{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T14:03:13Z","timestamp":1792677793025,"version":"4.5.0"},"reference-count":32,"publisher":"American Society of Tropical Medicine and Hygiene","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2012,2,1]]},"abstract":"<jats:p>Leptospirosis has recently been reported as an emerging disease worldwide, and a seroprevalence study was undertaken in American Samoa to better understand the drivers of transmission. Antibodies indicative of previous exposure to leptospirosis were found in 15.5% of 807 participants, predominantly against three serovars that were not previously known to occur in American Samoa. Questionnaires and geographic information systems data were used to assess behavioral factors and environmental determinants of disease transmission, and logistic regression was used to identify factors associated with infection. Many statistically significant factors were consistent with previous studies, but we also showed a significant association with living at lower altitudes (odds ratio [OR] = 1.53, 95% confidence interval [CI]: 1.03\u20132.28), and having higher numbers of piggeries around the home (OR = 2.63, 95% CI: 1.52\u20134.40). Our findings support a multifaceted approach to combating the emergence of leptospirosis, including modification of individual behavior, but importantly also managing the evolving environmental drivers of risk.<\/jats:p>","DOI":"10.4269\/ajtmh.2012.11-0398","type":"journal-article","created":{"date-parts":[[2012,2,6]],"date-time":"2012-02-06T21:50:37Z","timestamp":1328565037000},"page":"309-319","source":"Crossref","is-referenced-by-count":52,"title":["Leptospirosis in American Samoa 2010: Epidemiology, Environmental Drivers, and the Management of Emergence"],"prefix":"10.4269","volume":"86","author":[{"given":"Colleen L.","family":"Lau","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Annette J.","family":"Dobson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lee D.","family":"Smythe","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emily J.","family":"Fearnley","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chris","family":"Skelly","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Archie C. A.","family":"Clements","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Scott B.","family":"Craig","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Saipale D.","family":"Fuimaono","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Philip","family":"Weinstein","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2795","reference":[{"key":"R1","series-title":"Lancet Infect Dis","first-page":"757","article-title":"Leptospirosis: a zoonotic disease of global importance","volume":"3","author":"Bharti","year":"2003"},{"key":"R2","series-title":"Int J Infect Dis","first-page":"351","article-title":"The globalization of leptospirosis: worldwide incidence trends","volume":"12","author":"Pappas","year":"2008"},{"key":"R3","series-title":"Wkly Epidemiol Rec","first-page":"45","article-title":"Leptospirosis: an emerging public health problem","volume":"86","author":"World Health Organization","year":"2011"},{"key":"R4","series-title":"Clin Microbiol Infect","first-page":"494","article-title":"Emergence, control and re-emerging leptospirosis: dynamics of infection in the changing world","volume":"17","author":"Hartskeerl","year":"2011"},{"key":"R5","series-title":"BMC Infect Dis","first-page":"147","article-title":"Leptospirosis in the Asia Pacific region","volume":"9","author":"Victoriano","year":"2009"},{"key":"R6","series-title":"Ann Trop Med Parasitol","first-page":"543","article-title":"Emerging tropical diseases in Australia. Part 1. Leptospirosis","volume":"104","author":"Tulsiani","year":"2010"},{"key":"R7","series-title":"Trans R Soc Trop Med Hyg","first-page":"714","article-title":"Multicentre survey of incidence and public health impact of leptospirosis in the Western Pacific","volume":"101","author":"Berlioz-Arthaud","year":"2007"},{"key":"R8","series-title":"Trop Med Int Health","first-page":"926","article-title":"Outbreak of leptospirosis in New Caledonia: diagnosis issues and burden of disease","volume":"14","author":"Goarant","year":"2009"},{"key":"R9","series-title":"Emerg Infect Dis","first-page":"221","article-title":"Leptospirosis in Hawaii, USA, 1999\u20132008","volume":"17","author":"Katz","year":"2011"},{"key":"R10","series-title":"Epidemiol Infect","first-page":"167","article-title":"Animal leptospirosis in small tropical areas","volume":"139","author":"Desvars","year":"2010"},{"key":"R11","series-title":"Clin Microbiol Infect","first-page":"336","article-title":"The