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      El Niño Southern Oscillation and Leptospirosis Outbreaks in New Caledonia

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          Abstract

          Leptospirosis is an important cause of seasonal outbreaks in New Caledonia and the tropics. Using time series derived from high-quality laboratory-based surveillance from 2000–2012, we evaluated whether climatic factors, including El Niño Southern Oscillation (ENSO) and meteorological conditions allow for the prediction of leptospirosis outbreaks in New Caledonia. We found that La Niña periods are associated with high rainfall, and both of these factors were in turn, temporally associated with outbreaks of leptospirosis. The sea surface temperature in El Niño Box 4 allowed forecasting of leptospirosis outbreaks four months into the future, a time lag allowing public health authorities to increase preparedness. To our knowledge, our observations in New Caledonia are the first demonstration that ENSO has a strong association with leptospirosis. This association should be tested in other regions in the South Pacific, Asia or Latin America where ENSO may drive climate variability and the risk for leptospirosis outbreaks.

          Author Summary

          The El Niño Southern Oscillation is a major ocean – atmosphere phenomenon that strongly contributes to the timing and intensity of rainfall in the tropical Pacific islands and beyond. As a consequence, it also has a major effect on the number of cases of leptospirosis. By incorporating oceanographic parameters in models, we have been able to predict leptospirosis outbreaks in New Caledonia 4 months in advance. We discuss that this forecasting delay might be used to implement timely interventions prior to the occurrence of outbreaks. Possible interventions include controlling rodent reservoir populations before population growth and maintaining sewage networks or river banks. The major impact of El Niño on the climate of Pacific Islands Countries and Territories suggests that other countries might be able to build similar predictive models.

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          Most cited references25

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          Leptospira and leptospirosis.

          Leptospirosis is the most wide spread zoonosis worldwide; it is present in all continents except Antarctica and evidence for the carriage of Leptospira has been found in virtually all mammalian species examined. Humans most commonly become infected through occupational, recreational, or domestic contact with the urine of carrier animals, either directly or via contaminated water or soil. Leptospires are thin, helical bacteria classified into at least 12 pathogenic and 4 saprophytic species, with more than 250 pathogenic serovars. Immunity following infection is generally, but not exclusively, mediated by antibody against leptospiral LPS and restricted to antigenically related serovars. Vaccines currently available consist of killed whole cell bacterins which are used widely in animals, but less so in humans. Current work with recombinant protein antigens shows promise for the development of vaccines based on defined protective antigens. The cellular and molecular basis for virulence remains poorly understood, but comparative genomics of pathogenic and saprophytic species suggests that Leptospira expresses unique virulence determinants. However, the recent development of defined mutagenesis systems for Leptospira heralds the potential for gaining a much improved understanding of pathogenesis in leptospirosis. Copyright 2009 Elsevier B.V. All rights reserved.
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            Leptospira: the dawn of the molecular genetics era for an emerging zoonotic pathogen.

            Leptospirosis is a zoonotic disease that has emerged as an important cause of morbidity and mortality among impoverished populations. One hundred years after the discovery of the causative spirochaetal agent, little is understood about Leptospira spp. pathogenesis, which in turn has hampered the development of new intervention strategies to address this neglected disease. However, the recent availability of complete genome sequences for Leptospira spp. and the discovery of genetic tools for their transformation have led to important insights into the biology of these pathogens and their pathogenesis. We discuss the life cycle of the bacterium, the recent advances in our understanding and the implications for the future prevention of leptospirosis.
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              Emergence, control and re-emerging leptospirosis: dynamics of infection in the changing world.

              Globally, leptospirosis poses an increasing public health problem, as evidenced by markedly increasing incidence rates and multiple outbreaks in all continents. Yet, the disease is severely neglected and hence, its global burden is largely unknown. The estimated incidence of about half a million severe human cases annually is probably an underestimation while the burden for animal health is unknown. It is anticipated that current international initiatives will assess the global burden of leptospirosis, while mathematical modelling of transmission dynamics will allow the identification and testing of appropriate intervention and outbreak response measures within the coming years. © 2011 The Authors. Clinical Microbiology and Infection © 2011 European Society of Clinical Microbiology and Infectious Diseases.
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                Author and article information

                Contributors
                Role: Editor
                Journal
                PLoS Negl Trop Dis
                PLoS Negl Trop Dis
                plos
                plosntds
                PLoS Neglected Tropical Diseases
                Public Library of Science (San Francisco, USA )
                1935-2727
                1935-2735
                April 2014
                17 April 2014
                : 8
                : 4
                : e2798
                Affiliations
                [1 ]Yale School of Public Health, New Haven, Connecticut, United States of America
                [2 ]Institut Pasteur, Institut Pasteur International Network, Noumea, New Caledonia
                [3 ]Direction des Affaires Sanitaires et Sociales de la Nouvelle-Calédonie, Noumea, New Caledonia
                [4 ]Yale School of Medicine, New Haven, Connecticut, United States of America
                [5 ]Oswaldo Cruz Foundation, Salvador, Bahia, Brazil
                University of Tennessee, United States of America
                Author notes

                The authors have declared that no competing interests exist.

                Conceived and designed the experiments: DW NB AIK CG. Performed the experiments: DW NB JPG AIK CG. Analyzed the data: DW NB AIK CG. Contributed reagents/materials/analysis tools: DW NB JPG AIK CG. Wrote the paper: CG DW AIK.

                Article
                PNTD-D-14-00092
                10.1371/journal.pntd.0002798
                3990495
                24743322
                209dc868-1a9f-459f-9250-196a67bbf1f9
                Copyright @ 2014

                This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

                History
                : 19 January 2014
                : 5 March 2014
                Page count
                Pages: 7
                Funding
                This work was supported by grants from the National Institutes of Health (R01 TW009504, U01 AI088752, R01 AI052473), from the French Ministère de l'Enseignement Supérieur et de la Recherche and from Institut Pasteur. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
                Categories
                Research Article
                Biology and Life Sciences
                Veterinary Science
                Veterinary Diseases
                Zoonoses
                Leptospirosis
                Computational Biology
                Population Modeling
                Infectious Disease Modeling
                Computer and Information Sciences
                Geoinformatics
                Environmental Systems Modeling
                Earth Sciences
                Atmospheric Science
                Climatology
                Climate Modeling
                Geography
                Medicine and Health Sciences
                Infectious Diseases
                Public and Occupational Health
                Tropical Diseases
                Neglected Tropical Diseases
                Social Sciences

                Infectious disease & Microbiology
                Infectious disease & Microbiology

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