Urban Leptospirosis in Africa: A Cross-Sectional Survey of Leptospira Infection in Rodents in the Kibera Urban Settlement, Nairobi, Kenya

Leptospirosis is a widespread but under-reported cause of morbidity and mortality. Global re-emergence of leptospirosis has been associated with the growth of informal urban settlements in which rodents are thought to be important reservoir hosts. Understanding the multi-host epidemiology of leptospirosis is essential to control and prevent disease. A cross-sectional survey of rodents in the Kibera settlement in Nairobi, Kenya was conducted in September–October 2008 to demonstrate the presence of pathogenic leptospires. A real-time quantitative polymerase chain reaction showed that 41 (18.3%) of 224 rodents carried pathogenic leptospires in their kidneys, and sequence data identified Leptospira interrogans and L. kirschneri in this population. Rodents of the genus Mus (37 of 185) were significantly more likely to be positive than those of the genus Rattus (4 of 39; odds ratio = 15.03). Questionnaire data showed frequent contact between humans and rodents in Kibera. This study emphasizes the need to quantify the public health impacts of this neglected disease at this and other urban sites in Africa.

Refugee crisis and re-emergence of forgotten infections in Europe

Makeshift shelters are becoming increasingly evident in European cities as a consequence of the momentous influx of refugees seeking asylum in European countries. These individuals have endured long gruelling journeys to reach their target countries, often having to have survived appalling living conditions (figure 1a). One of the routes chosen by migrants is that from East Africa, through Sudan and Libya before reaching North Africa and eventually Europe (see figure 1b). Not unsurprisingly, this has led to the introduction of infectious diseases rarely encountered in developed nations, most notably louse-borne relapsing fever (LBRF).