Leptospirosis in American Samoa 2010: Epidemiology, Environmental Drivers, and the Management of Emergence

Colleen L. Lau School of Population Health, The University of Queensland, Brisbane, Queensland, Australia; WHO/OIE/FAO Collaborating Centre for Reference and Research on Leptospirosis, Queensland Health Forensic and Scientific Services, Brisbane, Queensland, Australia; University of the Sunshine Coast, Sippy Downs, Queensland, Australia; American Samoa Department of Health, Pago Pago, American Samoa; Barbara Hardy Institute, University of South Australia, Adelaide, South Australia, Australia

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Annette J. Dobson School of Population Health, The University of Queensland, Brisbane, Queensland, Australia; WHO/OIE/FAO Collaborating Centre for Reference and Research on Leptospirosis, Queensland Health Forensic and Scientific Services, Brisbane, Queensland, Australia; University of the Sunshine Coast, Sippy Downs, Queensland, Australia; American Samoa Department of Health, Pago Pago, American Samoa; Barbara Hardy Institute, University of South Australia, Adelaide, South Australia, Australia

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Lee D. Smythe School of Population Health, The University of Queensland, Brisbane, Queensland, Australia; WHO/OIE/FAO Collaborating Centre for Reference and Research on Leptospirosis, Queensland Health Forensic and Scientific Services, Brisbane, Queensland, Australia; University of the Sunshine Coast, Sippy Downs, Queensland, Australia; American Samoa Department of Health, Pago Pago, American Samoa; Barbara Hardy Institute, University of South Australia, Adelaide, South Australia, Australia

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Emily J. Fearnley School of Population Health, The University of Queensland, Brisbane, Queensland, Australia; WHO/OIE/FAO Collaborating Centre for Reference and Research on Leptospirosis, Queensland Health Forensic and Scientific Services, Brisbane, Queensland, Australia; University of the Sunshine Coast, Sippy Downs, Queensland, Australia; American Samoa Department of Health, Pago Pago, American Samoa; Barbara Hardy Institute, University of South Australia, Adelaide, South Australia, Australia

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Chris Skelly School of Population Health, The University of Queensland, Brisbane, Queensland, Australia; WHO/OIE/FAO Collaborating Centre for Reference and Research on Leptospirosis, Queensland Health Forensic and Scientific Services, Brisbane, Queensland, Australia; University of the Sunshine Coast, Sippy Downs, Queensland, Australia; American Samoa Department of Health, Pago Pago, American Samoa; Barbara Hardy Institute, University of South Australia, Adelaide, South Australia, Australia

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Archie C. A. Clements School of Population Health, The University of Queensland, Brisbane, Queensland, Australia; WHO/OIE/FAO Collaborating Centre for Reference and Research on Leptospirosis, Queensland Health Forensic and Scientific Services, Brisbane, Queensland, Australia; University of the Sunshine Coast, Sippy Downs, Queensland, Australia; American Samoa Department of Health, Pago Pago, American Samoa; Barbara Hardy Institute, University of South Australia, Adelaide, South Australia, Australia

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Scott B. Craig School of Population Health, The University of Queensland, Brisbane, Queensland, Australia; WHO/OIE/FAO Collaborating Centre for Reference and Research on Leptospirosis, Queensland Health Forensic and Scientific Services, Brisbane, Queensland, Australia; University of the Sunshine Coast, Sippy Downs, Queensland, Australia; American Samoa Department of Health, Pago Pago, American Samoa; Barbara Hardy Institute, University of South Australia, Adelaide, South Australia, Australia

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Saipale D. Fuimaono School of Population Health, The University of Queensland, Brisbane, Queensland, Australia; WHO/OIE/FAO Collaborating Centre for Reference and Research on Leptospirosis, Queensland Health Forensic and Scientific Services, Brisbane, Queensland, Australia; University of the Sunshine Coast, Sippy Downs, Queensland, Australia; American Samoa Department of Health, Pago Pago, American Samoa; Barbara Hardy Institute, University of South Australia, Adelaide, South Australia, Australia

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Philip Weinstein School of Population Health, The University of Queensland, Brisbane, Queensland, Australia; WHO/OIE/FAO Collaborating Centre for Reference and Research on Leptospirosis, Queensland Health Forensic and Scientific Services, Brisbane, Queensland, Australia; University of the Sunshine Coast, Sippy Downs, Queensland, Australia; American Samoa Department of Health, Pago Pago, American Samoa; Barbara Hardy Institute, University of South Australia, Adelaide, South Australia, Australia

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DOI:
https://doi.org/10.4269/ajtmh.2012.11-0398
Volume/Issue:
Volume 86: Issue 2
Page(s):
309–319
Restricted access
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Leptospirosis has recently been reported as an emerging disease worldwide, and a seroprevalence study was undertaken in American Samoa to better understand the drivers of transmission. Antibodies indicative of previous exposure to leptospirosis were found in 15.5% of 807 participants, predominantly against three serovars that were not previously known to occur in American Samoa. Questionnaires and geographic information systems data were used to assess behavioral factors and environmental determinants of disease transmission, and logistic regression was used to identify factors associated with infection. Many statistically significant factors were consistent with previous studies, but we also showed a significant association with living at lower altitudes (odds ratio [OR] = 1.53, 95% confidence interval [CI]: 1.03–2.28), and having higher numbers of piggeries around the home (OR = 2.63, 95% CI: 1.52–4.40). Our findings support a multifaceted approach to combating the emergence of leptospirosis, including modification of individual behavior, but importantly also managing the evolving environmental drivers of risk.

Author Notes

*Address correspondence to Colleen L. Lau, PO Box 12426, George St., Brisbane, Queensland 4003, Australia. E-mail: colleen.lau@uqconnect.edu.au

Financial support: This study was funded by the School Population Health, The University of Queensland; a Graduate School Research Travel Grant from The University of Queensland; and the WHO/OIE/FAO Collaborating Centre for Reference and Research on Leptospirosis, Queensland Health Forensic and Scientific Services, Brisbane, Australia.

Authors’ addresses: Colleen L. Lau, Annette J. Dobson, Emily J. Fearnley, Chris Skelly, and Archie C. A. Clements, School of Population Health, The University of Queensland, Herston, Queensland, Australia, E-mails: colleen.lau@uqconnect.edu.au, a.dobson@sph.uq.edu.au, emilyjfearnley@gmail.com, Wchris.skelly@gmail.com, and a.clements@sph.uq.edu.au. Lee D. Smythe and Scott B. Craig, WHO/OIE/FAO Collaborating Centre for Reference and Research on Leptospirosis, Queensland Health Forensic and Scientific Services, Brisbane, Queensland, Australia, E-mails: Lee_Smythe@health.qld.gov.au, and Scott_Craig@health.qld.gov.au. Saipale D. Fuimaono, American Samoa Department of Health, Pago Pago, American Samoa, E-mail: sfuima6@yahoo.com. Philip Weinstein, Barbara Hardy Institute, University of South Australia, Adelaide, South Australia, Australia, E-mail: philip.weinstein@unisa.edu.au.

Copyright:
©The American Society of Tropical Medicine and Hygiene 2012
Received:
22 Jun 2011
|
Accepted:
09 Oct 2011
|
Published Online:
01 Feb 2012
Cover The American Journal of Tropical Medicine and Hygiene
The American Journal of Tropical Medicine and Hygiene
Print ISSN:
0002-9637
Online ISSN:
1476-1645
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