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Leptospirosis
Current Leptospirosis Research
in Thailand
Clinical manifestations
 mild to multiorgan dysfunction
 fever, headache, chills, nausea,
muscle aches, vomiting, jaundice,
kidney failure, lung hemorrhage
Chin tana Chirathaworn, Ph .D.
Department o f Mi crob io lo gy
Faculty o f Medi cine
Chul alon gkorn University
Laboratory diagnosis
 antibody de tection
Symptoms are similar to other tropical
infectious diseases
Laboratory Diagnosis
MAT
• “stil l of majo r imp ortance”
• “has lo ng been with us”
MAT
IFA
Ig M-ELISA
Macro scop ic sli de agg lu tinatio n
ISO15189 accred ited
Kind ly pr ovided b y Dr. Wimol Petkanchanapong
Laboratory diagnosis
candidate proteins for Ab detection
 commo nly fou nd in pathogeni c strai ns
sampl es
MAT
cul ture
 extern all y expr essed
 Immu nogeni c
sero var
sero typin g
sero var
 MAT cor rectl y determi ned in fectin g sero var
in 33% of lep tospi ro sis cases
 sensi tive, speci fic!
 earl y Diag nosis!
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Sera
Leptospi ro sis
first sera : 3-10 days after fever onset
secon d sera and thir d sera
Saengj aruk P, et al, 2007
pathogenic
non-pathogenic
100% of
samples
5, 7, 1 8 days
Saengj aruk P, et al, 2007
Saengj aruk P, et al, 2007
>85% sensitivity duri ng the first week of il ln ess
IgM reactivity to 24-30, 32, 35/36, 37, 41/42, 45 and 48
occurred exclusively in sera from leptospirosis patients
Duangchawee K, et al, 2008
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sensi tivity 91. 9%, speci ficity 95.8%
blood donors
melioidosis
dengue fev er
hepat itis
malaria
24-30, 32, 41 and 64/69-kDa ~ LipL21, LipL32, LipL41, GroEL
Doangchawee G, et al, 2008
Doangchawee G, et al, 2008
Diagnostic criteria
reactivity with the 14- to 18-kDa band and/or
at least two positive bands from among the 19- to 23-,
24-to 30-, 32-, 35/36-, 37-, and 41/42-kDa
http:// virology-online.com/general/Test5.htm
Doangchawee G, et al, 2008
Laboratory diagnosis
 Antibody de tection
MAT
IFA
Anti-Lip L32 > anti-Loa22 > anti-Lip L21 > anti-Lip L41
ELI SA
Flannery B, et al. 20 01
Macro scop ic sli de agg lu tinatio n
Ig M resp onse : no sig nifican t difference amo ng
patien ts an d con trols
 Mole cular techniques
Chalayon P et al ,2011
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16S rR NA
Sensi tivity 43.6%
Speci ficity 83.5%
Laboratory diagnosis
“L eptospi ro sis is fou nd only when we lo ok for it”
Fonseca CA, e t a l. 2006
 Rapid
 Ag/DNA + Ab detection
Sla ck A, 2010
ht tp ://login.totalweblite.com/design /30 00 /ind ex.asp?p ageid=34 28 2&A ccId=50 18
Laboratory diagnosis
Gold nanoparticle-based assays
Amornpun Ser eemaspun, MD, Ph.D.
Department of Anatomy
Faculty of Medicine
Chulalongkorn Univ ersity
Sensitivity o f d etection : 10 l eptospi res/ml
No cross reactivity wi th bacterial commonl y fou nd i n urin e
Ab and Ag detection
Sereemaspun A., et al,
http :/ /web .sut . ac .th/ dsa /unit / me dic al_ cli nic/ima ges /storie s / hea th_n ew/ urine .pdf
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Laboratory Diagnosis
 Sensi tive, speci fic
 Earl y Diag nosis
 Ag/D NA + Ab detectio n
 One assay for mor e than on e i nfectio us disease !
 A test for several infectious diseases
Leptospirosis
Clinical m anifestations range from mild to
m ultiple organ failure
 Labo rato ry Di agn osis
ST
MT
LT
ST
MT
LT
Ab
Ag
250 µg of Ab was injected daily from day 1 to 7 post infection
 Vaccin es
 L. In terr ogans sero var Icter ohaemor rh agi ae
- for Ab pro ductio n
 L. In terr ogans sero var Pomo na
- for hamster in jecti on
Maneewatch S. et al, 2009
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Vaccine Development
Leptospirosis
Clinical m anifestations range from mild to
m ultiple organ failure
 Labo rato ry Di agn osis
 Vaccin es
Kanitha Patarakul, MD, Ph.D.
Department of Microbiology
Faculty of Medicine
Chulalongkorn Univ ersity
 Patho genesi s, Immu ne resp onse
 Leptospi ra in terr ogans
 Austral is
 Brati slava
 Autumnali s
 Icter ohaemor rh agi ae
 Leptospi ra biflexa serovar Patoc
Thongboonkerd V et al, 2009
Pro tein s :
 whose expression levels were significantly greater in
the pathogenic serovars
 were detectable only in the pathogenic serovars
 whose expression levels were significantly in serovar
Icterohaemorrhagiae
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Current Leptospirosis Research
in Thailand
 Labo rato ry Di agn osis
 Vaccin es
 Patho genesi s, Immu ne resp onse
htt p:/ /www.ok na ti on .ne t/b lo g/k on tran gne ws/ 20 09/01
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