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<front>
<journal-meta>
<journal-id journal-id-type="publisher-id">Front. Trop. Dis</journal-id>
<journal-title>Frontiers in Tropical Diseases</journal-title>
<abbrev-journal-title abbrev-type="pubmed">Front. Trop. Dis</abbrev-journal-title>
<issn pub-type="epub">2673-7515</issn>
<publisher>
<publisher-name>Frontiers Media S.A.</publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id pub-id-type="doi">10.3389/fitd.2023.1061038</article-id>
<article-categories>
<subj-group subj-group-type="heading">
<subject>Tropical Diseases</subject>
<subj-group>
<subject>Brief Research Report</subject>
</subj-group>
</subj-group>
</article-categories>
<title-group>
<article-title>Racehorses from a breeding farm in Tropical Ecuador have a high seroprevalence of anti-<italic>Leptospira</italic> spp. antibodies: a paradigm for leptospirosis management from a One Health perspective</article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname>Orlando</surname>
<given-names>Solon Alberto</given-names>
</name>
<xref ref-type="aff" rid="aff1">
<sup>1</sup>
</xref>
<xref ref-type="aff" rid="aff2">
<sup>2</sup>
</xref>
<uri xlink:href="https://loop.frontiersin.org/people/1983516"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Paez Martinez</surname>
<given-names>Katherine</given-names>
</name>
<xref ref-type="aff" rid="aff3">
<sup>3</sup>
</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Sanchez</surname>
<given-names>Ericka</given-names>
</name>
<xref ref-type="aff" rid="aff1">
<sup>1</sup>
</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>de la Cruz</surname>
<given-names>Carmen</given-names>
</name>
<xref ref-type="aff" rid="aff1">
<sup>1</sup>
</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Calderon</surname>
<given-names>Joselyn</given-names>
</name>
<xref ref-type="aff" rid="aff1">
<sup>1</sup>
</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Arcos</surname>
<given-names>Fabrizio</given-names>
</name>
<xref ref-type="aff" rid="aff3">
<sup>3</sup>
</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Torres-Lasso</surname>
<given-names>Pablo</given-names>
</name>
<xref ref-type="aff" rid="aff4">
<sup>4</sup>
</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Calvopi&#xf1;a</surname>
<given-names>Manuel</given-names>
</name>
<xref ref-type="aff" rid="aff5">
<sup>5</sup>
</xref>
</contrib>
<contrib contrib-type="author" corresp="yes">
<name>
<surname>Garcia-Bereguiain</surname>
<given-names>Miguel Angel</given-names>
</name>
<xref ref-type="aff" rid="aff5">
<sup>5</sup>
</xref>
<xref ref-type="author-notes" rid="fn001">
<sup>*</sup>
</xref>
<uri xlink:href="https://loop.frontiersin.org/people/965446"/>
</contrib>
</contrib-group>    <aff id="aff1">
<sup>1</sup>
<institution>Instituto Nacional de Salud P&#xfa;blica e Investigaci&#xf3;n</institution>, <addr-line>Guayaquil</addr-line>, <country>Ecuador</country>
</aff>    <aff id="aff2">
<sup>2</sup>
<institution>Universidad Espiritu Santo</institution>, <addr-line>Guayaquil</addr-line>, <country>Ecuador</country>
</aff>
<aff id="aff3">
<sup>3</sup>
<institution>Facultad de Medicina Veterinaria y Zootecnia, Universidad Agraria del Ecuador</institution>, <addr-line>Guayaquil</addr-line>, <country>Ecuador</country>
</aff>
<aff id="aff4">
<sup>4</sup>
<institution>Facultad de Veterinaria, Universidad de Guayaquil</institution>, <addr-line>Guayaquil</addr-line>, <country>Ecuador</country>
</aff>
<aff id="aff5">
<sup>5</sup>
<institution>One Health Research Group, Universidad de Las Am&#xe9;ricas</institution>, <addr-line>Quito</addr-line>, <country>Ecuador</country>
</aff>
<author-notes>
<fn fn-type="edited-by">
<p>Edited by: Gabriel Motoa, Jackson Health System, United States</p>
</fn>
<fn fn-type="edited-by">
<p>Reviewed by: Shih Keng Loong, University of Malaya, Malaysia; Gabriel Gustavo Varela Pensado, Universidad de la Rep&#xfa;blica, Uruguay</p>
</fn>
<fn fn-type="corresp" id="fn001">
<p>*Correspondence: Miguel Angel Garcia-Bereguiain, <email xlink:href="mailto:magbereguiain@gmail.com">magbereguiain@gmail.com</email>
</p>
</fn>
</author-notes>
<pub-date pub-type="epub">
<day>09</day>
<month>05</month>
<year>2023</year>
</pub-date>
<pub-date pub-type="collection">
<year>2023</year>
</pub-date>
<volume>4</volume>
<elocation-id>1061038</elocation-id>
<history>
<date date-type="received">
<day>04</day>
<month>10</month>
<year>2022</year>
</date>
<date date-type="accepted">
<day>17</day>
<month>04</month>
<year>2023</year>
</date>
</history>
<permissions>
<copyright-statement>Copyright &#xa9; 2023 Orlando, Paez Martinez, Sanchez, de la Cruz, Calderon, Arcos, Torres-Lasso, Calvopi&#xf1;a and Garcia-Bereguiain</copyright-statement>
<copyright-year>2023</copyright-year>
<copyright-holder>Orlando, Paez Martinez, Sanchez, de la Cruz, Calderon, Arcos, Torres-Lasso, Calvopi&#xf1;a and Garcia-Bereguiain</copyright-holder>
