This document reviews the leptospirosis situation in Fiji in 2012. Some key points: - There were 525 confirmed cases of leptospirosis in 2012, a significant increase from 2011, with 52 deaths. The incidence was estimated to be between 62.5-100 cases per 100,000 people. - Flooding was likely a factor in increased transmission. The disease disproportionately affected the iTaukei ethnic group and peaked among those aged 15-44. - Limited data exists on leptospirosis reservoirs in Fiji, but past studies found antibodies in cattle, dogs, rats, and mongooses. One study found around 70% of mongooses carried the

1. LEPTOSPIROSIS IN FIJI: A REVIEW
OF THE SITUATION IN 2012
Associate Professor Simon Reid
School of Population Health
University of Queensland
Brisbane, Australia
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2. Acknowledgements
Fiji Centre for CD Control
• Dr Vereniki Raiwalui
• Dr Mike Kama
• Aggie Dawainavesi
UQ
• Dr Vanessa Racloz
WHO (South Pacific)
• Dr Eric Nilles
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3. CRICOS Provider No 00025B

4. INCIDENCE OF LEPTOSPIROSIS
ELISA
• 2011: 12 per 100,000
• 2012: 62.5 – 100 per 100,000
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5. Fiji 2012
• 525 confirmed cases
• 52 deaths
• Up to ~300 more cases if PCR had been used

6. Floods
Ba
Lautoka
Nadi
Rewa
Suva
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7. ETHNICITY
400
350
Cases per 100,000
300
iTaukei
Indian
250
200
150
100
50
0
Ba
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Lautoka
Macuata
Nadi
Nadroga
Subdivision
Ra
Rewa
Suva

8. Age distribution
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9. RESERVOIRS?
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10. Serovars
• Predominant serovars in human cases (historical):
–
–
–
–
australis
copenhageni
canicola
cynoptera
• Limited data on range of serovars in domestic and feral
animals in Fiji
• 1981: antibodies detected (CFT) in:
– Cattle (27.5%), sheep (17.1%), goats (10.3%), pigs (10.0%)
– Dogs (57%), rats (55.8%), mongoose (53.1%), mice (40%)
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11. Naduri and Burebasaga (2002)
90%
80%
70%
60%
50%
40%
30%
20%
10%
0%
70.0%
60.0%
50.0%
40.0%
30.0%
20.0%
10.0%
Mongoose = ~70% Hardjo
0.0%
SPC ANIMAL HEALTH & PRODUCTION SERVICE
(http://www.spc.int/lrd/)

12. Prevalence of Leptospira Antibodies by Serovar in
Cattle from Naduri Village (n = 130)
50%
Prevalence
40%
30%
20%
10%
0%
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Serovar

13. Overlap with humans
Human
70%
60%
50%
40%
30%
20%
10%
0%
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Dog

14. One Health Issues/opportunities
• Major gaps in epidemiological information
• Case investigations are lead by environmental health
officers but need to include AH and PH personnel
• Importance of sampling ALL mammals (including humans)
at the site of transmission
• Need to work out how to get rats and mongoose
• MoH has initiated a national strategy
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