This article was downloaded by: [Australian National University] On: 29 December 2014, At: 23:24 Publisher: Taylor & Francis Informa Ltd Registered in England and Wales Registered Number: 1072954 Registered office: Mortimer House, 37-41 Mortimer Street, London W1T 3JH, UK
New Zealand Veterinary Journal Publication details, including instructions for authors and subscription information: http://www.tandfonline.com/loi/tnzv20
Seroprevalence and exposure to risk factors for leptospirosis among veterinary students at Massey University a
b
a
b
c
a
F Fang , J Benschop , PR Wilson , JM Collins-Emerson , C Heuer & D Prattley a
Institute of Veterinary, Animal and Biomedical Sciences, Massey University, Private Bag 11222, Palmerston North 4442, New Zealand b m
EpiLab, Hopkirk Research Institute, IVABS, Massey University, Private Bag 11222, Palmerston North 4442, New Zealand c
Epicentre, IVABS, Massey University, Private Bag 11222, Palmerston North 4442, New Zealand Published online: 19 Dec 2013.
Click for updates To cite this article: F Fang, J Benschop, PR Wilson, JM Collins-Emerson, C Heuer & D Prattley (2014) Seroprevalence and exposure to risk factors for leptospirosis among veterinary students at Massey University, New Zealand Veterinary Journal, 62:3, 130-135, DOI: 10.1080/00480169.2013.862161 To link to this article: http://dx.doi.org/10.1080/00480169.2013.862161
PLEASE SCROLL DOWN FOR ARTICLE Taylor & Francis makes every effort to ensure the accuracy of all the information (the “Content”) contained in the publications on our platform. However, Taylor & Francis, our agents, and our licensors make no representations or warranties whatsoever as to the accuracy, completeness, or suitability for any purpose of the Content. Any opinions and views expressed in this publication are the opinions and views of the authors, and are not the views of or endorsed by Taylor & Francis. The accuracy of the Content should not be relied upon and should be independently verified with primary sources of information. Taylor and Francis shall not be liable for any losses, actions, claims, proceedings, demands, costs, expenses, damages, and other liabilities whatsoever or howsoever caused arising directly or indirectly in connection with, in relation to or arising out of the use of the Content. This article may be used for research, teaching, and private study purposes. Any substantial or systematic reproduction, redistribution, reselling, loan, sub-licensing, systematic supply, or distribution in any form to anyone is expressly forbidden. Terms & Conditions of access and use can be found at http:// www.tandfonline.com/page/terms-and-conditions
130
New Zealand Veterinary Journal 62(3), 130–135, 2014
Scientific Article
Seroprevalence and exposure to risk factors for leptospirosis among veterinary students at Massey University
Downloaded by [Australian National University] at 23:24 29 December 2014
F Fang*§, J Benschop†, PR Wilson*, JM Collins-Emerson†, C Heuer‡ and D Prattley*
Abstract
Introduction
AIMS: To determine the seroprevalence and quantify putative risk factors for exposure to leptospirosis both within and outside the veterinary curriculum among undergraduate veterinary students at Massey University, New Zealand.
Leptospirosis is a zoonotic disease of worldwide importance caused by pathogenic spirochaetes belonging to the genus Leptospira (Levett 2001; Bharti et al. 2003; Dutta and Christopher 2005). Feral and domestic mammals can be maintenance hosts for various serovars, while humans usually serve as an incidental host (Plank and Dean 2000; Levett 2001). Human infection with Leptospira spp. results from direct exposure if the source of infection is animal tissue, body fluids or urine, or indirect exposure if the source is environmental, e.g. soil or water contaminated with urine of carrier animals (Bharti et al. 2003; Sharma and Yadav 2008). Therefore, occupations involving contact with animals present a significant risk of infection (Levett 2001). In temperate countries such as New Zealand, such occupations are livestock farming, veterinary practice, meat processing, butchering and forestry (Faine et al. 1999; Thornley et al. 2002). Fresh water exposures, including recreational activities, e.g. swimming, rafting, and exposure to flooding are also risk factors for human infection (Plank and Dean 2000; Levett 2001; Jansen et al. 2005).