<license xlink:href="http://creativecommons.org/licenses/by/4.0/">
<p>This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.</p>
</license>
</permissions>
<abstract>
<sec>
<title>Background</title>
<p>Leptospirosis is a zoonotic disease of worldwide distribution that affects humans and domestic and wild animals, and it is highly endemic in Ecuador. However, no reports of infections affecting horses have been published in the country.</p>
</sec>
<sec>
<title>Methods</title>
<p>This study evaluates the prevalence of anti-<italic>Leptospira</italic> spp. antibodies in racing horses from a breeding farm in the coastal Santa Elena province, southwest Ecuador. Sera were collected from 108 non-vaccinated horses and evaluated for 24 serovars of <italic>Leptospira</italic> spp. using the microscopic agglutination test (MAT).</p>
</sec>
<sec>
<title>Results</title>
<p>It was found that 100% of horses were reactive for <italic>Leptospira</italic> spp., most of them for multiple serovars. The most prevalent serovars were <italic>Leptospira kirschneri</italic> serovar Grippotyphosa (100%; 95% CI 99.9% to 100.1%); <italic>L. interrogans</italic> serovars Sejroe (96.3%; 95% CI 96.2% to 96.4%), Saxkoebing (95.4%; 95% CI 95.3% to 95.5%), Canicola (90.7%; 95% CI 90.5% to 90.9%), Icterohaemorrhagiae (80.5%; 95% CI 80.4% to 80.6%), Bataviae (73.1%; 95% CI 73.0% to 73.2%), Australis (75.0%; 95% CI 74.9% to 75.1%), and Bratislava (71.2%; 95% CI 71.1% to 71.4%); and <italic>L. borgpetersenii</italic> serovar Tarassovi (76.8%; 95% CI 76.6% to 77.0%).</p>
</sec>
<sec>
<title>Conclusions</title>
<p>We found a high prevalence of anti-<italic>Leptospira</italic> spp. seropositivity in racehorses from a breeding farm in Ecuador. This is the first serologic report for leptospirosis in horses in Ecuador. &#x201c;One Health&#x201d;-based sanitary practices for horse-breeding farms are recommended to improve animal and human health.</p>
</sec>
</abstract>
<kwd-group>
<kwd>Leptospira</kwd>
<kwd>MAT</kwd>
<kwd>leptospirosis</kwd>
<kwd>horses</kwd>
<kwd>Ecuador</kwd>
<kwd>One Health</kwd>
</kwd-group>
<counts>
<fig-count count="0"/>
<table-count count="3"/>
<equation-count count="0"/>
<ref-count count="23"/>
<page-count count="6"/>
<word-count count="2837"/>
</counts>
<custom-meta-wrap>
<custom-meta>
<meta-name>section-in-acceptance</meta-name>
<meta-value>Neglected Tropical Diseases</meta-value>
</custom-meta>
</custom-meta-wrap>
</article-meta>
</front>
<body>
<sec id="s1" sec-type="intro">
<title>Introduction</title>
<p>Leptospirosis is a zoonotic disease with worldwide distribution although its prevalence is higher in the tropics and poorer regions, and it is endemic in South America (<xref ref-type="bibr" rid="B1">1</xref>, <xref ref-type="bibr" rid="B2">2</xref>). Bacteria from the genus <italic>Leptospira</italic> are the causative agent and can infect almost all mammal species (<xref ref-type="bibr" rid="B3">3</xref>). Leptospirosis affects domestic and wild mammals, and cross-species transmission, including to humans, occurs through direct contact with urine from infected animals or indirect contact with contaminated soil and water where <italic>Leptospira</italic> spp. can survive for long periods (<xref ref-type="bibr" rid="B3">3</xref>, <xref ref-type="bibr" rid="B4">4</xref>). Free-roaming dogs and rats are considered the main reservoir of the disease in urban areas (<xref ref-type="bibr" rid="B5">5</xref>), while livestock plays an important role in occupational leptospirosis transmission (<xref ref-type="bibr" rid="B6">6</xref>). Leptospirosis is estimated to cause 1.03 million human cases and 58,900 deaths each year worldwide. Although infected individuals can be asymptomatic, severe disease may produce renal or hepatic failure and pulmonary bleeding that can lead to death (<xref ref-type="bibr" rid="B7">7</xref>, <xref ref-type="bibr" rid="B8">8</xref>).</p>
<p>
<italic>Leptospira</italic> spp. that infects human and animal populations include pathogenic, intermediate pathogenic, and saprophytic clusters, defined further by the presence of serological characteristics, or serovars. The pathogenic, or interrogans, cluster comprises 16 strains across nine species: <italic>L. interrogans</italic>, <italic>L. kirschneri, L. noguchii</italic>, <italic>L. borgpetersenii</italic>, <italic>L. weilii</italic>, <italic>L. santarosai</italic>, <italic>L. alexanderi</italic>, <italic>L. kmetyi</italic>, and <italic>L. alstonii.</italic> The intermediate cluster comprises <italic>L. fainei</italic>, <italic>L. licerasiae</italic>, and <italic>L. wolffii</italic>, which have been associated with mild disease and chronic infections. The saprophytic, or biflexa, cluster comprises 14 non-pathogenic strains, of the species <italic>L. biflexa</italic> and <italic>L. wolbachii.</italic>
</p>
