American Journal of Public Health Research, 2021, Vol. 9, No. 4, 180-183
Available online at http://pubs.sciepub.com/ajphr/9/4/9
Published by Science and Education Publishing
DOI:10.12691/ajphr-9-4-9
Leptospirosis and One Health Perspective
Mahendra Pal1,*, Mati Roba Bulcha2, Wakuma Mitiku Bune3
1
Narayan Consultancy on Veterinary Public Health and Microbiology- Anand-388001, Gujarat, India
Yemalog Walal Woreda Livestock and Fishery Development and Resource Office, Kellem Wollega zone, Oromia, Ethiopia
3
Ambo University, Guder Mamo Mezemer Campus, Veterinary Laboratory Technology, Ambo, Ethiopia
*Corresponding author:
2
Received May 17, 2021; Revised June 21, 2021; Accepted July 01, 2021
Abstract Zoonoses are primarily recognized as animal diseases that are transmitted to human beings through
various routes. These diseases have a serious impact on public health as well as economy throughout the world.
Leptospirosis is an emerging and re-emerging infectious zoonotic disease with global public health implications in
terms of morbidity and mortality of humans and livestock. The disease can occur in sporadic as well as in epidemic
forms. The source of infection is exogenous. Leptospirosis is a life threatening disease that causes 10.3 million cases
and 58900 deaths each year worldwide. Rodents are considered the main reservoir of Leptospira. The contact of the
skin with moist soil, water, and vegetation contaminated with urine of the infected animals and penetration of the
organism to the skin, mucous membrane through abrasion, cut, and injury help in the transmission of the infection.
Leptospirosis presents most important public health crisis that exists at the animals-humans-ecosystem interface. A
strategic break in the relationship between the host-pathogen and their ecosystem could provide effective control of
several possible zoonoses including leptospirosis. Global strategy to broaden interdisciplinary partnerships and
coordination in all areas of health care for humans, livestock and the community is required.
Keywords: one health approach, environment, Leptospirosis, public health, Zoonosis
Cite This Article: Mahendra Pal, Mati Roba Bulcha, and Wakuma Mitiku Bune, “Leptospirosis and
One Health Perspective.” American Journal of Public Health Research, vol. 9, no. 4 (2021): 180-183.
doi: 10.12691/ajphr-9-4-9.
1. Introduction
Zoonoses caused by varied etiologies, such as viruses,
bacteria, fungi, and parasites, are significant causes of
morbidity as well as mortality in humans and animals
including birds [1,2,3,4,5]. Currently, over 300 zoonotic
diseases are reported from developing and developed
nations of the world [6]. Leptospirosis is a highly
infectious zoonotic and waterborne disease that affects
people all over the world [2,7,8]. Leptospira spp. belongs
to the order Spirochetales. With over 260 antigenically
distinct serovars, Leptospira organisms have been
classified as pathogenic, intermediate, or saprophytic, with
varying degrees of pathogenicity for animals and humans
[9].
Global urbanization patterns are increasing the
dissemination of neglected zoonotic infections like
leptospirosis, and managing the infection in the animal
reservoir is the only way to reduce the number of human
cases of leptospirosis [10]. The pathogenic Leptospira are
excreted in the urine of reservoir hosts and may lead to
disease transmission either directly or indirectly by
interaction with mucous membranes or penetration of
another host's skin barrier. Disease is transmitted to
humans either directly through animals or indirectly
through polluted water or soil from an animal host [2,11].
It is an important occupational zoonosis of the agriculture
workers, butchers, veterinarians, dairy farmers, livestock
handlers, sewer workers and others. Leptospirosis is a life
threatening zoonotic disease, which is endemic in many
countries of the world including India [8,12]. Globally,
leptospirosis is responsible to cause 10.3 million cases and
58900 deaths annually [13].
Leptospirosis in humans should be diagnosed based on
a combination of epidemiological and clinical evidence,
with mandatory laboratory testing to validate the diagnosis
[14]. Polymerase chain reaction (PCR) is a sensitive and
precise approach for diagnosing Leptospira infection, and
it has spawned a slew of techniques aimed at improving
its sensitivity, specificity, and reliability [14].
For a global strategy to broaden interdisciplinary
partnerships and coordination in all areas of health care
for humans, livestock, and the community, close
cooperation and coordination between veterinarians,
occupational health doctors, and public health operators
are very much needed. Leptospirosis involves rapid
worldwide cooperation using a One Health solution that
combines evidence from humans, wildlife, and the
environment. This is crucial for designing efficient
prevention mechanisms and avoiding the spread of disease
[15].
Leptospirosisis a major public health problem that
occurs at the animal–human–environment ecosystem
interface, and is complex to geographic and host barriers.