METHODS: A cross-sectional study was conducted from September 2010 to November 2011. In total, 302 students were blood sampled, with serum tested by microscopic agglutination test (MAT) for antibodies to Leptospira borgpetersenii serovars Hardjobovis, Leptospira interrogans Pomona and Leptospira borgpetersenii Ballum. Information on demographic characteristics, potential exposure within and outside the veterinary curriculum in the previous 18 months, and previous leptospirosis-like clinical history were recorded using an online questionnaire. RESULTS: All students were MAT negative for each serovar, using a cut-point of ≥1:48. Potential exposure to animal urine within and outside the veterinary curriculum was reported by 259/302 (85.8%) and 150/302 (49.7%) of the students, respectively. The median number of potential exposures to animal urine by each student within the veterinary curriculum in the previous 18 months was 63 (min 1, max 155). The other potential exposures among respondents included home slaughter (63/302; 20.9%), hunting (43/302; 14.2%) and outdoor activities involving exposure to fresh water (241/302; 79.8%). CONCLUSIONS: This study demonstrated that these veterinary students were at low risk of contracting leptospirosis, despite frequent exposure to potential sources of infection. The findings in this study contribute to a broader understanding of the occupational risk of leptospirosis. Data describe the level of animal exposure in veterinary students, which can support other zoonotic disease studies in this group. KEY WORDS: Leptospirosis; veterinary students; seroprevalence; risk factors
* Institute of Veterinary, Animal and Biomedical Sciences, Massey University, Private Bag 11222, Palmerston North 4442, New Zealand † m EpiLab, Hopkirk Research Institute, IVABS, Massey University, Private Bag 11222, Palmerston North 4442, New Zealand ‡ Epicentre, IVABS, Massey University, Private Bag 11222, Palmerston North 4442, New Zealand § Author for correspondence. Email: [email protected] http://dx.doi.org/10.1080/00480169.2013.862161 © 2013 New Zealand Veterinary Association
The majority of cases of human leptospirosis, particularly in New Zealand, show mild symptoms and medical treatment is not required (Keenan 2007). However, a diverse range of severe clinical manifestations including jaundice, aseptic meningitis, renal failure and rarely, lethal pulmonary haemorrhage and cardiac involvement, have been reported in infections with Leptospira spp. (Bharti et al. 2003). In New Zealand, leptospirosis is the most common occupationally acquired zoonotic disease (Vickery et al. 2006; Keenan 2007). From 2009 to 2011, there were 222 notified cases of leptospirosis in New Zealand. Meat workers and farmers comprised 36/160 (22.5%) and 118/160 (73.8%) of those with occupations reported and previously identified as high risk for exposure to Leptospira spp. respectively (Anonymous 2012). For the 62 notified cases during this period that either reported low-risk occupations or did not have an occupation recorded, 37 (59.7%) reported animal or environmental exposure (Anonymous 2012). Leptospira spp. serovar(s) were recorded for 181/222 (81.5%) cases from 2009 to 2011 with Leptospira borgpetersenii serovar Ballum, Leptospira borgpetersenii serovar Hardjobovis and Leptospira interrogans serovar Pomona, in decreasing order, reported as the most commonly identified serovars (Anonymous 2012).
ESR MAT PPE
Institute of Environmental Science and Research Microscopic agglutination test Personal protective equipment
Fang et al.
New Zealand Veterinary Journal, 2014
Downloaded by [Australian National University] at 23:24 29 December 2014
Undergraduate veterinary students have close contact with animals during on-farm practical, extramural veterinary clinical practice, and intramural teaching experiences during the curriculum. Furthermore, they are likely to have contact with animals in their leisure time, e.g. pet owning, lifestyle farming, and hunting. This group is therefore likely at high risk of infection with zoonotic agents (Venables and Allender 2006). Examples of zoonotic exposures in veterinary students included rabies (Russell et al. 1977), Brucella abortus (Duclos et al. 1989), and cryptosporidiosis (Grinberg et al. 2011). Studies of leptospirosis in veterinary students are limited in the international literature and have not been conducted in New Zealand. A repeated cross-sectional study conducted in veterinary students from Spain (Simon et al. 1999) reported 8.1% (39/479) seroprevalence of leptospirosis at the beginning of the study and 11.4% (54/472) 1 year later. A cross-sectional study of veterinary students in Peru, using the microscopic agglutination test (MAT) reported overall seroprevalence of leptospirosis as 11.9% (14/118) (Dammert et al. 2009). The aim of the present study was to determine the seroprevalence of leptospirosis among veterinary students at Massey University, New Zealand, and to better understand the level of exposure to putative risk factors both within the veterinary curriculum, including intramural and extramural components, and personal life, that may be associated with infections with Leptospira spp. Results from this population could be used to determine the need or otherwise for targeted prevention strategies, and for comparison with other occupational groups at risk, such as meat workers and practising veterinarians, as part of on-going research and understanding of leptospirosis in human and animal populations in New Zealand.
