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Home / Equine Research Bank / Nat Rev Dis Primers / Leptospirosis.
Nature reviews. Disease primers2025; 11(1); 32; doi: 10.1038/s41572-025-00614-5

Leptospirosis.

Abstract: Leptospirosis is a zoonotic bacterial infection that is prevalent across all continents and is caused by pathogenic spirochaetes of the genus Leptospira. Although infection can be asymptomatic, symptomatic disease can vary in severity from mild to severe illness, the latter characterized by icterus and/or multi-organ dysfunction and potentially death. An estimated one million cases of leptospirosis occur globally each year, resulting in ~60,000 deaths. The pathogenesis of severe leptospirosis is poorly understood but is believed to involve an interplay between genetic predisposition, pathogen virulence and dysregulated immune responses that trigger a cytokine storm with associated immunoparesis. Leptospira are susceptible to several low-cost antibiotics, including benzyl penicillin, doxycycline, cephalosporins and macrolides, when used in the early phase of infection. Late disease with organ dysfunction is treated with supportive care, and the benefit of antibiotics during late disease is doubtful. Very few countries have licensed a vaccine for human leptospirosis, and available vaccines only protect against rodent-associated serogroups. Exposure control by behavioural modifications and personal protective measures are the major preventative measures in leptospirosis, and the efficacy of prophylactic antibiotics has not been confirmed in clinical trials. Future research is needed to accurately estimate leptospirosis disease burden across the globe, to understand the pathophysiology of severe leptospirosis to inform the design of targeted immunotherapies and vaccines, and to develop cost-effective and accurate point-of-care diagnostics.
© 2025. Springer Nature Limited.
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Publication Date: 2025-05-02 PubMed ID: 40316520PubMed Central: 4442676DOI: 10.1038/s41572-025-00614-5Google Scholar: Lookup
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Summary

This research summary has been generated with artificial intelligence and may contain errors and omissions. Refer to the original study to confirm details provided. Submit correction.

This research article primarily discusses the connection between the disease Leptospirosis and ocular changes in horses, including the recurrent sequelae of these changes. The research also explores the more recent increase in reports of equine abortion, stillbirth, and neonatal disease associated with this infection and potential treatments to be used.

Disease and its effects

  • The research starts by discussing how clinical leptospirosis in horses is primarily connected to changes in the horse’s eyes, more specifically uveitis and recurrent sequelae, or the aftereffects of these ocular changes. Sequelae are typically pathological conditions resulting from a disease or injury.
  • While there have been sporadic reports of kidney and liver involvement in horses due to this disease, these are less common.

Emerging Concerns

  • In recent times, a type of leptospira called serovar bratislava has been found to be adapted in horses, which is significant for the study of the disease in this species.
  • Reports on equine abortion and stillbirth have become more frequent. This frequency is likely due to improved diagnostic techniques, rather than a rise in the disease itself.
  • Particularly noteworthy is the increasing recognition of equine neonatal disease circumstance associated with leptospira infection.
  • Whether the infection causes abortion or affects foals (young horses) may depend on the stage of gestation when the mare is exposed and the immune status of the host (the mare, in this case).

Treatment Options

  • The article then moves onto discussing the treatment options for this condition. The choice of antibiotic for treating equine leptospirosis is uncertain because specific studies focused on equine have not yet been conducted.
  • That said, treatments used for other species suggest that streptomycin might be a good therapeutic choice for the chronic shedding state (where the bacteria is persistently released in the urine).
  • Streptomycin may also be used in combination with other antimicrobials for treating acute (short-term but severe) disease.
  • Furthermore, Penicillins (specifically potentiated ones) and tetracycline might be logical choices for treating acute leptospirosis, provided they are given in the appropriate or high-end dosages.

Cite This Article

APA
Rajapakse S, Fernando N, Dreyfus A, Smith C, Rodrigo C. (2025). Leptospirosis. Nat Rev Dis Primers, 11(1), 32. https://doi.org/10.1038/s41572-025-00614-5

Publication

Nature reviews. Disease primers
ISSN: 2056-676X
NlmUniqueID: 101672103
Country: England
Language: English
Volume: 11
Issue: 1
Pages: 32

Researcher Affiliations

Rajapakse, Senaka
  • Department of Clinical Medicine, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka. senaka@med.cmb.ac.lk.
Fernando, Narmada
  • Institute of Biochemistry, Molecular Biology and Biotechnology, University of Colombo, Colombo, Sri Lanka.
Dreyfus, Anou
  • Section of Epidemiology, Vetsuisse Faculty, University of Zurich, Zurich, Switzerland.
Smith, Chris
  • Department of Clinical Research, Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, UK.
  • School of Tropical Medicine and Global Health, Nagasaki University, Nagasaki, Japan.
Rodrigo, Chaturaka
  • Department of Pathology, School of Biomedical Sciences, Faculty of Medicine and Health, University of New South Wales, Sydney, New South Wales, Australia.

MeSH Terms

  • Humans
  • Leptospirosis / epidemiology
  • Leptospirosis / physiopathology
  • Leptospirosis / diagnosis
  • Anti-Bacterial Agents / therapeutic use
  • Anti-Bacterial Agents / pharmacology
  • Animals
  • Leptospira / pathogenicity

Conflict of Interest Statement

Competing interests: The authors declare no competing interests.

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