In the future, a strategic break in the relationship between
the host, pathogen, and their ecosystem could provide
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effective control of several possible zoonoses including
leptospirosis. To avoid, monitor, and eradicate these
neglected zoonotic infections, good intersectoral
cooperation, and coordination between the animal and
human health sectors at state, national, and international
levels are highly essential [16]. This manuscript delineates
the importance of One Health approach in the control
leptospirosis, an enigmatic zoonosis of global public
health concern.
1.1. General Overview of One Health
One Health is defined as a collective, multisectoral, and
transdisciplinary approach for achieving optimal health
outcomes by understanding the interconnections between
humans, livestock, plants, and their common ecosystem at
the local, state, national, and global levels [17]. One
Health is a broad term that encompasses a variety of
disciplines, occupations, and fields of concern, including
animal health care, animal cruelty relief, livestock resource
management, public health promotion, and medical
awareness development. Since zoonoses can infect both
humans and animals, it is therefore, imperative that
medical and veterinary professionals should collaborate in
clinical, public health, and laboratory settings [15].
One Health strategy seeks to improve global attempts to
keep zoonoses and other diseases from spreading. The
ability to coordinate capital across industries, as well as
collaboration and intersectoral approaches across national
(or international) veterinarian, environmental, and public
health systems, is critical to preventing and managing a lot
of neglected zoonotic diseases, such as anthrax,
brucellosis, leptospirosis and others [17].
1.1.1. Veterinarian and One Health Approach
Veterinary medicine is the potential to be effective in
several fields, including biomedical research, agroterrorism, food safety and security, and public health.
Veterinarians have a good knowledge of population
wellbeing, comparative medicine, and preventative
medicine [17].
The idea of One Health has become a rallying cry in
response to our world's failing health care needs, and a
lack of joint effort among our veterinary and human
experts, who are focused on individualized health care ;
and deeper exploration of biomedical science, has
exacerbated the problem [16]. One Health approach
allows veterinarians to work together with physicians,
public health authorities, conservation experts, and
environmental health practitioners and gain a greater
understanding of diseases that impact humans and animals.
Veterinarians detect, investigate, and monitor indirect
zoonoses and non-zoonotic communicable diseases that
impact human health in addition to controlling direct
zoonotic diseases in animals [17].
The complexities of identifying resurgent infectious
diseases and designing new therapeutics have placed a
greater focus on handling and sustaining experimental
animal colonies for the scientific and diagnostic purposes
than ever before. Veterinarians are in charge of delivering
these programs effectively and humanely [6,17]. The
importance of Public Health Veterinarians in all public
health programmes to achieve One Health is emphasized
by earlier researchers [1,18]
2. Leptospirosis and One Health
Perspective
One Health is a philosophy that emphasizes the
interconnectedness of human, animal, and environmental
health. The interaction between humans, animals, and the
environment, which include other living beings, such as
plants, results in integrated health in a broad sense. The
health of people is linked to the health of animals and the
environment. According to the One Health approach,
which is characterized as a concerted effort of multiple
disciplines working locally, nationally, and globally to
achieve optimal health for people, animals, and the
environment [19]. Because of intensified interaction
between animals and humans, as well as human
encroachment into a natural habitat, leptospirosis is
considered as an emerging zoonosis of global public
health importance.
Human health, animal health, plant health, ecosystem
health, and biodiversity must all be addressed in terms of
health protection on a global scale and from a global and
cross-cutting perspective. Integrated approaches to
reducing leptospirosis pressure on a global scale must be
pursued, based not only on sound One Health values, but
also on economic facts, social equity principles, and
global access to good healthcare for people and their
animals and also environments [15]. Global changes are
accelerated by human population growth, industrialization,
and geopolitical concerns, resulting in substantial
biodiversity loss, widespread habitat depletion, and the
significant migratory movement of humans and other
animals that leads to emerging of leptospirosis from
wildlife [20].
Therefore, "One Health" initiative is a global policy
that stresses the need for a comprehensive and
transdisciplinary approach to coping with the health of
people, livestock, and habitats that integrates multi-sector
knowledge. The biology and ecology of Leptospira, their
hosts, and their vectors all play a role in the emergence
and re-emergence of the diseases [15]. A detailed
understanding of ecosystem dynamics is needed, as it
offers insight into the processes that contribute to the
emergence or recurrence of Leptospira, as well as their
spread and extinction in natural habitats. Understanding
transmission cycles is critical from a One Health
perspective, as is looking for pathways of transmission,
prevention and mitigation that could be useful for
potential risk conditions in the context of these neglected
zoonotic diseases [20].
Due attention to public awareness and collaborative
disease control strategies must be implemented in the
right directions by various sectors and stake-holders
and regulatory health agencies for implementing
warranted interventions to effectively check the
transmission and spread and to prevent the spread of
leptospirosis [19].