Materials and methods Study design
The study was a cross-sectional study of veterinary students at Massey University, New Zealand conducted from September 2010 to November 2011. This study was reviewed and approved by the Massey University Human Ethics Committee: Southern A. Student recruitment
Massey University is the only university in New Zealand that offers a Bachelor of Veterinary Science degree course. It is a 5year full time programme and is registerable with the Veterinary Council of New Zealand. For each academic year, entry is restricted to around 100 students. The recruitment for this study followed consultation with the programme director and head of undergraduate teaching. All veterinary students (notionally 500) were invited to participate in the study either by the research nurse or academic staff at the beginning or after classes. Sampling of students for this study was conducted throughout the study period based on the students’ availability. A blood sample from each participant was taken by the research nurse at a room set up for this study. Subsequently, participants were asked to go on-line with their study ID and complete a foursection questionnaire (Supplementary Table 11) either using computers provided in the same room, or independently at a later time. The procedure took around 20 to 30 minutes. If completed surveys were not received, a reminder was sent to increase the 1
http://dx.doi.org/10.1080/00480169.2013.862161
131
response rate. Blood samples were kept at room temperature for the first 30 minutes then transported to the Hopkirk Leptospirosis Research Laboratory, IVABS, Massey University while maintained at cool conditions. Survey
The first section of the questionnaire obtained demographic information, including gender, age, ethnic affiliation, academic year, speciality track (fifth-year students only) and residential location in the past 18 months. The second section was specific to the risk of exposure to animal urine within the veterinary curriculum, both intramural and extramural, in the past 18 months. Questions were stratified by animal species. Students were also asked what percentage of the time they used personal protective equipment (PPE) during the veterinary curriculum. The third section asked about the potential for exposure in the student’s personal life in the past 18 months, i.e. other than during the veterinary curriculum. Questions included ownership of animals, regular (at least weekly) contact with animals that may lead to exposure or risk of exposure to animal urine, contact with wildlife, home-slaughter or helping with home slaughter of livestock, and hunting, all stratified by animal species. Questions also covered outdoor activities that involved exposure to fresh water, and flooding around residences. The fourth section asked whether the students had been diagnosed with leptospirosis any time previously or had influenza-like symptoms in the past 18 months. Serological test
Sera were tested for antibodies against Leptospira serovars Hardjobovis, Pomona and Ballum using the MAT procedure based on Faine (1982). A titre of ≥1:48 was considered positive for any serovar and used to indicate past infections with Leptospira spp., as used elsewhere for serosurvey in asymptomatic high-risk groups (Faine et al. 1999; Shivakumar and Krishnakumar 2006). If MAT titres were found in any samples, they were then to be sent to the Leptospira reference laboratory at the Institute of Environmental Science and Research (ESR) for confirmation (a panel of eight serovars representative of New Zealand Leptospira serovars were included). Test results were reported to students by post within 3 months after sampling. It was intended that seropositive students would be advised to consult a medical practitioner, in compliance with ethical approval. Statistical analyses
Descriptive analysis was performed for all variables using statistical software R 2.14.1 (R Development Core Team 2011, R Foundation for Statistical Computing, Vienna, Austria). The association between academic year and the outcomes animal exposure frequency (total number of exposures) and total number of animals associated with all exposures within the veterinary curriculum in the past 18 months were investigated using box plots and linear regression models.
Results In total, 327 (of notional 500) veterinary students agreed to participate in the study. Blood samples were collected from 311 and completed questionnaires were returned from 318. Sixteen students either declined to be blood sampled or difficulty was experienced with sampling. Overall, 302 students supplied both complete questionnaires and blood samples, forming the final
132
New Zealand Veterinary Journal, 2014
Table 1. Demographic characteristics of the 302 veterinary students who completed a questionnaire and provided blood samples to determine exposure to risk factors for leptospirosis Variables
Fang et al.
