Disease transmission in horses refers to the spread of infectious agents such as bacteria, viruses, fungi, and parasites among equine populations. These pathogens can be transmitted through various routes, including direct contact, vector-borne transmission, or environmental exposure. Factors influencing disease transmission include horse density, management practices, and biosecurity measures. Understanding the mechanisms and conditions that facilitate the spread of diseases is essential for developing effective prevention and control strategies. This page compiles peer-reviewed research studies and scholarly articles that investigate the modes of transmission, risk factors, and management practices related to infectious diseases in horses.
Aharonson-Raz K, Steinman A, Bumbarov V, Maan S, Maan NS, Nomikou K, Batten C, Potgieter C, Gottlieb Y, Mertens P, Klement E.During 2008-2009 in Israel, equine encephalosis virus (EEV) caused febrile outbreaks in horses. Phylogenetic analysis of segment 10 of the virus strains showed that they form a new cluster; analysis of segment 2 showed ≈92% sequence identity to EEV-3, the reference isolate. Thus, the source of this emerging EEV remains uncertain.
Scoles GA, Hutcheson HJ, Schlater JL, Hennager SG, Pelzel AM, Knowles DP.We report an outbreak of equine piroplasmosis in southern Texas, USA, in 2009. Infection prevalence reached 100% in some areas (292 infected horses). Amblyomma cajennense was the predominant tick and experimentally transmitted Theileria equi to an uninfected horse. We suggest that transmission by this tick species played a role in this outbreak.
Dos Santos TM, Roier EC, Santos HA, Pires MS, Vilela JA, Moraes LM, Almeida FQ, Baldani CD, Machado RZ, Massard CL.Serum samples from 714 equids of Itaguaí and Serrana microregions, Rio de Janeiro, southeastern Brazil, were examined by indirect fluorescent antibody test (titer 1:80) for Theileria equi. The prevalence in the microregions and factors associated with seropositivity were evaluated and the prevalence ratio (PR) calculated. The overall prevalence of T. equi infection was 81.09% (n = 579), with higher prevalence (p < 0.05) in the Itaguaí (85.43%) when compared to Serrana microregion (76.92%). The geographic area, altitude, farming condition and area of origin of equids were associated (p <...
Hayama Y, Kobayashi S, Nishida T, Muroga N, Tsutsui T.An equine infectious anemia (EIA) transmission model was developed by constructing a network structure of horse movement patterns in a non-racehorse population. This model was then used to evaluate the effectiveness and efficiency of several EIA surveillance strategies. Because EIA had not been detected in Japan since 1993, it was appropriate to review the current surveillance strategy, which aims to eradicate EIA by intensive testing, and to consider alternative strategies suitable for the current EIA status in Japan. The non-racehorse population was divided into four sectors based on horse u...
Scheffer EG, Venter GJ, Labuschagne K, Page PC, Mullens BA, MacLachlan NJ, Osterrieder N, Guthrie AJ.Culicoides biting midges (Diptera: Ceratopogonidae) are vectors of a variety of pathogens including African horse sickness virus (AHSV), a member of the family Reoviridae, genus Orbivirus. AHSV causes African horse sickness (AHS), an endemic disease of equids with an extremely high mortality rate in horses in sub-Saharan Africa. Culicoides (Avaritia) imicola Kieffer is considered to be the principal vector of AHSV and is the dominant Culicoides species in South Africa. Due to the global distribution of Culicoides vectors, there is a potential risk of AHS spreading from endemic areas to areas t...
Asseged BD, Habtemariam T, Tameru B, Nganwa D.Deriving horse oocytes in the USA is hampered by the lack of abattoirs processing horse carcasses which could provide abundant quantities of ovaries from slaughtered mares. Therefore, several cloning industries in the USA are attempting to import cloned horse embryos from Canada. Like any agricultural commodity, cloned embryos pose a risk of introduction of exotic animal diseases into the importing country. Under such circumstances, risk assessment could provide an objective, transparent, and internationally accepted means for evaluating the risk. This quantitative risk assessment (QRA) was in...