<p>Although leptospirosis is mainly subclinical in horses, it can lead to abortion, stillbirth, and neonatal mortality (<xref ref-type="bibr" rid="B9">9</xref>, <xref ref-type="bibr" rid="B10">10</xref>). Clinical signs of leptospirosis in horses include moderate fever, anorexia, jaundice, and pulmonary bleeding; death by interstitial nephritis has also been described as indicative of leptospirosis (<xref ref-type="bibr" rid="B10">10</xref>&#x2013;<xref ref-type="bibr" rid="B13">13</xref>). Leptospirosis causes economic losses in the racehorse business due to the interruption of training, poor performance, and disqualification in competition, as well as the cost of treatment for sick horses (<xref ref-type="bibr" rid="B11">11</xref>). In addition, leptospirosis in racehorses is a threat for zoonotic transmission due to the closeness of horse&#x2013;human contact. In addition, as racehorses are among the most expensive domestic animals, leptospirosis in racehorses could be considered as a paradigm for evaluating leptospirosis management and concern in a particular region.</p>
<p>Leptospirosis is a neglected tropical disease in Ecuador, with 1,279 human cases reported in 2012 (<xref ref-type="bibr" rid="B14">14</xref>&#x2013;<xref ref-type="bibr" rid="B16">16</xref>). A total of 2,584 hospitalizations were recorded from 2000 to 2022 across 22 provinces in Ecuador (<xref ref-type="bibr" rid="B17">17</xref>). The few studies addressing leptospirosis in livestock in Ecuador report a high prevalence in cattle, pigs, and dogs (<xref ref-type="bibr" rid="B18">18</xref>, <xref ref-type="bibr" rid="B19">19</xref>). Moreover, leptospirosis has never been studied in horses in Ecuador although it is considered endemic in South America, with prevalence values ranging from 4.5% to 90.7% (<xref ref-type="bibr" rid="B6">6</xref>). A recent publication from 2019 found a prevalence of 85% using a 24-serovar microscopic agglutination test (MAT) panel on horses from police departments in Colombia (<xref ref-type="bibr" rid="B20">20</xref>). There are no public health policies with a &#x201c;One Health&#x201d; perspective to address leptospirosis in Ecuador, and even livestock vaccination is scarce. Considering this situation, the aim of this study was to evaluate the seroprevalence of anti-<italic>Leptospira</italic> spp. antibodies in an exploited animal of high economic value, namely, horses from racehorse farms in the coastal region of Ecuador, where leptospirosis is endemic.</p>
</sec>
<sec id="s2">
<title>Methods</title>
<sec id="s2_1">
<title>Study design and setting</title>
<p>This study was performed in a racehorse-breeding farm located in the province of Santa Elena, in the southwest coastal region of Ecuador. This is, to our knowledge, the only farm of this kind in the coastal region of Ecuador. The ecological features of this area allow exposure to <italic>Leptospira</italic> spp. through direct contact between horses and free-roaming dogs and cats and wild rodents, or through contaminated water sources.</p>
<p>For the present study, samples were collected from December 2016 to February 2017. None of the animals were vaccinated against leptospirosis. In addition, no signs of leptospirosis were found in any of the horses at the time of sample collection (we were allowed only one quick and superficial animal inspection). The farm veterinarians did not report any horses with signs of leptospirosis during the sample collection period. As this study uses samples collected from domestic animals for diagnosis, in accordance with animal research regulations in Ecuador, IRB approval was waived.</p>
</sec>
<sec id="s2_2">
<title>Blood sample collection</title>
<p>Horses were managed by certified veterinarians. Blood was collected from the jugular vein. The serum was separated by centrifugation (5,000 rpm for 5&#xa0;min). A total of 108 samples of sera were collected from all horses older than 1 year present on the farm at the time of the study (<xref ref-type="supplementary-material" rid="SM1">
<bold>Supplementary Material 1</bold>
</xref>).</p>
</sec>
<sec id="s2_3">
<title>Microscopic agglutination test for anti-Leptospira spp.</title>
<p>The microscopic agglutination test (MAT) was performed using 24 live antigens. The <italic>Leptospira</italic> species, serogroups, serovars, and strains used for MAT are detailed in <xref ref-type="supplementary-material" rid="SM1">
<bold>Supplementary Table&#xa0;1</bold>
</xref>. MAT was performed in the Laboratorio Nacional de Referencia para Zoonosis of the Instituto Nacional de Salud P&#xfa;blica e Investigaci&#xf3;n in Guayaquil. This laboratory focuses on human sample analysis and uses a MAT panel implemented following Pan American Health Organization guidelines.</p>
<p>The antigens were prepared from the reference strains detailed in <xref ref-type="supplementary-material" rid="SM1">
<bold>Supplementary Table&#xa0;1</bold>