Table 2. Number (%) of students reporting that they had contact with animals that may have lead to exposure or risk of exposure to animal urine within the veterinary curriculum (n=245) and outside the veterinary curriculum (n=143) within the previous 18 months, by species
Number (%) Number (%) exposed
Gender
Animal species
Male Female
70 (23.2)
New Zealand Veterinary Journal Publication details, including instructions for authors and subscription information: http://www.tandfonline.com/loi/tnzv20
Seroprevalence and exposure to risk factors for leptospirosis among veterinary students at Massey University a
b
a
b
c
a
F Fang , J Benschop , PR Wilson , JM Collins-Emerson , C Heuer & D Prattley a
Institute of Veterinary, Animal and Biomedical Sciences, Massey University, Private Bag 11222, Palmerston North 4442, New Zealand b m
EpiLab, Hopkirk Research Institute, IVABS, Massey University, Private Bag 11222, Palmerston North 4442, New Zealand c
Epicentre, IVABS, Massey University, Private Bag 11222, Palmerston North 4442, New Zealand Published online: 19 Dec 2013.
Click for updates To cite this article: F Fang, J Benschop, PR Wilson, JM Collins-Emerson, C Heuer & D Prattley (2014) Seroprevalence and exposure to risk factors for leptospirosis among veterinary students at Massey University, New Zealand Veterinary Journal, 62:3, 130-135, DOI: 10.1080/00480169.2013.862161 To link to this article: http://dx.doi.org/10.1080/00480169.2013.862161
PLEASE SCROLL DOWN FOR ARTICLE Taylor & Francis makes every effort to ensure the accuracy of all the information (the “Content”) contained in the publications on our platform. However, Taylor & Francis, our agents, and our licensors make no representations or warranties whatsoever as to the accuracy, completeness, or suitability for any purpose of the Content. Any opinions and views expressed in this publication are the opinions and views of the authors, and are not the views of or endorsed by Taylor & Francis. The accuracy of the Content should not be relied upon and should be independently verified with primary sources of information. Taylor and Francis shall not be liable for any losses, actions, claims, proceedings, demands, costs, expenses, damages, and other liabilities whatsoever or howsoever caused arising directly or indirectly in connection with, in relation to or arising out of the use of the Content. This article may be used for research, teaching, and private study purposes. Any substantial or systematic reproduction, redistribution, reselling, loan, sub-licensing, systematic supply, or distribution in any form to anyone is expressly forbidden. Terms & Conditions of access and use can be found at http:// www.tandfonline.com/page/terms-and-conditions
130
New Zealand Veterinary Journal 62(3), 130–135, 2014
Scientific Article
Seroprevalence and exposure to risk factors for leptospirosis among veterinary students at Massey University
Downloaded by [Australian National University] at 23:24 29 December 2014
F Fang*§, J Benschop†, PR Wilson*, JM Collins-Emerson†, C Heuer‡ and D Prattley*
Abstract
Introduction
AIMS: To determine the seroprevalence and quantify putative risk factors for exposure to leptospirosis both within and outside the veterinary curriculum among undergraduate veterinary students at Massey University, New Zealand.
Leptospirosis is a zoonotic disease of worldwide importance caused by pathogenic spirochaetes belonging to the genus Leptospira (Levett 2001; Bharti et al. 2003; Dutta and Christopher 2005). Feral and domestic mammals can be maintenance hosts for various serovars, while humans usually serve as an incidental host (Plank and Dean 2000; Levett 2001). Human infection with Leptospira spp. results from direct exposure if the source of infection is animal tissue, body fluids or urine, or indirect exposure if the source is environmental, e.g. soil or water contaminated with urine of carrier animals (Bharti et al. 2003; Sharma and Yadav 2008). Therefore, occupations involving contact with animals present a significant risk of infection (Levett 2001). In temperate countries such as New Zealand, such occupations are livestock farming, veterinary practice, meat processing, butchering and forestry (Faine et al. 1999; Thornley et al. 2002). Fresh water exposures, including recreational activities, e.g. swimming, rafting, and exposure to flooding are also risk factors for human infection (Plank and Dean 2000; Levett 2001; Jansen et al. 2005).
