الفهرس 
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Abstract
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7. SUMMARY
Leptospirosis, as a zoonotic infectious bacterial disease with global
distribution caused by pathogenic spirochetes of leptospira species. Many wild
and domestic animals are the main reservoirs for the leptospira species.
Transmission usually results from direct or indirect exposure to the urine or
other tissues of the infected Animal. Indirect exposure, which is more common,
occurs via contact contaminated water and wet soil. When Leptospira species
enters the body through abrasions in skin, intact skin, mucosa such as
respiratory tract and conjunctiva. Early symptoms of leptospirosis are usually
undiagnosed clinically. Early diagnosis is essential, since the untreated illness
can progress rapidly and mortality rates are high in severe cases.
Due to the public and zoonotic importance of leptospirosis, the following
points were investigated:
Investigate occurrence of leptospirosis among the examined rats and dogs
by using culturing on a specific medium and Polymerase Chain Reaction
(PCR) in El-Menoufia Governorate.
Investigate the seroprevalence of leptospirosis among some animals ( Rats
and dogs in El- Menoufia Governorate by using microscopic agglutination
test (MAT).
Study the extent of the disease among human population in El-Menoufia,
Governorate by using Enzyme Linked Immunosorbent Assay (ELISA)
and microscopic agglutination test (MAT).
In this study, a total of 135 Dog samples were collected from 46 dogs
arranged in 46 blood samples, 46 kidney samples and 43 urine samples from El-
Menoufia governorate as well as a total of 53 rat samples were collected from
black rats (Rattus rattus) were arranged in 21 blood samples, 21 kidney samples
and 11 urine samples from 21 rats. All kidney and urine samples were subjected
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for culturing on specific medium for leptospires , the isolation give no growth
on the medium.
The negative kidney and urine cultures were subjected after that to
Polymerase Chain Reaction (PCR), A total of 47 negative cultures (18 rat
samples and 29 dog samples) were subjected to PCR. The overall detection by
PCR was 31.9% (15 out of 47) including 33.3% for rats (6 out of 18) and 31%
for dogs (9 out of 29), as well as positive control by using PCR at the expected
size 362 bp.
Regarding to the seropositivity of the detected leptospira serovars from the
examined rat and dog samples by MAT.The overall detection was 42.85% for
rats (9/21) with titres ranged ( 1/200- 1/12800). The reactive serovars were
serovar canicola (9.52%) with titre 1/12800, serovar Icterohaemorragiae
(9.52%) with titre 1/6400- 1/12800 and 4.76% for each serovar Alexi, Georgia,
Hebdomadis, Pyrogens and Wolfii with titre ranged( 1/200- 1/12800) as well as
the overall detection by MAT was 34.78%(16/46) for dogs with titres (1/200-
1/6400) arranged in descending order as serovar canicola 21.73%, followed by
serovar Icterohaemorragiae 8.69% then serovar Grippotyphosa 2.17% and
serovar Australis 2.17%.
Concerning to the animal sex, The detection rate of leptospiral antibodies in
male and female rats was 50.00% and 36.36%, respectively and it was found
that male dogs had higher seroprevalence 41.93% (13/31) than female dogs 20%
(3/15) by MAT.
According to animal age, The seroprevalence of leptospirosis among the
examined rat samples was 53.84 and 25.00% in adult and juvenile rats,
respectively and the seropositivity for the examined dogs was 28.57% (age
group <1year), 25% (age group 1 < 3years) and 43.47% (age group 3 – 6years)
by MAT.
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Regarding to the prevailing climatic condition, the seropositivty in rats was
44.4 and 41.66% in warm and cold climate, respectively. As well as The overall
detection of leptospira serovars in dogs was 45% in warm climate and 26.92%
in cold climate.
Concerning to the presence of visceral lesions in rats, the overall detection of
leptospiral antibodies in the presence of visceral lesions was 60% by MAT.
Regarding to the infestation of dogs with fleas, It was found that dogs
infestated with fleas showed higher seroprevalence for leptospirosis (37.83%)
than dogs did not infestated with fleas (22.22%) by MAT.
According to habitat, the seropositivity was 25% for the household dogs and
38.23% for the strayed dogs.
A total of 184 serum samples were taken from febrile patients suffering from
fever of unknown origin (FUO). All human samples were subjected to ELISA
test for detection of leptospira IgM then the positive samples were subjected to
MAT for detecting the infective serovars.
