{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T15:09:15Z","timestamp":1788880155124,"version":"build-2803163510"},"reference-count":19,"publisher":"American Society of Tropical Medicine and Hygiene","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,9,8]]},"abstract":"<jats:title>ABSTRACT.<\/jats:title>\n                  <jats:p>Leptospirosis is a globally distributed disease associated with recreational aquatic activities; environmental exposure; and a range of occupational exposures, including animal handling, sanitation work, military operations, and sewer maintenance. We report a case of severe leptospirosis in a New York City sanitation worker after exposure to contaminated water. Because of the nonspecific presentation of his infection and the nuances of diagnostic testing, the patient presented to multiple care settings before leptospirosis was diagnosed. This case illustrates the importance of clinician awareness of urban leptospirosis and its broadening epidemiology in the United States, the time-dependent performance of diagnostic testing, and opportunities to improve personal protective equipment recommendations for sanitation employees.<\/jats:p>","DOI":"10.4269\/ajtmh.26-0203","type":"journal-article","created":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T14:37:29Z","timestamp":1788878249000},"source":"Crossref","is-referenced-by-count":0,"title":["Occupational Leptospirosis in Urban Sanitation: Lessons for Early Recognition and Worker Protection"],"prefix":"10.4269","author":[{"given":"Abigail","family":"Graham","sequence":"first","affiliation":[{"name":"Columbia University Vagelos College of Physicians and Surgeons, New York, New York, USA;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah","family":"Hill","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Columbia University Irving Medical Center, New York, New York, USA;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carly","family":"Kaplan","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, Columbia University Irving Medical Center, New York, New York, USA;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zachary C.","family":"LeBlanc","sequence":"additional","affiliation":[{"name":"Columbia University Vagelos College of Physicians and Surgeons, New York, New York, USA;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nancyanne","family":"Schmidt","sequence":"additional","affiliation":[{"name":"Division of Rheumatology, Columbia University Irving Medical Center, New York, New York, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2795","reference":[{"issue":"1","key":"b1","series-title":"Clin Med (Lond)","first-page":"14","article-title":"Leptospirosis: Clinical 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change","volume":"389","author":"Semenza","year":"2023"},{"issue":"13","key":"b6","series-title":"J Am Vet Med Assoc","first-page":"1589","article-title":"A global One Health perspective on leptospirosis in humans and animals","volume":"260","author":"Sykes","year":"2022"},{"issue":"1","key":"b7","series-title":"Heliyon","first-page":"e23473","article-title":"Environmental and occupational factors associated with leptospirosis: A systematic review","volume":"10","author":"Baharom","year":"2023"},{"issue":"2","key":"b8","series-title":"Int J Environ Res Public Health","first-page":"427","article-title":"Occupational determinants of leptospirosis among urban service workers","volume":"17","author":"Atil","year":"2020"},{"key":"b9","series-title":"Front Public Health","first-page":"1627155","article-title":"Unveiling Leptospira prevalence and exposure in sanitation workers: A cross-sectional study in Ningbo City, China","volume":"13","author":"Su","year":"2025"},{"issue":"2","key":"b10","series-title":"Am J Trop Med Hyg","first-page":"376","article-title":"Leptospirosis risk among occupational groups in Brazil, 2010\u20132015","volume":"109","author":"Galan","year":"2023"},{"issue":"2","key":"b11","series-title":"Travel Med Infect Dis","first-page":"143","article-title":"Ocular and cutaneous manifestation of leptospirosis acquired in Albania: A retrospective analysis with implications for travel medicine","volume":"14","author":"Puca","year":"2016"},{"issue":"3","key":"b12","series-title":"Microorganisms","first-page":"667","article-title":"Diagnostic advances in leptospirosis: A comparative analysis of paraclinical tests with a focus on PCR","volume":"13","author":"Ciurariu","year":"2025"},{"issue":"9","key":"b13","series-title":"Front Biosci (Landmark Ed.)","first-page":"1655","article-title":"Recent advances in the diagnosis of leptospirosis","volume":"25","author":"Verma","year":"2020"},{"issue":"8","key":"b14","series-title":"Cochrane Database Syst Rev","first-page":"CD011871","article-title":"Nucleic acid and antigen detection tests for leptospirosis","volume":"8","author":"Yang","year":"2019"},{"issue":"6","key":"b15","series-title":"PLoS One","first-page":"e0129236","article-title":"Diagnosis of leptospirosis: Comparison between microscopic agglutination test, IgM-ELISA and IgM rapid immunochromatography test","volume":"10","author":"Niloofa","year":"2015"},{"issue":"5","key":"b16","series-title":"Occup Environ Med","first-page":"357","article-title":"Risk factors for leptospirosis seropositivity in slaughterhouse workers in western Kenya","volume":"74","author":"Cook","year":"2017"},{"key":"b17","series-title":"Epidemiol Infect","first-page":"e67","article-title":"Case-control study of leptospirosis in Aotearoa New Zealand reveals behavioural, occupational, and environmental risk 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