Zoonoses and public healthSeptember 28, 2011
Volume 59, Issue 3 217-228 doi: 10.1111/j.1863-2378.2011.01438.x
Bolton DJ, O'Neill CJ, Fanning S.The aims of this study were to investigate the incidence of Salmonella, verocytotoxigenic Escherichia coli (VTEC)/Escherichia coli O157 and Campylobacter on four mixed farms and to characterize the isolates in terms of a range of virulence factors. Eighty-nine composite (five different samples from the same animal species combined) faecal [cattle (24), pigs (14), sheep (4), poultry (4), horses (7), deer (4), dogs (9), rodents (2) and wild birds (20)] samples, 16 composite soil samples plus 35 individual water samples were screened using culture-based, immunomagnetic separation and molecular me...
Chhabra S, Ranjan R, Uppal SK, Singla LD.This article communicates the first per-acute and fatal clinical report of transplacental transmission of Theileria equi from carrier mothers to foals from Punjab, India. Two cases of equine piroplasmosis due to T. equi were diagnosed in neonatal foals borne to Throughbred mares. High degree of parasitemia with annular and maltese cross shaped parasites in erythrocytes was seen in both cases. Blood cellular changes revealed leucopenia and neutropenia with mild degenerative left shift. Anaemia was macrocytic normochromic type. Intense yellow discoloration of mucous membranes indicated jaundice....
Sieber S, Gerber V, Jandova V, Rossano A, Evison JM, Perreten V.A total of 70 Staphylococcus aureus isolates from postoperative infections in hospitalized horses were isolated between January 2005 and January 2011. Among them, 12 isolates were methicillin-susceptible S. aureus (MSSA), 18 were borderline-oxacillin-resistant S. aureus (BORSA), and 40 were methicillin-resistant S. aureus (MRSA). During the same period, the equine clinic personnel were screened for nasal carriage of BORSA and MRSA. Genotyping revealed that BORSA ST1(MLST)-t2863(spa) isolates were responsible for most equine infections and were the main isolates found in colonized members of th...
Boyle A.Streptococcus equi subspecies equi (strangles) is a highly contagious upper respiratory infection in horses. The infection is transmitted by inhalation or direct contact with mucopurulent discharge from an infective animal, resulting in fever, depression, and submandibular and retropharyngeal lymph node enlargement that can lead to respiratory distress. Complications include purpura hemorrhagica and metastatic abscessation. Control of outbreaks requires strict isolation protocols and hygiene measures. Detection of carriers is essential for preventing disease recurrence on a farm.
Maddox TW, Pinchbeck GL, Clegg PD, Wedley AL, Dawson S, Williams NJ.The increasing prevalence of antimicrobial resistant bacteria such as antimicrobial-resistant and extended spectrum β-lactamase (ESBL)-producing Escherichia coli represents a significant problem for human and veterinary medicine. Despite this, the risk factors for faecal carriage of such bacteria by horses in the UK, particularly those in the wider community, have not been well described. Objective: To characterise the risk factors for faecal carriage of antimicrobial-resistant E. coli amongst horses in the mainland UK. Methods: A cross-sectional study of horses recruited by 65 randomly selec...
Major DA.This paper describes a protocol for hygiene practices that was devised by a practice in which all veterinarians were involved on a daily basis in visiting infected premises, including sampling, treatment of clinical cases and general veterinary work. This protocol was strictly followed when attending an infected or at risk property.
Britton AL, Major DA, Perry GH, Read AJ.The interaction and stabling of horses at equine events may have a substantial impact on the spread of a zoonotic disease. This study aimed to investigate the spread of equine influenza (EI) at an equestrian event at the start of the Australian outbreak. Around one-third of the competing horses were stabled overnight at the event and, of these, 70% developed symptoms of EI within 7 days. The index case was never positively identified, but stabling position and disease onset provided clues to its potential identity.
Ander M, Meiswinkel R, Chirico J.The outbreak of bluetongue (BT) in northern Europe 2006 initiated the monitoring of vectors, biting midges of the genus Culicoides in Sweden. In order to determine the diversity, distribution and seasonal dynamics of Culicoides, weekly collections were made during 2008 and during March-December 2009 using the Ondestepoort Veterinary Institute black light trap. Twenty sampling sites were selected in 12 provinces. In total of 30,704 Culicoides were collected in 2008 and 32,252 in 2009. The most abundant species were the potential vectors of BTV Culicoides obsoletus/C. scoticus that comprised of ...