socio-ecology of zoonotic infections","volume":"17","author":"Cascio","year":"2011"},{"key":"R12","series-title":"Trans R Soc Trop Med Hyg","first-page":"631","article-title":"Climate change, flooding, urbanization and leptospirosis: fueling the fire?","volume":"104","author":"Lau","year":"2010"},{"key":"R13","series-title":"Lancet","first-page":"820","article-title":"Urban epidemic of severe leptospirosis in Brazil. Salvador Leptospirosis Study Group","volume":"354","author":"Ko","year":"1999"},{"key":"R14","series-title":"Travel Med Infect Dis","first-page":"33","article-title":"Leptospirosis: an emerging disease in travelers","volume":"8","author":"Lau","year":"2010"},{"key":"R15","series-title":"Emerg Infect Dis","first-page":"1016","article-title":"Environmental exposure and leptospirosis, Peru","volume":"10","author":"Johnson","year":"2004"},{"key":"R16","series-title":"Med Hypotheses","first-page":"339","article-title":"Biodiversity and leptospirosis risk: a case of pathogen regulation?","volume":"77","author":"Derne","year":"2011"},{"key":"R17","series-title":"Nature","first-page":"647","article-title":"Impacts of biodiversity on the emergence and transmission of infectious diseases","volume":"468","author":"Keesing","year":"2010"},{"key":"R18","series-title":"PLoS Negl Trop Dis","first-page":"e228","article-title":"Impact of environment and social gradient on Leptospira infection in urban slums","volume":"2","author":"Reis","year":"2008"},{"key":"R19","series-title":"Int J Environ Health Res","first-page":"301","article-title":"Socio-environmental determinants of the leptospirosis outbreak of 1996 in western Rio de Janeiro: a geographical approach","volume":"10","author":"Barcellos","year":"2000"},{"issue":"(Suppl):","key":"R20","series-title":"Cad Saude Publica","first-page":"59","article-title":"The place behind the case: leptospirosis risks and associated environmental conditions in a flood-related outbreak in Rio de Janeiro","volume":"17","author":"Barcellos","year":"2001"},{"key":"R21","series-title":"The World Factbook: American Samoa (Territory of the US)","author":"Central Intelligence Agency","year":"2010"},{"key":"R22","series-title":"Leptospirosis, Fatal: USA (American Samoa)","author":"ProMED-mail","year":"2004"},{"key":"R23","series-title":"Leptospirosis: A Seroprevalence Survey on American Samoa","author":"Winger","year":"2004"},{"key":"R24","series-title":"Pago Pago, American Samoa","author":"National Oceanic and Atmospheric Administration, National Weather Service","year":"2011"},{"key":"R25","author":"American Samoa GIS User Group","year":"2011"},{"key":"R26","series-title":"Digital Elevation Models of Pago Pago, American Samoa: Procedures, Data Sources and Analysis","author":"Lim","year":"2010"},{"key":"R27","series-title":"Human Leptospirosis: Guidance for Diagnosis, Surveillance and Control","author":"WHO","year":"2003"},{"key":"R28","series-title":"Leptospira and Leptospirosis","author":"Faine","year":"1999"},{"key":"R29","series-title":"Density Estimation for Statistics and Data Analysis","author":"Silverman","year":"1986"},{"key":"R30","series-title":"Trans R Soc Trop Med Hyg","first-page":"859","article-title":"Serological studies on leptospirosis in livestock and chickens from Grenada and Trinidad","volume":"79","author":"Everard","year":"1985"},{"key":"R31","series-title":"Pac Health Dialog","first-page":"30","article-title":"Animal leptospirosis in the Federated States of Micronesia","volume":"5","author":"Simms","year":"1997"},{"key":"R32","series-title":"Piggery Compliance","article-title":"American Samoa Environmental Protection Agency","year":"2011"}],"container-title":["The American Society of Tropical Medicine and Hygiene"],"original-title":[],"link":[{"URL":"https:\/\/www.ajtmh.org\/view\/journals\/tpmd\/86\/2\/article-p309.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.ajtmh.org\/downloadpdf\/journals\/tpmd\/86\/2\/article-p309.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/www.ajtmh.org\/downloadpdf\/journals\/tpmd\/86\/2\/article-p309.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,8,7]],"date-time":"2024-08-07T18:08:00Z","timestamp":1723054080000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ajtmh.org\/view\/journals\/tpmd\/86\/2\/article-p309.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2012,2,1]]},"references-count":32,"journal-issue":{"issue":"2"},"URL":"https:\/\/doi.org\/10.4269\/ajtmh.2012.11-0398","relation":{},"ISSN":["0002-9637","1476-1645"],"issn-type":[{"value":"0002-9637","type":"print"},{"value":"1476-1645","type":"electronic"}],"subject":[],"published":{"date-parts":[[2012,2,1]]}}}