American Journal of Public Health Research
2.1. Risk Factors
2.1.1. Wild Animals
Over the last three decades, it has become increasingly
clear that the majority of the novel, emerging zoonotic
infectious diseases originate in animals, especially wildlife,
and that the primary drivers of their emergence are human
activities, such as changes in habitats and land use,
agricultural intensification, urbanization, and international
travel and trade [1,2,21].
Because of the vast range of wild and domestic animal
species that can serve as natural or unintended hosts,
leptospirosis is a globally dispersed, re-emerging zoonosis
[6,8]. Domestication of animals has assisted in the spread
of infectious agents from livestock to human beings [2].
The majority of emerging infectious diseases that are
considered to be important in terms of public health have a
zoonotic cause [1], with wild animals accounting for
nearly three-quarters of all cases [22].
Leptospirosis is a bacterial infection that affects both
domestic and wild animals, as well as humans [2,23]. The
natural infection has been described in buffalo, camel, cat,
cattle, deer, fox, goat, horse, pig, rodent, sea-lion, and
sheep [2,23]. Many wild animals serve as reservoirs for
Leptospira. However, the true position of wildlife animals
as a source of infection in livestock and humans, as well
as the most significant reservoirs and leptospiral strains, is
unknown. Wild animals play a different function as hosts
for leptospiral strains that can infect domestic animals as
well as humans. Although some studies indicate that
free-living species are primary sources of infection for
other species in some cases, other studies say that strains
circulating in the wild animal population are unlikely to
pose a disease threat to domestic animals [24].
Many wild animals could serve as reservoirs; leptospires
colonize the proximal renal tubules of carrier and
maintenance hosts, and the bacteria are excreted in the
urine regularly. Despite this, infections in livestock are
rarely lethal, with abortion being the most common
clinical indication [25].
2.1.2. Environmental Factors
The degree of transmission of leptospirosis can
be affected by the climate change and its related
environmental changes. Several outbreaks of leptospirosis
have been linked to flooding and heavy rainfall around the
world. Extreme weather events, such as cyclones and
floods are predicted to increase in frequency and severity
as a result of global climate change, possibly leading to an
increase in disease incidence and the size of leptospirosis
outbreaks [26].
Warm-blooded animals, mostly mammals, are preferred
by leptospires. The organism is extremely adaptable to its
surroundings and can live in the water and wet soil for
long periods. Weather factors that benefit disease transmission
include heavy rain, floods, and high temperatures. Water
sports, environmental disasters, and occupational exposure
have all been related to the outbreaks of leptospirosis.
Because of their ability to live in the wet conditions,
leptospires pose a high risk of contamination when they
come into contact with dirty water [27].
182
Owing to favorable climatic conditions and lower
hygienic measures, the prevalence of leptospirosis in the
tropical and developing countries is usually higher than in
the temperate and developed countries [21]. The natural
disasters including cyclones and flooding raise the
prevalence of disease, and a vast number of animals serve
as carriers. Sub-clinically infected animals with hostadapted serovars function as long-term carriers and
persistent shedders of the bacteria, mostly by their urine.
Furthermore, the soil exposure by this bacterium found in
the animal excreta is a cause of the infection for humans,
making the farm workers, animal handlers, livestock
keepers, pet owners, and occupational workers at risk of
the infection [23,28].
3. Conclusion and Recommendations
One Health approach consists three tiers that
incorporate human, animal and environment. The risk of
zoonoses rises from time to time in the environment as a
result of the behavioral and demographic shifts in
response to human needs. The consequences of neglected
zoonoses are not limited to human and animal health risks;
social consequences are also important. It is emphasized
that better coordination and cooperation between
veterinarians, physicians, and public health officials are
highly imperative. The impact of zoonoses grows with
time, and the severity of the health crisis in humans and
animals grows exponentially.
Therefore, based on the above conclusions the
following recommendations are forwarded:
• Health institutions, government agencies, medical,
environmental industry, and veterinary care all need
to work together more closely to achieve the target
of One Health.
• Knowledge and public awareness should be created
on the economic and health significance of
leptospirosis.
• Further research should be conducted into zoonotic
importance, detection, and potential prevention and
control strategies.
Acknowledgements
The authors are very thankful to Prof. Dr.R.K. Narayan
for his suggestions during the preparation of manuscript
and Anubha Priyabandhu for computer help.
Contribution of Authors
All the authors contributed equally. They read the final
version, and approved it for the publication.
Conflict of Interest
The authors declare that they do not have conflict of
interest.
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American Journal of Public Health Research
Source of Financial Grant
[15] Orlando, S.A., Perez, A., Sanchez, E., de la Cruz, C., Rugel, O.
There was no financial support for this manuscript.
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