Backer JA, Nodelijk G.African horse sickness (AHS) is an equine viral disease that is spread by Culicoides spp. Since the closely related disease bluetongue established itself in The Netherlands in 2006, AHS is considered a potential threat for the Dutch horse population. A vector-host model that incorporates the current knowledge of the infection biology is used to explore the effect of different parameters on whether and how the disease will spread, and to assess the effect of control measures. The time of introduction is an important determinant whether and how the disease will spread, depending on temperature a...
Watson J, Daniels P, Kirkland P, Carroll A, Jeggo M.In August 2007 Australia experienced its first outbreak of equine influenza. The disease occurred first in a quarantine station for imported horses near Sydney and subsequently escaped into the general horse population. After an extensive campaign the disease was eradicated and Australia is again recognised as free of this disease. Equine influenza was then, and is now, recognised to be the major disease risk associated with live horse imports into Australia and measures designed to mitigate this risk formed the basis of the quarantine protocols then in place. Subsequent investigations into th...
Venter M, Human S, van Niekerk S, Williams J, van Eeden C, Freeman F.In 2010, lineage 1 West Nile virus was detected in South Africa in the brain of a pregnant mare that succumbed to neurologic disease and in her aborted fetus, suggesting an association with abortion in horses. All West Nile virus strains previously detected in horses and humans in South Africa were lineage 2.
Quintana AM, Hussey SB, Burr EC, Pecoraro HL, Annis KM, Rao S, Landolt GA.To evaluate whether an equine-derived canine H3N8 influenza A virus was capable of infecting and transmitting disease to ponies. Methods: 20 influenza virus-seronegative 12- to 24-month-old ponies. Methods: 5 ponies were inoculated via aerosol exposure with 10(7) TCID(50) of A/Canine/Wyoming/86033/07 virus (Ca/WY)/pony. A second group of 5 ponies (positive control group) was inoculated via aerosol exposure with a contemporary A/Eq/Colorado/10/07 virus (Eq/CO), and 4 sham-inoculated ponies served as a negative control group. To evaluate the potential for virus transmission, ponies (3/inoculatio...
Fall AG, Diaïté A, Etter E, Bouyer J, Ndiaye TD, Konaté L.Active catches of adult females of Aedes vexans arabiensis Patton, (Diptera: Culicidae) Patton by nets or aspirator, were conducted in 2003 and 2004 in the vegetation at the edge of temporary ponds in Barkedji, Senegalese Ferlo area. Two hundred and forty-one engorged females were captured, dissected and the gut content adsorbed on a Whatman filter paper and analysed using the enzyme-linked immunosorbent assay (ELISA) technique to determinate the bloodmeal origin. Results indicated that Ae v. arabiensis fed primarily on mammals, including horses (35.7% of the bloodmeals), but also on birds (10...
Wernery U, Wernery R, Joseph M, Al-Salloom F, Johnson B, Kinne J, Jose S, Jose S, Tappendorf B, Hornstra H, Scholz HC.We confirm a natural infection of dromedaries with glanders. Multilocus variable number tandem repeat analysis of a Burkholderia mallei strain isolated from a diseased dromedary in Bahrain revealed close genetic proximity to strain Dubai 7, which caused an outbreak of glanders in horses in the United Arab Emirates in 2004.
Waller AS, Paillot R, Timoney JF.Strangles caused by the host adapted Lancefield group C Streptococcus equi subspecies equi (S. equi) is a frequently diagnosed infectious disease of horses worldwide. Critical to the global success of S. equi is its ability to establish persistent infections within the guttural pouches of recovered apparently healthy horses that can result in transmission to in-contact animals. Recent research has identified key events in the S. equi genome, which occurred during its evolution from an ancestral strain of S. equi subspecies zooepidemicus, that may enhance its ability to evade host innate immune...
Damborg P, Marskar P, Baptiste KE, Guardabassi L.The objective of this longitudinal study was to investigate the occurrence and genetic background of faecal Escherichia coli resistant to cefotaxime (CTX) in horses receiving broad-spectrum antimicrobial prophylaxis after admission to a veterinary teaching hospital. The ten horses enrolled in the study were treated with cefquinome either alone (n=4) or in combination with metronidazole (n=3) or other antimicrobial agents (n=3). CTX-resistant coliforms in faeces collected before, during and after treatment were quantified on selective MacConkey agar supplemented with CTX, and a colony isolated ...