</xref>. For the screening of sera, a 1:200 dilution was used initially. Reactive samples were then examined with increasing dilutions from 1:200 to 1:3,200, taking the highest positive dilution to be the titer of the serum. The serum was considered reactive when at least 50% agglutination occurred at a magnification of 40&#xd7; under the microscope.</p>
</sec>
</sec>
<sec id="s3" sec-type="results">
<title>Results</title>
<p>All the 108 horses tested were seropositive for 5&#x2013;15 different <italic>Leptospira</italic> spp. serovars when a MAT titer cut-off value of 200 was set, with titers ranging from 200 to 1,600 (<xref ref-type="table" rid="T1">
<bold>Tables&#xa0;1</bold>
</xref>, <xref ref-type="table" rid="T2">
<bold>2</bold>
</xref>). The most prevalent serovars were <italic>Leptospira kirschneri</italic> serovar Grippotyphosa (100%; 95% CI 99.9% to 100.1%); <italic>Leptospira interrogans</italic> serovars Sejroe (96.3%; 95% CI 96.2% to 96.4%), Saxkoebing (95.4%; 95% CI 95.3% to 95.5%), Canicola (90.7%; 95% CI 90.5% to 90.9%), Icterohaemorrhagiae (80.5%; 95% CI 80.4% to 80.6%), Bataviae (73.1%; 95% CI 73.0% to 73.2%), Australis (75.0%; 95% CI 74.9% to 75.1%), and Bratislava (71.2%; 95% CI 71.1% to 71.4%); and <italic>Leptospira borgpetersenii</italic> serovar Tarassovi (76.8%; 95% CI 76.6% to 77.0%). Serogroup and serovar distribution and titers for all horses included in the study are detailed in <xref ref-type="supplementary-material" rid="SM1">
<bold>Supplementary Table&#xa0;2</bold>
</xref>. No differences in serovar prevalence were found between horses of different ages. As no horses presented signs of leptospirosis at the time that we visited the farm, no association between serovars and signs could be addressed.</p>
<table-wrap id="T1" position="float">
<label>Table&#xa0;1</label>
<caption>
<p>Distribution of <italic>Leptospira spp.</italic> serogroups, serovars and strains in the 108 horses included in this study for microaglutination test (MAT) with a cut off titer value of 200.</p>
</caption>
<table frame="hsides">
<thead>
<tr>
<th valign="top" align="center">N&#xb0;</th>
<th valign="top" align="center">Serogroup</th>
<th valign="top" align="center">Serovar</th>
<th valign="top" align="center">Number of Horses (%; IC 95%)</th>
<th valign="top" align="center">TiTER RANGE</th>
</tr>
</thead>
<tbody>
<tr>
<td valign="top" align="center" style="background-color:#f2f2f2">1</td>
<td valign="top" align="center" style="background-color:#f2f2f2">Bataviae</td>
<td valign="top" align="center" style="background-color:#f2f2f2">Bataviae</td>
<td valign="top" align="center" style="background-color:#f2f2f2">79 (73,1%; 72,94-73,26)</td>
<td valign="top" align="center" style="background-color:#f2f2f2">1/200 - 1/800</td>
</tr>
<tr>
<td valign="top" align="center">2</td>
<td valign="top" align="center">Cynopteri</td>
<td valign="top" align="center">Cynopteri</td>
<td valign="top" align="center">48 (44,4%; 44,24-44,56)</td>
<td valign="top" align="center">1/200</td>
</tr>
<tr>
<td valign="top" align="center" style="background-color:#f2f2f2">3</td>
<td valign="top" align="center" style="background-color:#f2f2f2">Tarassovi</td>
<td valign="top" align="center" style="background-color:#f2f2f2">Tarassovi</td>
<td valign="top" align="center" style="background-color:#f2f2f2">83(76,9%; 76,74-77,06)</td>
<td valign="top" align="center" style="background-color:#f2f2f2">1/200 - 1/800</td>
</tr>
<tr>
<td valign="top" align="center">4</td>
<td valign="top" align="center">Sejroe</td>
<td valign="top" align="center">Sejroe</td>
<td valign="top" align="center">104(96,3%; 96,14-96,46)</td>
<td valign="top" align="center">1/200 - 1/800</td>
</tr>
<tr>
<td valign="top" align="center" style="background-color:#f2f2f2">5</td>
<td valign="top" align="center" style="background-color:#f2f2f2">Sejroe</td>
<td valign="top" align="center" style="background-color:#f2f2f2">Saxkoebing</td>
<td valign="top" align="center" style="background-color:#f2f2f2">103(95,4%; 95,24-95,56)</td>
<td valign="top" align="center" style="background-color:#f2f2f2">1/200 - 1/800</td>
</tr>
<tr>
<td valign="top" align="center">6</td>
<td valign="top" align="center">Sejroe</td>
<td valign="top" align="center">Hardjo</td>
<td valign="top" align="center">26(24,1%; 23,94-24,26)</td>
<td valign="top" align="center">1/200</td>
</tr>
<tr>
<td valign="top" align="center" style="background-color:#f2f2f2">7</td>
<td valign="top" align="center" style="background-color:#f2f2f2">Sejroe</td>
<td valign="top" align="center" style="background-color:#f2f2f2">Wolffi</td>
<td valign="top" align="center" style="background-color:#f2f2f2">23(21,3%; 21,14-21,46)</td>
<td valign="top" align="center" style="background-color:#f2f2f2">1/200</td>
</tr>
<tr>
<td valign="top" align="center">8</td>
<td valign="top" align="center">Pomona</td>
<td valign="top" align="center">Pomona</td>
