Leptospirosis in Fiji: A Review of the Situation in 2012

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LEPTOSPIROSIS IN FIJI: A REVIEW OF THE SITUATION IN 2012

Associate Professor Simon ReidSchool of Population HealthUniversity of QueenslandBrisbane, Australia

Acknowledgements

Fiji Centre for CD Control• Dr Vereniki Raiwalui• Dr Mike Kama• Aggie Dawainavesi

UQ• Dr Vanessa Racloz

WHO (South Pacific)• Dr Eric Nilles

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INCIDENCE OF LEPTOSPIROSIS

• 2011: 12 per 100,000• 2012: 62.5 – 100 per 100,000

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ELISA

Fiji 2012

• 525 confirmed cases• 52 deaths• Up to ~300 more cases if PCR had been used

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Ba

Lautoka

Nadi

Rewa

Suva

Floods

ETHNICITY

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Ba Lautoka Macuata Nadi Nadroga Ra Rewa Suva0

50

100

150

200

250

300

350

400

iTaukei Indian

Subdivision

Cas

es p

er 1

00,0

00

Age distribution

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RESERVOIRS?

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Serovars

• Predominant serovars in human cases (historical):– australis– copenhageni– canicola– cynoptera

• Limited data on range of serovars in domestic and feral animals in Fiji

• 1981: antibodies detected (CFT) in:– Cattle (27.5%), sheep (17.1%), goats (10.3%), pigs (10.0%)– Dogs (57%), rats (55.8%), mongoose (53.1%), mice (40%)

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Horse

(3)

Cattle

(50)

Dog (8

)

Pig (3

8)

Cat (1

)

All Spe

cies

(100

)0.0%

10.0%

20.0%

30.0%

40.0%

50.0%

60.0%

70.0%

80.0%

Horse

(20)

Cattle

(130

)

Dog (2

5)

Goa

t (13

)

Pig (4

1)

Human

(...

Cat (2

)0%

10%20%30%40%50%60%70%80%90%

Naduri and Burebasaga (2002)

SPC ANIMAL HEALTH & PRODUCTION SERVICE (http://www.spc.int/lrd/)

Mongoose = ~70% Hardjo

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pom

ona

hard

jo

tara

ssov

i

gripp

otyp

hosa

celle

doni

cope

nhag

eni

aust

ralis

pyro

gene

s

canic

ola

hebd

omad

ism

ini

sarm

in

bulga

rica

cyno

pter

i

ballu

m

bata

viae

djasim

an

javan

ica

pana

ma

sher

nani

mwalo

k0%

10%

20%

30%

40%

50%

Prevalence of Leptospira Antibodies by Serovar in Cattle from Naduri Village (n = 130)

Serovar

Pre

vale

nce

Overlap with humans

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pom

ona

hard

jo

tara

ssov

i

cope

nhag

eni

aust

ralis

canic

ola

bulga

rica

cyno

pter

i

ballu

m0%

10%

20%

30%

40%

50%

60%

70%

Human Dog

One Health Issues/opportunities• Major gaps in epidemiological information• Case investigations are lead by environmental health

officers but need to include AH and PH personnel• Importance of sampling ALL mammals (including humans)

at the site of transmission• Need to work out how to get rats and mongoose

• MoH has initiated a national strategy

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