Jorge RS, Ferreira F, Ferreira Neto JS, Vasconcellos Sde A, Lima Ede S, Morais ZM, Souza GO.Leptospirosis is a zoonotic disease affecting most mammals and is distributed throughout the world. Several species of domestic and wild animals may act as reservoirs for this disease. The purpose of this study was to assess the exposure of free-ranging wild carnivores, horses and domestic dogs on a private reserve located in the northern Pantanal (Brazil) and the surrounding areas to Leptospira spp from 2002-2006, 75 free-ranging wild carnivores were captured in the Pantanal and serum samples were collected. In addition, samples from 103 domestic dogs and 23 horses in the region were collecte...
Dhand NK, Sergeant ES.During the 2007 equine influenza (EI) outbreak in Australia, there was no objective information about the possible under-reporting of cases by horse owners either so that they would avoid movement restrictions or because of their inability to detect infection. This investigation aimed to estimate the proportion of under-reporting during the outbreak based on the results of surveillance undertaken in conjunction with vaccination. The results provided improved estimates of morbidity during the outbreak and indicated the level of under-reporting likely to occur in future outbreaks of other infect...
Wilson G, Cooper K, Williams J, Eastwood S, Peake C.The 2007 equine influenza (EI) outbreak in New South Wales (NSW) consisted of a central infected area that extended south from the lower New England Tableland, across the Hunter Valley, Central Coast and the Sydney basin, and a series of isolated clusters outside this area across rural NSW. The central area was assigned the status of a Purple Zone (Special Restricted Area, SRA) approximately 1 month after the outbreak commenced. Within this SRA, the eradication program's focus was to increase the proportion of horses immune to EI via vaccination, thus reducing the susceptible proportion to a l...
Gilchrist P, Sergeant ES.Australia has the world's largest population of wild equids and equine influenza (EI) was confirmed on several properties in New South Wales (NSW) close to uncontrolled areas of land during the 2007 outbreak. Likelihood and risk management assessments were carried out to determine the risk of EI infection of the wild horse populations. The likelihood of spread to the wild horse population was determined to be extremely low, but the likelihood of spread from an established wild horse reservoir back to domestic horses was considered high. The most effective mechanism of control was determined to...
Ryan D.Outbreaks of equine influenza (EI) cause major disruption to the racing industry, resulting in cessation of racing until affected horses have recovered from the disease. The introduction of EI to a large population of Thoroughbred horses stabled at a Sydney racecourse provided the opportunity to observe clinical signs and monitor the spread of EI in this predominantly naïve population and to assist in determining an endpoint to infection spread to allow resumption of racing events.
Kung N, Mackenzie S, Pitt D, Robinson B, Perkins NR.An outbreak of equine influenza (EI) caused by influenza A H3N8 subtype virus occurred in the Australian states of Queensland and New South Wales in August 2007. Infection in the Australian horse population was associated with the introduction of infection by horses from overseas. The first case of EI in Queensland was detected on 25 August 2007 at an equestrian sporting event. Infection subsequently spread locally and to other clusters through horse movements prior to the implementation of an official standstill. There were five main clusters of infected properties during this outbreak and se...
Wong D.The clinical signs of horses diagnosed with equine influenza (EI) at Centennial Parklands Equestrian Centre (CPEC) and the events surrounding their diagnosis are described. This was the site of the first case of EI diagnosed outside of the Eastern Creek Animal Quarantine Station. The clinical data demonstrate the rapid spread of the disease after a sufficient viral load had developed from the initial cases within CPEC.
Cámara A, Contigiani MS, Medeot SI.A serologic survey of horses for Kairi (KRI) and Cache Valley (CV), two related Bunyaviruses, was conducted simultaneously in Cordoba and Santa Fe provinces, Argentina, during late 1983 and 1984. The prevalence of neutralizing antibodies only for KRI was 13.3% and only for CV was 40.0%; but if the total positive sera for KRI and CV were taken into account, the prevalence reached 48.3 and 75.0%, respectively. The prevalence for CV was higher than for KRI in Cordoba (p less than 0.01), but both were similar in Santa Fe province. The demonstration of seroconversion in horses of the two zones for ...