<td valign="top" align="center">64(69,3%; 69,14-69,46)</td>
<td valign="top" align="center">1/200 - 1/400</td>
</tr>
<tr>
<td valign="top" align="center" style="background-color:#f2f2f2">9</td>
<td valign="top" align="center" style="background-color:#f2f2f2">Canicola</td>
<td valign="top" align="center" style="background-color:#f2f2f2">Canicola</td>
<td valign="top" align="center" style="background-color:#f2f2f2">98(90,7%; 90,54-90,86)</td>
<td valign="top" align="center" style="background-color:#f2f2f2">1/200 - 1/1600</td>
</tr>
<tr>
<td valign="top" align="center">10</td>
<td valign="top" align="center">Celledoni</td>
<td valign="top" align="center">Celledoni</td>
<td valign="top" align="center">7 (6,5%; 6,34-6,66)</td>
<td valign="top" align="center">1/200</td>
</tr>
<tr>
<td valign="top" align="center" style="background-color:#f2f2f2">11</td>
<td valign="top" align="center" style="background-color:#f2f2f2">Grippotyphosa</td>
<td valign="top" align="center" style="background-color:#f2f2f2">Grippotyphosa</td>
<td valign="top" align="center" style="background-color:#f2f2f2">108 (100,0%; 99,84-<break/>100,16)</td>
<td valign="top" align="center" style="background-color:#f2f2f2">1/200 - 1/800</td>
</tr>
<tr>
<td valign="top" align="center">12</td>
<td valign="top" align="center">Pyrogenes</td>
<td valign="top" align="center">Pyrogenes</td>
<td valign="top" align="center">10 (9,3%; 9,14-9,46)</td>
<td valign="top" align="center">1/200</td>
</tr>
<tr>
<td valign="top" align="center" style="background-color:#f2f2f2">13</td>
<td valign="top" align="center" style="background-color:#f2f2f2">Australis</td>
<td valign="top" align="center" style="background-color:#f2f2f2">Bratislava</td>
<td valign="top" align="center" style="background-color:#f2f2f2">77(71,3%; 71,14-71,46)</td>
<td valign="top" align="center" style="background-color:#f2f2f2">1/200 - 1/1600</td>
</tr>
<tr>
<td valign="top" align="center">14</td>
<td valign="top" align="center">Australis</td>
<td valign="top" align="center">Australis</td>
<td valign="top" align="center">81(75,0%; 74,84-75,16)</td>
<td valign="top" align="center">1/200 - 1/400</td>
</tr>
<tr>
<td valign="top" align="center" style="background-color:#f2f2f2">15</td>
<td valign="top" align="center" style="background-color:#f2f2f2">Icterohaemorrhagiae</td>
<td valign="top" align="center" style="background-color:#f2f2f2">Copenhageni</td>
<td valign="top" align="center" style="background-color:#f2f2f2">64(59,3%; 59,14-59,46)</td>
<td valign="top" align="center" style="background-color:#f2f2f2">1/200 - 1/800</td>
</tr>
<tr>
<td valign="top" align="center">16</td>
<td valign="top" align="center">Icterohaemorrhagiae</td>
<td valign="top" align="center">Icterohaemorrhagiae</td>
<td valign="top" align="center">87(80,6%; 80,44-80,76)</td>
<td valign="top" align="center">1/200 - 1/800</td>
</tr>
<tr>
<td valign="top" align="center" style="background-color:#f2f2f2">17</td>
<td valign="top" align="center" style="background-color:#f2f2f2">Djasiman</td>
<td valign="top" align="center" style="background-color:#f2f2f2">Djasiman</td>
<td valign="top" align="center" style="background-color:#f2f2f2">8(7,4%; 7,24-7,56)</td>
<td valign="top" align="center" style="background-color:#f2f2f2">1/200 - 1/800</td>
</tr>
</tbody>
</table>
</table-wrap>
<table-wrap id="T2" position="float">
<label>Table&#xa0;2</label>
<caption>
<p>Number and percentage of seropositive horses for multiple <italic>Leptospira</italic> spp. serovars.</p>
</caption>
<table frame="hsides">
<thead>
<tr>
<th valign="middle" align="left"/>
<th valign="middle" colspan="11" align="center">Number of serovars</th>
</tr>
<tr>
<th valign="middle" align="left"/>
<th valign="middle" align="center">5</th>
<th valign="middle" align="center">6</th>
<th valign="middle" align="center">7</th>
<th valign="middle" align="center">8</th>
<th valign="middle" align="center">9</th>
<th valign="middle" align="center">10</th>
<th valign="middle" align="center">11</th>
<th valign="middle" align="center">12</th>
<th valign="middle" align="center">13</th>
<th valign="middle" align="center">14</th>
<th valign="middle" align="center">15</th>
</tr>
</thead>
<tbody>
<tr>
<td valign="middle" align="left">
<bold>Number of horses (%)</bold>
</td>
<td valign="middle" align="center">1 (0.9)</td>
<td valign="middle" align="center">4 (3.7)</td>
<td valign="middle" align="center">16 (14.8)</td>
<td valign="middle" align="center">13 (12)</td>
<td valign="middle" align="center">17 (15.7)</td>
<td valign="middle" align="center">11 (10.2)</td>
<td valign="middle" align="center">6 (5.5)</td>
<td valign="middle" align="center">17 (15.7)</td>
<td valign="middle" align="center">14 (13.0)</td>
<td valign="middle" align="center">8 (7.4)</td>
<td valign="middle" align="center">1 (0.9)</td>
</tr>
</tbody>
</table>
</table-wrap>
<p>We also addressed MAT seropositivity for the 108 horses using a MAT titer cut-off value of 800, as detailed in <xref ref-type="table" rid="T3">
