1Department of Medicine and Epidemiology, School of Veterinary Medicine, University of California-Davis, Davis, CA.
2VA Greater Los Angeles Healthcare System, Los Angeles, CA.
J Am Vet Med Assoc. 2022 Jul 25;260(13):1589-1596. doi: 10.2460/javma.22.06.0258.
Leptospirosis is a quintessential one health disease of humans and animals caused by pathogenic spirochetes of the genus Leptospira. Intra- and interspecies transmission is dependent on 1) reservoir host animals in which organisms replicate and are shed in urine over long periods of time, 2) the persistence of spirochetes in the environment, and 3) subsequent human-animal-environmental interactions. The combination of increased flooding events due to climate change, changes in human-animal-environmental interactions as a result of the pandemic that favor a rise in the incidence of leptospirosis, and under-recognition of leptospirosis because of nonspecific clinical signs and severe signs that resemble COVID-19 represents a "perfect storm" for resurgence of leptospirosis in people and domestic animals. Although often considered a disease that occurs in warm, humid climates with high annual rainfall, pathogenic Leptospira spp have recently been associated with disease in animals and humans that reside in semiarid regions like the southwestern US and have impacted humans that have a wide spectrum of socioeconomic backgrounds. Therefore, it is critical that physicians, veterinarians, and public health experts maintain a high index of suspicion for the disease regardless of geographic and socioeconomic circumstances and work together to understand outbreaks and implement appropriate control measures. Over the last decade, major strides have been made in our understanding of the disease because of improvements in diagnostic tests, molecular epidemiologic tools, educational efforts on preventive measures, and vaccines. These novel approaches are highlighted in the companion Currents in One Health by Sykes et al, AJVR, September 2022.
钩端螺旋体病是一种人与动物共患的典型的“同一健康”疾病，由钩端螺旋体属的致病性螺旋体引起。种内和种间传播取决于 1）宿主动物，病原体在这些动物中复制并长时间通过尿液排出，2）螺旋体在环境中的持续存在，以及 3）随后的人与动物-环境相互作用。气候变化导致洪水事件增加，大流行导致人类-动物-环境相互作用的改变，有利于钩端螺旋体病发病率上升，以及由于非特异性临床症状和与 COVID-19 相似的严重症状导致钩端螺旋体病的识别不足，这些因素共同构成了钩端螺旋体病在人和家畜中再次流行的“完美风暴”。尽管钩端螺旋体病通常被认为是一种发生在温暖、潮湿气候和高年降雨量地区的疾病，但最近致病性钩端螺旋体属与美国西南部等半干旱地区的动物和人类疾病有关，并影响到具有广泛社会经济背景的人类。因此，无论地理和社会经济情况如何，医生、兽医和公共卫生专家都必须对这种疾病保持高度怀疑，共同努力了解疫情并实施适当的控制措施。在过去十年中，由于诊断检测、分子流行病学工具、预防措施教育工作以及疫苗的改进，我们对这种疾病的认识取得了重大进展。这些新方法在 AJVR 2022 年 9 月 Sykes 等人发表的《Currents in One Health》一文中得到了强调。