Garris GI, Scotland K.Cattle, sheep, goats and horses were examined for ticks. Over 95% of Holstein cross-breeds, 28% of sheep (local mixed breeds) and 18% of goats (local mixed breeds) examined from 18 August to 4 September 1983 were infested with the southern cattle tick, Boophilus microplus Canestrini. About 90 and 17% of the horses examined were infested with the tropical horse tick, Anocentor nitens Neumann, and the tropical bont tick, Amblyomma variegatum Fabricius, respectively. The tropical bont tick was found infesting 10% of cattle in the Gros Islet area of St. Lucia. The tropical bont tick was also found...
Downs J, Vaziri M, Jenkins A, Unnasch T.Eastern Equine Encephalitis Virus (EEEV) is the most pathogenic arbovirus endemic to the United States. EEEV primarily infects birds but can be fatal to humans, horses, and some other mammals. Although EEEV transmission occurs in the Northeastern, Southeastern, and Midwestern United States, the largest number of horse and human cases have been reported in Florida, the only state where transmission occurs year round. Currently, a GIS-based risk index (RI) model is used to map EEE transmission risk to horses in Florida. This study validates that RI model using a 5-yr dataset of horse cases in Fl...
Singha H, Elschner MC, Malik P, Saini S, Tripathi BN, Mertens-Scholz K, Brangsch H, Melzer F, Singh RK, Neubauer H.We collected 10 Burkholderia mallei isolates from equids in 9 districts in India during glanders outbreaks in 2013-2016. Multilocus variable-number tandem-repeat analysis showed 7 outbreak area-related genotypes. The study highlights the utility of this analysis for epidemiologically tracing of specific B. mallei isolates during outbreaks.
Craig TM, Bowen JM, Ludwig KG.After foaling, 6 mares and their foals were placed on equine parasite-free pastures. Observations of fecal nematode eggs and pasture larvae indicated peak cyathostome egg production occurred in late August and early September, with greatest numbers of larvae on the forage appearing during October. Two foals were necropsied for parasitologic evaluations at approximately 155 days of age. Both had approximately 100,000 adult cyathostomes, mostly Cylicostephanus longibursatus, Cylicocyclus nassatus and Cyathostomum catinatum. However, there were nearly 7 times more cyathostome larvae (189,004) in ...
De Vroey C, Wuytack-Raes C, Fossoul F.Several M. praecox isolates of saprophytic origin were obtained in Belgium from horses and their surroundings. Visualization of macroconidia in dust collected in stables proved its saprophytic origin. A few strains were obtained from human cases of tinea corporis.
Hahn NE, Fletcher M, Rice RM, Kocan KM, Hansen JW, Hair JA, Barker RW, Perry BD.Dermacentor variabilis, Rhipicephalus sanguineus, Amblyomma americanum, and Ixodes scapularis ticks were investigated for their ability to transmit Potomac horse fever. Larval and nymphal ticks were exposed to Ehrlichia risticii by feeding on mice inoculated with the organism. Molted exposed ticks were then allowed to feed on susceptible ponies or mice. No evidence of transmission, either clinically or by detection of antibodies to E. risticii in mice or ponies, was observed for any tick species examined.
Hebia I, Fiéni F, Duchamp G, Destrumelle S, Pellerin JL, Zientara S, Vautherot JF, Bruyas JF.The objective of this study was to determine whether the 10 wash cycles proposed by the International Embryo Transfer Society (IETS) for bovine embryos efficiently decontaminated equine embryos exposed to equine herpes virus 1 (EHV-1) in vitro. Donor mares and stallions were individually screened and shown to be negative for the virus by PCR detection of EHV-1 DNA in blood leukocytes, semen, and uterine lavages in which embryos were recovered. Twenty embryos were recovered and randomly assigned to one of two groups: 10 embryos were exposed for 24h to infectious EHV-1 at 10(6)TCID(50)/ml, and 1...
Hathaway SC, Little TW, Stevens AE, Ellis WA, Morgan J.Eighteen isolates from the Australis serogroup from free-living and domestic animals were identified using the cross agglutination absorption test. Serovar muenchen was found only in England and Wales in wood mice, short tailed and bank voles, a grey squirrel and a pig. Serovar bratislava was found in hedgehogs in England, Wales and Northern Ireland and also in a brown rat from Northern Ireland. Serovar bratislava was isolated from sheep in both England and Northern Ireland and from horses in Northern Ireland. The distribution of these serovars in relation to possible maintenance hosts is disc...