<bold>Table&#xa0;3</bold>
</xref> and <xref ref-type="supplementary-material" rid="SM1">
<bold>Supplementary Table&#xa0;3</bold>
</xref>. In this case, 55 out of 108 horses were positive for at least 1 of 11 different <italic>Leptospira</italic> spp. serovars, and the prevalence obtained was 50.9%. For this cut-off value of 800, the most prevalent serovars were <italic>Leptospira kirschneri</italic> serovar Grippotyphosa (12/108; 11.1%; 95% CI 11.0% to 11.2%), and <italic>Leptospira interrogans</italic> serovars Bataviae (22/108; 22.4%; 95% CI 21.9% to 22.1%) and Canicola (20/108; 18.5%; 95% CI 18.3% to 18.7%).</p>
<table-wrap id="T3" position="float">
<label>Table&#xa0;3</label>
<caption>
<p>Distribution of <italic>Leptospira spp</italic>. serogroups, serovars and strains in the 108 horses included in this study for microaglutination test (MAT) with a cut off titer value of 800.</p>
</caption>
<table frame="hsides">
<thead>
<tr>
<th valign="top" align="left">N&#xb0;</th>
<th valign="top" align="center">SEROGROUP</th>
<th valign="top" align="center">SEROVAR</th>
<th valign="top" align="center">NUMBER OF HORSES<break/>(%; IC 95%)</th>
<th valign="top" align="center">TITER RANGE</th>
</tr>
</thead>
<tbody>
<tr>
<td valign="top" align="left" style="background-color:#f2f2f2">1</td>
<td valign="top" align="center" style="background-color:#f2f2f2">Bataviae</td>
<td valign="top" align="center" style="background-color:#f2f2f2">Bataviae</td>
<td valign="top" align="center" style="background-color:#f2f2f2">22(27.5%; 27,34-<break/>27,66)</td>
<td valign="top" align="center" style="background-color:#f2f2f2">1/800</td>
</tr>
<tr>
<td valign="top" align="left">2</td>
<td valign="top" align="center">Tarassovi</td>
<td valign="top" align="center">Tarassovi</td>
<td valign="top" align="center">2 (2,5%; 2,34-2,66)</td>
<td valign="top" align="center">1/800</td>
</tr>
<tr>
<td valign="top" align="left" style="background-color:#f2f2f2">3</td>
<td valign="top" align="center" style="background-color:#f2f2f2">Sejroe</td>
<td valign="top" align="center" style="background-color:#f2f2f2">Sejroe</td>
<td valign="top" align="center" style="background-color:#f2f2f2">9(11,25%; 11,09-<break/>11,41)</td>
<td valign="top" align="center" style="background-color:#f2f2f2">1/800</td>
</tr>
<tr>
<td valign="top" align="left">4</td>
<td valign="top" align="center">Sejroe</td>
<td valign="top" align="center">Saxkoebing</td>
<td valign="top" align="center">2 (2,5%; 2,34-2,66)</td>
<td valign="top" align="center">1/800</td>
</tr>
<tr>
<td valign="top" align="left" style="background-color:#f2f2f2">5</td>
<td valign="top" align="center" style="background-color:#f2f2f2">Canicola</td>
<td valign="top" align="center" style="background-color:#f2f2f2">Canicola</td>
<td valign="top" align="center" style="background-color:#f2f2f2">20(25%; 24,84-<break/>25,16)</td>
<td valign="top" align="center" style="background-color:#f2f2f2">1/800 - 1/1600</td>
</tr>
<tr>
<td valign="top" align="left">6</td>
<td valign="top" align="center">Grippotyphosa</td>
<td valign="top" align="center">Grippotyphosa</td>
<td valign="top" align="center">12(15%; 14,84-<break/>15,16)</td>
<td valign="top" align="center">1/800</td>
</tr>
<tr>
<td valign="top" align="left" style="background-color:#f2f2f2">7</td>
<td valign="top" align="center" style="background-color:#f2f2f2">Australis</td>
<td valign="top" align="center" style="background-color:#f2f2f2">Bratislava</td>
<td valign="top" align="center" style="background-color:#f2f2f2">8(10%; 9,84-10,16)</td>
<td valign="top" align="center" style="background-color:#f2f2f2">1/800 - 1/1600</td>
</tr>
<tr>
<td valign="top" align="left">8</td>
<td valign="top" align="center">Icterohaemorrhagiae</td>
<td valign="top" align="center">Copenhageni</td>
<td valign="top" align="center">2(2,5%; 2.34-2,66)</td>
<td valign="top" align="center">1/800</td>
</tr>
<tr>
<td valign="top" align="left" style="background-color:#f2f2f2">9</td>
<td valign="top" align="center" style="background-color:#f2f2f2">Icterohaemorrhagiae</td>
<td valign="top" align="center" style="background-color:#f2f2f2">Icterohaemorrhagiae</td>
<td valign="top" align="center" style="background-color:#f2f2f2">2(2,5%; 2.34-<break/>2.66)</td>
<td valign="top" align="center" style="background-color:#f2f2f2">1/800</td>
</tr>
<tr>
<td valign="top" align="left">10</td>
<td valign="top" align="center">Djasiman</td>
<td valign="top" align="center">Djasiman</td>
<td valign="top" align="center">1(1,25%; 1.09-1.41)</td>
<td valign="top" align="center">1/800</td>
</tr>
</tbody>
</table>
</table-wrap>
</sec>
<sec id="s4" sec-type="discussion">
<title>Discussion</title>
