in Seychelles: a prospective study confirms the heavy burden of the disease but suggests that rats are not the main reservoir

Biscornet, Leon, Dellagi, Koussay, Pagès, Frederic, Bibi, Jastin, de Comarmond, Jeanine, Mélade, Julien, Govinden, Graham, Tirant, Maria, Gomard, Yann, Guernier, Vanina, Lagadec, Erwan, Mélanie, Jimmy, Rocamora, Gerard, Le Minter, Gildas, Jaubert, Julien, Mavingui, Patrick and Tortosa, Pablo 2017, Human leptospirosis in Seychelles: a prospective study confirms the heavy burden of the disease but suggests that rats are not the main reservoir, PLoS neglected tropical diseases, vol. 11, no. 8, doi: 10.1371/journal.pntd.0005831.

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Title Human leptospirosis in Seychelles: a prospective study confirms the heavy burden of the disease but suggests that rats are not the main reservoir
Author(s) Biscornet, Leon
Dellagi, Koussay
Pagès, Frederic
Bibi, Jastin
de Comarmond, Jeanine
Mélade, Julien
Govinden, Graham
Tirant, Maria
Gomard, Yann
Guernier, VaninaORCID iD for Guernier, Vanina orcid.org/0000-0002-0960-3874
Lagadec, Erwan
Mélanie, Jimmy
Rocamora, Gerard
Le Minter, Gildas
Jaubert, Julien
Mavingui, Patrick
Tortosa, Pablo
Journal name PLoS neglected tropical diseases
Volume number 11
Issue number 8
Article ID e0005831
Total pages 22
Publisher Public Library of Science
Place of publication San Francisco, Calif.
Publication date 2017-08
ISSN 1935-2727
1935-2735
Keyword(s) Adolescent
Adult
Animals
Cost of Illness
Disease Reservoirs
Disease Transmission, Infectious
Enzyme-Linked Immunosorbent Assay
Female
Humans
Incidence
Leptospira interrogans
Leptospirosis
Male
Middle Aged
Prospective Studies
Rats
Real-Time Polymerase Chain Reaction
Seychelles
Young Adult
Zoonoses
Science & Technology
Life Sciences & Biomedicine
Infectious Diseases
Parasitology
Tropical Medicine
INDIAN-OCEAN
PATHOGENIC LEPTOSPIRA
MADAGASCAR
EMERGENCE
SPP.
BIODIVERSITY
INTERROGANS
ANTIBODIES
INFECTION
COMOROS
Summary Background
Leptospirosis is a bacterial zoonosis caused by pathogenic Leptospira for which rats are considered as the main reservoir. Disease incidence is higher in tropical countries, especially in insular ecosystems. Our objectives were to determine the current burden of leptospirosis in Seychelles, a country ranking first worldwide according to historical data, to establish epidemiological links between animal reservoirs and human disease, and to identify drivers of transmission.

Methods
A total of 223 patients with acute febrile symptoms of unknown origin were enrolled in a 12-months prospective study and tested for leptospirosis through real-time PCR, IgM ELISA and MAT. In addition, 739 rats trapped throughout the main island were investigated for Leptospira renal carriage. All molecularly confirmed positive samples were further genotyped.

Results
A total of 51 patients fulfilled the biological criteria of acute leptospirosis, corresponding to an annual incidence of 54.6 (95% CI 40.7–71.8) per 100,000 inhabitants. Leptospira carriage in Rattus spp. was overall low (7.7%) but dramatically higher in Rattus norvegicus (52.9%) than in Rattus rattus (4.4%). Leptospira interrogans was the only detected species in both humans and rats, and was represented by three distinct Sequence Types (STs). Two were novel STs identified in two thirds of acute human cases while noteworthily absent from rats.

Conclusions
This study shows that human leptospirosis still represents a heavy disease burden in Seychelles. Genotype data suggests that rats are actually not the main reservoir for human disease. We highlight a rather limited efficacy of preventive measures so far implemented in Seychelles. This could result from ineffective control measures of excreting animal populations, possibly due to a misidentification of the main contaminating reservoir(s). Altogether, presented data stimulate the exploration of alternative reservoir animal hosts.
Language eng
DOI 10.1371/journal.pntd.0005831
Field of Research 06 Biological Sciences
11 Medical And Health Sciences
HERDC Research category C1.1 Refereed article in a scholarly journal
ERA Research output type C Journal article
Copyright notice ©2017, The Authors
Free to Read? Yes
Use Rights Creative Commons Attribution licence
Persistent URL http://hdl.handle.net/10536/DRO/DU:30108624

Document type: Journal Article
Collections: School of Medicine
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Every reasonable effort has been made to ensure that permission has been obtained for items included in DRO. If you believe that your rights have been infringed by this repository, please contact drosupport@deakin.edu.au.