METHODS: A cross-sectional study was conducted from September 2010 to November 2011. In total, 302 students were blood sampled, with serum tested by microscopic agglutination test (MAT) for antibodies to Leptospira borgpetersenii serovars Hardjobovis, Leptospira interrogans Pomona and Leptospira borgpetersenii Ballum. Information on demographic characteristics, potential exposure within and outside the veterinary curriculum in the previous 18 months, and previous leptospirosis-like clinical history were recorded using an online questionnaire. RESULTS: All students were MAT negative for each serovar, using a cut-point of ≥1:48. Potential exposure to animal urine within and outside the veterinary curriculum was reported by 259/302 (85.8%) and 150/302 (49.7%) of the students, respectively. The median number of potential exposures to animal urine by each student within the veterinary curriculum in the previous 18 months was 63 (min 1, max 155). The other potential exposures among respondents included home slaughter (63/302; 20.9%), hunting (43/302; 14.2%) and outdoor activities involving exposure to fresh water (241/302; 79.8%). CONCLUSIONS: This study demonstrated that these veterinary students were at low risk of contracting leptospirosis, despite frequent exposure to potential sources of infection. The findings in this study contribute to a broader understanding of the occupational risk of leptospirosis. Data describe the level of animal exposure in veterinary students, which can support other zoonotic disease studies in this group. KEY WORDS: Leptospirosis; veterinary students; seroprevalence; risk factors
* Institute of Veterinary, Animal and Biomedical Sciences, Massey University, Private Bag 11222, Palmerston North 4442, New Zealand † m EpiLab, Hopkirk Research Institute, IVABS, Massey University, Private Bag 11222, Palmerston North 4442, New Zealand ‡ Epicentre, IVABS, Massey University, Private Bag 11222, Palmerston North 4442, New Zealand § Author for correspondence. Email: [email protected] http://dx.doi.org/10.1080/00480169.2013.862161 © 2013 New Zealand Veterinary Association
The majority of cases of human leptospirosis, particularly in New Zealand, show mild symptoms and medical treatment is not required (Keenan 2007). However, a diverse range of severe clinical manifestations including jaundice, aseptic meningitis, renal failure and rarely, lethal pulmonary haemorrhage and cardiac involvement, have been reported in infections with Leptospira spp. (Bharti et al. 2003). In New Zealand, leptospirosis is the most common occupationally acquired zoonotic disease (Vickery et al. 2006; Keenan 2007). From 2009 to 2011, there were 222 notified cases of leptospirosis in New Zealand. Meat workers and farmers comprised 36/160 (22.5%) and 118/160 (73.8%) of those with occupations reported and previously identified as high risk for exposure to Leptospira spp. respectively (Anonymous 2012). For the 62 notified cases during this period that either reported low-risk occupations or did not have an occupation recorded, 37 (59.7%) reported animal or environmental exposure (Anonymous 2012). Leptospira spp. serovar(s) were recorded for 181/222 (81.5%) cases from 2009 to 2011 with Leptospira borgpetersenii serovar Ballum, Leptospira borgpetersenii serovar Hardjobovis and Leptospira interrogans serovar Pomona, in decreasing order, reported as the most commonly identified serovars (Anonymous 2012).
ESR MAT PPE
Institute of Environmental Science and Research Microscopic agglutination test Personal protective equipment
Fang et al.
New Zealand Veterinary Journal, 2014
Downloaded by [Australian National University] at 23:24 29 December 2014
Undergraduate veterinary students have close contact with animals during on-farm practical, extramural veterinary clinical practice, and intramural teaching experiences during the curriculum. Furthermore, they are likely to have contact with animals in their leisure time, e.g. pet owning, lifestyle farming, and hunting. This group is therefore likely at high risk of infection with zoonotic agents (Venables and Allender 2006). Examples of zoonotic exposures in veterinary students included rabies (Russell et al. 1977), Brucella abortus (Duclos et al. 1989), and cryptosporidiosis (Grinberg et al. 2011). Studies of leptospirosis in veterinary students are limited in the international literature and have not been conducted in New Zealand. A repeated cross-sectional study conducted in veterinary students from Spain (Simon et al. 1999) reported 8.1% (39/479) seroprevalence of leptospirosis at the beginning of the study and 11.4% (54/472) 1 year later. A cross-sectional study of veterinary students in Peru, using the microscopic agglutination test (MAT) reported overall seroprevalence of leptospirosis as 11.9% (14/118) (Dammert et al. 2009). The aim of the present study was to determine the seroprevalence of leptospirosis among veterinary students at Massey University, New Zealand, and to better understand the level of exposure to putative risk factors both within the veterinary curriculum, including intramural and extramural components, and personal life, that may be associated with infections with Leptospira spp. Results from this population could be used to determine the need or otherwise for targeted prevention strategies, and for comparison with other occupational groups at risk, such as meat workers and practising veterinarians, as part of on-going research and understanding of leptospirosis in human and animal populations in New Zealand.
