{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,3]],"date-time":"2026-08-03T17:53:39Z","timestamp":1785779619919,"version":"3.56.0"},"reference-count":24,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T00:00:00Z","timestamp":1777593600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T00:00:00Z","timestamp":1777593600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100001691","name":"Japan Society for the Promotion of Science","doi-asserted-by":"publisher","award":["24K13452"],"award-info":[{"award-number":["24K13452"]}],"id":[{"id":"10.13039\/501100001691","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Tropical Med Int Health"],"published-print":{"date-parts":[[2026,8]]},"abstract":"ABSTRACT<\/jats:title>\n \n Objectives<\/jats:title>\n \n Leptospirosis is a zoonotic disease caused by\n Leptospira<\/jats:italic>\n spp. often linked to freshwater exposure in subtropical and tropical regions. Okinawa Prefecture reports the highest number of leptospirosis cases in Japan based on national surveillance data. Although recreational river activities in Okinawa are a major opportunity for exposure, direct evidence connecting environmental contamination with human infection remains limited. We investigated the spatiotemporal distribution of pathogenic\n Leptospira<\/jats:italic>\n spp. in rivers on Iriomote Island, Okinawa, a subtropical region with a high leptospirosis incidence.\n <\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n \n Ten laboratory\u2010confirmed patients treated at the regional hospital and affiliated clinics in 2024 were assessed for demographics, onset dates and exposure histories. Water samples were collected monthly from seven major rivers (June\u2013September and December 2024). Pathogenic\n Leptospira<\/jats:italic>\n spp. were detected by nested polymerase chain reaction targeting\n flaB<\/jats:italic>\n , followed by sequencing and phylogenetic analysis.\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n A cluster of six cases occurred with onset on August 26\u201327; all reported river activities during incubation periods. In the environmental survey, highly and intermediately pathogenic genotypes were identified in all rivers (\n n<\/jats:italic>\n \u2009=\u200984 water samples).\n \n Leptospira interrogans<\/jats:italic>\n <\/jats:styled-content>\n was frequently identified, particularly during summer. Novel sequences within the highly pathogenic group suggest potentially unreported species. Pathogenic\n Leptospira<\/jats:italic>\n were detected in river water both before and after rainfall. The case cluster occurred following heavy rainfall, suggesting a possible temporal association between rainfall and increased exposure risk.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n \n Pathogenic\n Leptospira<\/jats:italic>\n spp., including clinically relevant\n \n L. interrogans<\/jats:italic>\n <\/jats:styled-content>\n , were widely detected in rivers on Iriomote Island. Human case occurrence followed heavy rainfall where pathogenic\n Leptospira<\/jats:italic>\n were already present in the environment. While this temporal pattern suggests that rainfall may have exacerbated exposure risk, exposures unrelated to rainfall cannot be excluded. This integrated approach may improve case detection and risk assessment in endemic settings and is adaptable to other tropical and subtropical regions with similar exposure risks.\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1111\/tmi.70157","type":"journal-article","created":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T08:45:32Z","timestamp":1777625132000},"page":"1073-1081","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Environmental Distribution of Pathogenic\n Leptospira<\/i>\n spp. in Subtropical Rivers of Japan and Implications for Human Infection"],"prefix":"10.1111","volume":"31","author":[{"ORCID":"https:\/\/orcid.org\/0009-0002-2250-1503","authenticated-orcid":false,"given":"Atsuhiro","family":"Kanayama","sequence":"first","affiliation":[{"name":"Division of Infectious Disease Epidemiology and Control National Defense Medical College Research Institute Tokorozawa Saitama Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiroko","family":"Ejiri","sequence":"additional","affiliation":[{"name":"Division of Infectious Disease Epidemiology and Control National Defense Medical College Research Institute Tokorozawa Saitama Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuki","family":"Chiko","sequence":"additional","affiliation":[{"name":"Department of General Medicine Okinawa Prefectural Yaeyama Hospital Ishigaki Okinawa Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ikumi","family":"Namihira","sequence":"additional","affiliation":[{"name":"Department of General Medicine Okinawa Prefectural Yaeyama Hospital Ishigaki Okinawa Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tomoki","family":"Yonaha","sequence":"additional","affiliation":[{"name":"Department of General Medicine Okinawa Prefectural Yaeyama Hospital Ishigaki Okinawa Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kanetaka","family":"Kuba","sequence":"additional","affiliation":[{"name":"Department of General Medicine Okinawa Prefectural Yaeyama Hospital Ishigaki Okinawa Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Miyu","family":"Yoshimi","sequence":"additional","affiliation":[{"name":"Department of General Medicine Okinawa Prefectural Yaeyama Hospital Ishigaki Okinawa Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nobuo","family":"Koizumi","sequence":"additional","affiliation":[{"name":"Department of Bacteriology I, National Institute of Infectious Diseases Japan Institute for Health Security Shinjuku Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shigeto","family":"Takeshima","sequence":"additional","affiliation":[{"name":"Emergency Department Okinawa Prefectural Yaeyama Hospital Ishigaki Okinawa Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Koki","family":"Kaku","sequence":"additional","affiliation":[{"name":"Division of Infectious Disease Epidemiology and Control National Defense Medical College Research Institute Tokorozawa Saitama Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,5,1]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijid.2007.09.011"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41572\u2010025\u201000614\u20105"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1038\/nrmicro2208"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1128\/AEM.02728\u201012"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.3201\/eid1801.101892"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1473\u20103099(01)00058\u20105"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365\u20102672.2009.04220.x"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pntd.0009993"},{"key":"e_1_2_9_10_1","first-page":"43","article-title":"A Survey on Leptospira Antibody in Seven Municipalities of Okinawa Prefecture People","volume":"35","author":"Nakamura M.","year":"2001","journal-title":"Annual Report of Okinawa Prefectural Institute of Health and Environment"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1292\/jvms.68.83"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pntd.0007270"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1093\/milmed\/usx013"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pntd.0010234"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.7883\/yoken.JJID.2008.465"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.1093\/molbev\/msab120"},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1348\u20100421.2011.00347.x"},{"key":"e_1_2_9_18_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pntd.0004895"},{"key":"e_1_2_9_19_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pntd.0005414"},{"key":"e_1_2_9_20_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0227055"},{"key":"e_1_2_9_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.onehlt.2025.101016"},{"key":"e_1_2_9_22_1","first-page":"105","article-title":"Infectious Agents Surveillance Report (IASR)","volume":"37","author":"National Institute of Infectious Diseases","year":"2016","journal-title":"IASR"},{"key":"e_1_2_9_23_1","doi-asserted-by":"publisher","DOI":"10.1128\/aem.01204\u201023"},{"key":"e_1_2_9_24_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0312556"},{"key":"e_1_2_9_25_1","doi-asserted-by":"publisher","DOI":"10.1111\/tmi.13965"}],"container-title":["Tropical Medicine & International Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/tmi.70157","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/tmi.70157","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/tmi.70157","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,3]],"date-time":"2026-08-03T17:12:46Z","timestamp":1785777166000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/tmi.70157"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,5,1]]},"references-count":24,"journal-issue":{"issue":"8","published-print":{"date-parts":[[2026,8]]}},"alternative-id":["10.1111\/tmi.70157"],"URL":"https:\/\/doi.org\/10.1111\/tmi.70157","archive":["Portico"],"relation":{},"ISSN":["1360-2276","1365-3156"],"issn-type":[{"value":"1360-2276","type":"print"},{"value":"1365-3156","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,5,1]]},"assertion":[{"value":"2026-01-30","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-04-21","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-05-01","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}