<p>This study reports on the striking case of a racehorse-breeding farm in Ecuador, where 100% of the horses were seropositive for <italic>Leptospira</italic> spp. at a MAT cut-off titer value of 200. Furthermore, most horses were positive for multiple <italic>Leptospira</italic> spp. serovars. Cross-reactivity between different <italic>Leptospira</italic> spp. serovars has been described for the MAT technique; therefore, we also addressed anti-<italic>Leptospira</italic> spp. antibody seroprevalence using a MAT titer cut-off value of 800 (<xref ref-type="bibr" rid="B21">21</xref>). Although there was a remarkable reduction in seropositivity and serovar distribution (some serovars were not present at the 800 titer cut-off value), we cannot totally rule out the possibility that positive MAT results for titers ranging from 200 to 800 are due to cross-reactivity. Moreover, anti-<italic>Leptospira</italic> spp. antibody seroprevalence was over 50% even for a high specific cut-off titer value of 800. In addition, for a titer cut-off value of 800, the main infective serovars were Bataviae (20.4%) and Canicola (18.5%), which belong to the pathogenic cluster. We found six horses that were positive for both serovars, belonging to different serogroups, so either coinfection with multiple serovars or successive infections could have occurred.</p>
<p>We could not find any differences associated with age for <italic>Leptospira</italic> spp. serovar distribution. The differences in serovars between horses could be partially explained by the different origins of the horses (some of them were brought from neighboring countries such as Peru, Chile, and Argentina) or frequent travel to competitions. However, this information was not provided in detail by the farm and could not be evaluated. Another limitation of our study was the scarce information regarding signs of leptospirosis in the horses, as we were allowed only one quick evaluation of the horses prior to sample collection; furthermore, no clinical records were provided by the farm, and the veterinarians did not recall any horses with signs of leptospirosis. Therefore, no associations between signs of leptospirosis and specific serovars could be addressed.</p>
<p>The results of our study coincide with previous reports showing that horse leptospirosis is endemic in South America, with prevalence values ranging from 4.5% to 90.7% (<xref ref-type="bibr" rid="B6">6</xref>). In addition, a recent publication, from 2019, found a prevalence of 85% using a 24-serovar MAT panel on horses from police departments in Colombia (<xref ref-type="bibr" rid="B20">20</xref>). However, it is important to note that the most prevalent serovars in our study (Grippotyphosa, Bataviae, Sejroe, Canicola, Bratislava, and Tarassovi) differed from the most prevalent ones reported in South America (Icterohaemorrhagiae, Australis, and Pomona) (<xref ref-type="bibr" rid="B6">6</xref>) or in Colombia in particular (Djasiman) (<xref ref-type="bibr" rid="B20">20</xref>). These differences may be explained by environmental differences, such as the amount of rain or the duration of the rainy season, or by the presence of different transmission vectors depending on the area of study. Notably, the <italic>Leptospira</italic> spp. serovar MAT panels used by different countries in South America may differ, which could be an additional methodological reason for the difference in serovars reported in this study (<xref ref-type="bibr" rid="B22">22</xref>). Moreover, a recent study from New Zealand of 499 racing horses from 25 different breading farms found a <italic>Leptospira</italic> spp. seroprevalence of 25%, despite only five serovars being tested (<xref ref-type="bibr" rid="B23">23</xref>). These results indicate that leptospirosis is not just a problem for horse health in low- and middle-income countries.</p>
<p>The ultrahigh seroprevalence of anti-<italic>Leptospira</italic> spp. antibodies reported in our study coincide with values reported in previous publications regarding leptospirosis prevalence in livestock and domestic animals in Ecuador: 70% in dogs, 35.4%&#x2013;74% in cattle, and 67% in pigs (<xref ref-type="bibr" rid="B16">16</xref>, <xref ref-type="bibr" rid="B18">18</xref>, <xref ref-type="bibr" rid="B19">19</xref>). Although those studies reported a high prevalence of leptospirosis, they were performed using PCR or a MAT panel comprising only eight serovars for diagnosis; these methodological differences could explain the higher prevalence found in our study. Moreover, a recent report from our laboratory using a MAT panel of 24 serovars for diagnosis also found 100% seroprevalence for <italic>Leptospira</italic> spp. in domestic and wild animals from a mixed-use rescue center in the coastal region of Ecuador (<xref ref-type="bibr" rid="B22">22</xref>). Although this is the first report of leptospirosis in horses from Ecuador, the <italic>Leptospira</italic> spp. serovars reported in those studies were also found in our study, suggesting the widespread distribution of serovars among livestock.</p>