Materials and methods Study design
The study was a cross-sectional study of veterinary students at Massey University, New Zealand conducted from September 2010 to November 2011. This study was reviewed and approved by the Massey University Human Ethics Committee: Southern A. Student recruitment
Massey University is the only university in New Zealand that offers a Bachelor of Veterinary Science degree course. It is a 5year full time programme and is registerable with the Veterinary Council of New Zealand. For each academic year, entry is restricted to around 100 students. The recruitment for this study followed consultation with the programme director and head of undergraduate teaching. All veterinary students (notionally 500) were invited to participate in the study either by the research nurse or academic staff at the beginning or after classes. Sampling of students for this study was conducted throughout the study period based on the students’ availability. A blood sample from each participant was taken by the research nurse at a room set up for this study. Subsequently, participants were asked to go on-line with their study ID and complete a foursection questionnaire (Supplementary Table 11) either using computers provided in the same room, or independently at a later time. The procedure took around 20 to 30 minutes. If completed surveys were not received, a reminder was sent to increase the 1
http://dx.doi.org/10.1080/00480169.2013.862161
131
response rate. Blood samples were kept at room temperature for the first 30 minutes then transported to the Hopkirk Leptospirosis Research Laboratory, IVABS, Massey University while maintained at cool conditions. Survey
The first section of the questionnaire obtained demographic information, including gender, age, ethnic affiliation, academic year, speciality track (fifth-year students only) and residential location in the past 18 months. The second section was specific to the risk of exposure to animal urine within the veterinary curriculum, both intramural and extramural, in the past 18 months. Questions were stratified by animal species. Students were also asked what percentage of the time they used personal protective equipment (PPE) during the veterinary curriculum. The third section asked about the potential for exposure in the student’s personal life in the past 18 months, i.e. other than during the veterinary curriculum. Questions included ownership of animals, regular (at least weekly) contact with animals that may lead to exposure or risk of exposure to animal urine, contact with wildlife, home-slaughter or helping with home slaughter of livestock, and hunting, all stratified by animal species. Questions also covered outdoor activities that involved exposure to fresh water, and flooding around residences. The fourth section asked whether the students had been diagnosed with leptospirosis any time previously or had influenza-like symptoms in the past 18 months. Serological test
Sera were tested for antibodies against Leptospira serovars Hardjobovis, Pomona and Ballum using the MAT procedure based on Faine (1982). A titre of ≥1:48 was considered positive for any serovar and used to indicate past infections with Leptospira spp., as used elsewhere for serosurvey in asymptomatic high-risk groups (Faine et al. 1999; Shivakumar and Krishnakumar 2006). If MAT titres were found in any samples, they were then to be sent to the Leptospira reference laboratory at the Institute of Environmental Science and Research (ESR) for confirmation (a panel of eight serovars representative of New Zealand Leptospira serovars were included). Test results were reported to students by post within 3 months after sampling. It was intended that seropositive students would be advised to consult a medical practitioner, in compliance with ethical approval. Statistical analyses
Descriptive analysis was performed for all variables using statistical software R 2.14.1 (R Development Core Team 2011, R Foundation for Statistical Computing, Vienna, Austria). The association between academic year and the outcomes animal exposure frequency (total number of exposures) and total number of animals associated with all exposures within the veterinary curriculum in the past 18 months were investigated using box plots and linear regression models.
Results In total, 327 (of notional 500) veterinary students agreed to participate in the study. Blood samples were collected from 311 and completed questionnaires were returned from 318. Sixteen students either declined to be blood sampled or difficulty was experienced with sampling. Overall, 302 students supplied both complete questionnaires and blood samples, forming the final
132
New Zealand Veterinary Journal, 2014
Table 1. Demographic characteristics of the 302 veterinary students who completed a questionnaire and provided blood samples to determine exposure to risk factors for leptospirosis Variables
Fang et al.
Table 2. Number (%) of students reporting that they had contact with animals that may have lead to exposure or risk of exposure to animal urine within the veterinary curriculum (n=245) and outside the veterinary curriculum (n=143) within the previous 18 months, by species
Number (%) Number (%) exposed
Gender
Animal species
Male Female
70 (23.2)
