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. 2016 Oct 18;5(1):1796.
doi: 10.1186/s40064-016-3483-8. eCollection 2016.

Risk factors for human Leptospira seropositivity in South Germany

Stefan O Brockmann  1 , Lena Ulrich  2 , Isolde Piechotowski  3 , Christiane Wagner-Wiening  4 , Karsten Nöckler  5 , Anne Mayer-Scholl  5 , Martin Eichner  2
Affiliations

Risk factors for human Leptospira seropositivity in South Germany

Stefan O Brockmann et al. Springerplus. .

Abstract

We analyzed risk factors for Leptospira seropositivity in humans, using data from a population-based cross-sectional zoonosis survey in South Germany (2008/9). Out of 1007 participants 42 (4.2 %) were sero-positive (19/446 men; 23/561 women), indicating that Leptospira exposure and sero-conversion is much more frequent than commonly assumed. Relative risks (RR) for seropositivity with exact 95 % confidence intervals (CI; adjusted for specificity and sensitivity of the ELISA test) were calculated for various exposure factors. Contact with pet rats (RR = 13.9 CI [4.8; 25.3]), guinea pigs (3.0[1.1; 7.4]), cattle (3.7[1.3; 9.6]), poultry (3.6[1.3; 8.6]) or livestock (2.3[1.1; 4.9]) as well as occupation as forestry worker (9.2[2.6; 21.4]) were identified as important exposure factors. None of the participants has ever been diagnosed with leptospirosis, yet 45 had experienced symptoms which may have been caused by Leptospira infection (12 with scleral icterus, 25 dark urine, 8 liver inflammation, 7 kidney failure). Three times as many participants with prior symptoms were seropositive as participants without symptoms (RR = 3.4[1.3; 8.3]), suggesting that sero-positive patients with severe symptoms may frequently not be diagnosed as leptospirosis cases. Physicians should consider leptospirosis as a differential diagnosis. Currently, the vast majority of symptomatic leptospirosis patients may neither be diagnosed nor reported.

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Figures

Fig. 1
Fig. 1
Uncorrected relative Risks (RR; points with associated values) and their exact 95 % confidence intervals (vertical lines) for Leptospira IgG sero-positivity (“exposed” vs. “non-exposed”), using different exposure groupings of “rat contact”. The data were collected in the course of the population-based cross-sectional zoonosis study from April 2008 to December 2009 by the Baden-Württemberg State Health Office Baden-Württemberg, Germany. The horizontal line marks RR = 1. The allocation of the subjects to the groups of “exposed” and “non-exposed” is displayed above and below the graph
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