<p>These horses were not vaccinated against <italic>Leptospira</italic> spp., despite the high economic value of this kind of horses in the market (some of the most prevalent serovars are included in the vaccine formulation, such as Grippotyphosa and Canicola). The farm lacked proper sanitary conditions, and free-roaming dogs, cats, and wild rodents were reported by the farm workers. Moreover, the farm is located in the coastal region of Ecuador, where seasonal floods are frequent and could facilitate leptospirosis transmission (<xref ref-type="bibr" rid="B18">18</xref>).</p>
<p>Future directions of our research will include a deeper &#x201c;One Health&#x201d; approach, identifying the <italic>Leptospira</italic> spp. serovars associated with free-roaming dogs, cats, and rodents found in farms, and also with water sources, to identify a potential transmission route. Finally, it is also necessary to increase awareness among the public health authorities of the risk of environmental exposure to <italic>Leptospira</italic> spp. in farm workers and other high-risk groups in Ecuador, in order to develop guidelines for leptospirosis surveillance and prevention according to the &#x201c;One Health&#x201d; concept.</p>
</sec>
<sec id="s5" sec-type="conclusions">
<title>Conclusions</title>
<p>Although the main limitation of our study was that only a single horse-breeding farm was included, a &#x201c;One Health&#x201d;-based management approach to horse breeding must be improved in an epidemiological context such as that in Ecuador, where anti-<italic>Leptospira</italic> spp. antibody seroprevalence in livestock and companion animals is extremely high, especially considering the close human&#x2013;horse contact that racehorse breeding and training implies.</p>
</sec>
<sec id="s8" sec-type="data-availability">
<title>Data availability statement</title>
<p>The original contributions presented in the study are included in the article/<xref ref-type="supplementary-material" rid="SM1">
<bold>Supplementary Material</bold>
</xref>. Further inquiries can be directed to the corresponding author.</p>
</sec>
<sec id="s9" sec-type="ethics-statement">
<title>Ethics statement</title>
<p>The animal study was reviewed and approved by Universidad de Las Americas. Written informed consent was obtained from the owners for the participation of their animals in this study.</p>
</sec>
<sec id="s10" sec-type="author-contributions">
<title>Author contributions</title>
<p>SO contributed to study conceptualization, logistics and funds allocation, data collection, experimental analysis, drafting the first manuscript, and reviewing the final version. KP contributed to data collection, experimental analysis, and reviewing the final version. ES contributed to data collection, experimental analysis, drafting of the first manuscript, and reviewing the final version. CC contributed to data collection, experimental analysis, and reviewing the final version. FA contributed to logistics and funds allocation, data collection, and reviewing the final version. PT-L contributed to logistics and funds allocation, data collection, and reviewing the final version. MG-B contributed to study conceptualization, logistics and funds allocation, publication funds allocation, data collection, experimental analysis, and drafting of the first and final version of the manuscript. All authors contributed to the article and approved the submitted version.</p>
</sec>
</body>
<back>
<ack>
<title>Acknowledgments</title>
<p>The authors of this work thank the staff from the horse-breeding farm for their support in carrying out this study.</p>
</ack>
<sec id="s11" sec-type="COI-statement">
<title>Conflict of interest</title>
<p>The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.</p>
</sec>
<sec id="s12" sec-type="disclaimer">
<title>Publisher&#x2019;s note</title>
<p>All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article, or claim that may be made by its manufacturer, is not guaranteed or endorsed by the publisher.</p>
</sec>
<sec id="s13" sec-type="supplementary-material">
<title>Supplementary material</title>
<p>The Supplementary Material for this article can be found online at: <ext-link ext-link-type="uri" xlink:href="https://www.frontiersin.org/articles/10.3389/fitd.2023.1061038/full#supplementary-material">https://www.frontiersin.org/articles/10.3389/fitd.2023.1061038/full#supplementary-material</ext-link>
</p>
<supplementary-material xlink:href="Table_1.docx" id="SM1" mimetype="application/vnd.openxmlformats-officedocument.wordprocessingml.document"/>
<supplementary-material xlink:href="Table_2.xlsx" id="SM2" mimetype="application/vnd.openxmlformats-officedocument.spreadsheetml.sheet"/>
</sec>
<fn-group>
<title>Abbreviations</title>
<fn fn-type="abbr">
<p>MAT, microscopic agglutination test.</p>
</fn>
</fn-group>
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