The overall detection was 21.19% (39/184) for human samples examined by
ELISA IgM and the positive samples then subjected to MAT, the seroreactivity
of the detected leptospira serovars from the examined human samples as
examined by MAT was 33.33% (13/39) with titre ( 1/200- 1/6400). The most
prominent serovar was serovar icterohaemorragiae 38.46% (5/13) followed by
serovar canicola 30.76% (4/13) then serovar grippothphosa 15.38% (2/13),
serovar hardjo 7.69%(1/13) and serovar hebdomadis also 7.69% (1/13).
Regarding to age, It can be noticed that the majority of the positive samples
was 32.07% (17/53) by ELISA and 47.05% (8/17) by MAT belonged to the age
group of between (15-29 years old); 23.52% (8/34) by ELISA and 25.00%(2/8)
by MAT belonged to the age group of (< 15 years old) ; 19.56% (9/46) by
ELISA and 22.22% (2/9) by MAT belonged to the age group of between (30-44
years old); 15.62% (5/32) by ELISA and 20.00% (1/5) by MAT belonged to the
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age group of between (45-59 years old) and zero result by ELISA and MAT
belonged to the age group of (> 59 years old).
Concerning to sex, the seroprevalence was 25.47% (27/106) by ELISA and
37.03% (10/27) by MAT for male patients, 15.38% (12/78) by ELISA and
25.00% (3/12) by MAT for female patients, respectively.
The seroprevalence of leptospirosis among the examined humans in relation
to their occupation. It was found that the most prevalent occupational risk group
was sewer workers and fishers 57.14%(4/7) by ELISA and 75.00% (3/4) by
MAT, followed by laborers 38.09% (8/21) by ELISA and 50.00% (4/8) by
MAT, then farmers 25.80% (8/31) by ELISA and 25.00% (2/8) by MAT,
students 23.80% (10/42) by ELISA and 20.00% (2/10) by MAT, Housewives
17.24% (5/29) and 20% by MAT, and others 7.40% (4/54) by ELISA and
25.00% by MAT.
Concerning to residence, the overall detection was 27.18% (28/103) by
ELISA and 35.71% (10/28) by MAT for rural patients but 13.58% (11/81) by
ELISA and 27.27% (3/11) by MAT for urban patients, resectively.
According to prevalent clinical signs, the seropositivity of feverish patients
with pulmonary signs was 14.6% (17/116) by ELISA and 23.52% (4/17) by
MAT but for feverish patients with renal signs was 32.35%(22/68) by ELISA
and 40.90%(9/22) by MAT.
Regarding to prevalent climatic conditions, the overall prevalence was
34.78% (32/92) by ELISA and 34.37% (11/32) by MAT for patient samples that
were taken in warm climate, The overall prevalence in cold climate was 7.60%
(7/92) by ELISA and 28.57% (2/7) by MAT.
the relation of seropositivity among the examined samples and the detected
serovars. The seroreactivity was differed according to the host and detected
infected serovar as follow:
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The seropositivity by MAT for humans was 34.21% (13/38), for dogs was
42.11% (16/38), for rats was 23.68% (9/38) and the total overall seropositivity
was 35.84% (38/106) including ( 46 dog serum samples, 21 rat serum samples
and 39 positive ELISA human samples). In comparing serovars frequency
between human and reservoir animals. It was found that L interrogans serovar
canicola was the most prevalent serovar in this study 42.11% (16/38) including
4 for human, 10 for dogs and 2 for rats. L.interrogans serovar
icterohaemorragiae was seropositive about 28.94% ( 11/38) including 5 for
human, 4 for dogs and 2 for rats. L.kischneri serovar grippotyphosa was 7.89%
(3/38) including 2 for human and 1 for dogs. Also L.interrogans serovar
hebdomadis 5.26% (2/38) one for human and one for rats. One serovar alexi in
rats, one serovar australis in dogs, one serovar pyrogens in rats, one serovar
wolffii for rats and one serovar Georgia for rats, one serovar hardjo for human.
Finally, the presence of leptospiral antibodies in animal and human sera as
well as the positive result of PCR indicates the circulation of leptospires in
animal and human being in the study area. However, taking into consideration
the complete lake of reports of clinical disease recently in the study area it
appears more likely that these antibodies were due to along standing infection
that might have maintained in animal and specially in human. Also, the
seroprevalence studies in animals and human are very necessary to obtain
epidemiological data about the disease in Egypt.