Major DA.This paper describes a protocol for hygiene practices that was devised by a practice in which all veterinarians were involved on a daily basis in visiting infected premises, including sampling, treatment of clinical cases and general veterinary work. This protocol was strictly followed when attending an infected or at risk property.
Pascoe RR.The epidemiology of dermatomycocis due to Trichophyton equinum var autotrophicum was studied in a number of thoroughbred stables in south-east Queensland. The significant factors in the epidemiology were defined. The infection was readily transmitted, particularly by infected saddle-girths, on which the fungus could survive for 12 months. Mild abrasion from the saddle during work favoured the development of lesions and prolonged the recovery period. A pronounced age and seasonal incidence of the disease was demonstrated as young horses under the age of 3 years were most susceptible, and the ma...
Johnston KG, Henderson AW.Under the title “Equine Granuloma in the
Northern Territory of Australia” Lewis (1914)
gave an account of a disease of horses otherwise
known as “swamp cancer”. A variety of superficial sites are affected but these are rarely above
the level of the shoulder joint and principally
involve the lower legs and the ventral aspect of the
thoracoabdominal wall. The lesions on the legs are
granulating ulcers, those on the body are subcutaneous swellings and both are characterised by
the presence of conspicuous necrotic cores or
“kunkers” in the inflammatory tissue.
Johnston (1971)...
Bonilla-Aldana DK, Bonilla Carvajal CD, Moreno-Ramos E, Barboza JJ, Rodriguez-Morales AJ.Eastern equine encephalitis virus (EEEV) and Venezuelan equine encephalitis virus (VEEV) viruses are zoonotic pathogens affecting humans, particularly equines. These neuroarboviruses compromise the central nervous system and can be fatal in different hosts. Both have significantly influenced Colombia; however, few studies analyse its behaviour, and none develop maps using geographic information systems to characterise it. To describe the temporal-spatial distribution of those viruses in Colombia between 2008 and 2019. Retrospective cross-sectional descriptive study, based on weekly reports by ...
Zamarchi TBO, Henriques AL, Krolow TK, Krüger RF, Rodrigues GD, Munari A, Pessoa FAC, Camargo ELMA.Tabanidae is one of the most diverse families of hematophagous dipterans. Tabanids, in general, are mechanical vectors of some pathogens. Given the vector importance and the lack of knowledge of the tabanid fauna in horses in Amazon Forest fragments of the state of Rondônia, this work aimed to determine the season that the different species of horse flies prefer to carryout hematophagy on horses and verify whether the horse fly community remains the same throughout the year. The sampling areas for tabanid captures were in the municipality of Monte Negro, Western Amazon, Brazil. Four new occur...
Storey ES, Gerding PA, Scherba G, Schaeffer DJ.To determine survival over time of infectious equine herpesvirus-4, feline herpesvirus-1, and feline calicivirus in three commercially available and commonly used ophthalmic solutions (eyewash, fluorescein, and proparacaine HCl). Methods: Viruses used in this study were originally isolated from eyes of animals referred to the University of Illinois. Equine herpesvirus-4 was propagated in MDBK cells and feline herpesvirus-1 and feline calicivirus in CRFK cells. Methods: After separately inoculating a designated solution with a specific titer of an individual virus, solutions were incubated per ...
Bergström K, Grönlund U.Detection of nosocomial methicillin-resistant Staphylococcus aureus infections in horses in Sweden has increased attention on infection control (IC) in equine hospitals. This study established baseline data on IC programmes within such settings, evaluated compliance with some IC procedures before and after an education intervention, and examined barriers to compliance.The study was carried out between 2008 and 2011 in four Swedish equine hospitals. Data on current IC of each hospital, purchase data on hand sanitisers and disposable gloves per patient, and direct observations of compliance with...
Hamond C, Martins G, Bremont S, Medeiros MA, Bourhy P, Lilenbaum W.The purpose of the present study was to detect the presence of DNA of pathogenic Leptospira sp. in vaginal fluids of mares regarding a possible role of the sexual transmission. A total of 134 breeding mares from four troops were studied and sampling was conducted from vaginal fluids and urine for culture and PCR; and blood for serology. From the 134 serum samples tested, 59 (44%) were seroreactive, and serovar Bratislava was the most frequent (54.2%). None positive culture was obtained, but leptospiral DNA was detected by PCR (lipL32 gene) in 45 (33.5%) urine samples and 43 (32%) vaginal fluid...