@article{fdi:010071055,
  title = {{H}uman leptospirosis in {S}eychelles : a prospective study confirms the heavy burden of the disease but suggests that rats are not the main reservoir},
  author = {{B}iscornet, {L}. and {D}ellagi, {K}oussay and {P}ages, {F}. and {B}ibi, {J}. and de {C}omarmond, {J}. and {M}elade, {J}. and {G}ovinden, {G}. and {T}irant, {M}. and {G}omard, {Y}. and {G}uernier, {V}. and {L}agadec, {E}. and {M}elanie, {J}. and {R}ocamora, {G}. and le {M}inter, {G}. and {J}aubert, {J}. and {M}avingui, {P}. and {T}ortosa, {P}.},
  editor = {},
  language = {{ENG}},
  abstract = {{B}ackground {L}eptospirosis is a bacterial zoonosis caused by pathogenic {L}eptospira for which rats are considered as the main reservoir. {D}isease incidence is higher in tropical countries, especially in insular ecosystems. {O}ur objectives were to determine the current burden of leptospirosis in {S}eychelles, a country ranking first worldwide according to historical data, to establish epidemiological links between animal reservoirs and human disease, and to identify drivers of transmission. {M}ethods {A} total of 223 patients with acute febrile symptoms of unknown origin were enrolled in a 12-months prospective study and tested for leptospirosis through real-time {PCR}, {I}g{M} {ELISA} and {MAT}. {I}n addition, 739 rats trapped throughout the main island were investigated for {L}eptospira renal carriage. {A}ll molecularly confirmed positive samples were further genotyped. {R}esults {A} total of 51 patients fulfilled the biological criteria of acute leptospirosis, corresponding to an annual incidence of 54.6 (95% {CI} 40.7-71.8) per 100,000 inhabitants. {L}eptospira carriage in {R}attus spp. was overall low (7.7%) but dramatically higher in {R}attus norvegicus (52.9%) than in {R}attus rattus (4.4%). {L}eptospira interrogans was the only detected species in both humans and rats, and was represented by three distinct {S}equence {T}ypes ({ST}s). {T}wo were novel {ST}s identified in two thirds of acute human cases while noteworthily absent from rats. {C}onclusions {T}his study shows that human leptospirosis still represents a heavy disease burden in {S}eychelles. {G}enotype data suggests that rats are actually not the main reservoir for human disease. {W}e highlight a rather limited efficacy of preventive measures so far implemented in {S}eychelles. {T}his could result from ineffective control measures of excreting animal populations, possibly due to a misidentification of the main contaminating reservoir(s). {A}ltogether, presented data stimulate the exploration of alternative reservoir animal hosts.},
  keywords = {{SEYCHELLES}},
  booktitle = {},
  journal = {{PLOS} {N}eglected {T}ropical {D}iseases},
  volume = {11},
  numero = {8},
  pages = {e0005831 [22 p.]},
  ISSN = {1935-2735},
  year = {2017},
  DOI = {10.1371/journal.pntd.0005831},
  URL = {https://www.documentation.ird.fr/hor/fdi:010071055},
}