Common animal-associated infections (England and Wales): second quarter 2022
Updated 14 February 2023
Applies to England and Wales
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This quarterly report is produced by the Emerging Infections and Zoonoses team in the Clinical and Emerging Infections Directorate, UK Health Security Agency (UKHSA).
The report summarises confirmed (and probable for leptospirosis) cases of selected zoonoses reported in England and Wales between April and June 2022 (second quarter) and includes additional information on the quarterly trends for leptospirosis, Lyme disease and toxoplasmosis. The impacts of the public health measures implemented in England and Wales due to the coronavirus (COVID-19) pandemic during quarter 2 of 2021 should be considered when making comparisons with this time period.
Data reported as provisional is subject to change due to late notifications and de-duplication.
The data presented in this report supersedes data in previous reports due to late notifications and de-duplication.
Hepatitis E data is not presented in this quarterly report. As part of an internal review, the data is being validated and will be published as soon as possible.
Overview
Common animal-associated infections (England and Wales): Q1 2020 to Q2 2022
Table 1. Animal-associated infections in England and Wales: quarterly confirmed laboratory reports by specimen date, Q1 2020 to Q2 2022
| Disease (Organism) | Q1 2020 | Q2 2020 | Q3 2020 | Q4 2020 | Total 2020 | Q1 2021 | Q2 2021 | Q3 2021 | Q4 2021 | Total 2021 | Q1 2022 | Q2 2022* | Total 2022* |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Anthrax (Bacillus anthracis) | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
| Brucellosis (Brucella spp.) ** | 1 | 1 | 6 | 1 | 9 | 1 | 3 | 3 | 1 | 8 | 1 | 3 | 4 |
| Leptospirosis (Leptospira spp.) | 15 | 7 | 22 | 7 | 51 | 8 | 5 | 16 | 26 | 55 | 4 | 11 | 15 |
| Lyme disease (Borrelia burgdorferi) | |||||||||||||
| All cases | 173 | 188 | 625 | 276 | 1,262 | 119 | 225 | 573 | 239 | 1,156 | 142 | 232 | 374 |
| Acute infections | 53 | 132 | 468 | 155 | 808 | 59 | 146 | 477 | 180 | 862 | 92 | 185 | 277 |
| Pasteurellosis (Pasteurella spp.) | 175 | 153 | 214 | 190 | 732 | 196 | 258 | 243 | 188 | 885 | 211 | 242 | 453 |
| Q-fever (Coxiella burnetii) | |||||||||||||
| All cases | 7 | 5 | 3 | 2 | 17 | 3 | 2 | 5 | 2 | 12 | 6 | 3 | 9 |
| Acute infections | 6 | 3 | 3 | 1 | 13 | 2 | 2 | 5 | 2 | 11 | 4 | 2 | 6 |
| Toxoplasmosis (Toxoplasma gondii)† | n/a | n/a | n/a | n/a | n/a | n/a | n/a | 45 | 53 | 98 | 55 | 39 | 94 |
*Provisional data.
** Serology results, in addition to culture results, were introduced in Q1 2019.
† Based on date specimen received.
n/a = not available due to issues in the reference laboratory related to COVID-19.
Leptospirosis
Data for leptospirosis was obtained from the Rare and Imported Pathogens Laboratory (RIPL, UKHSA Porton Down). As of 1 August 2020, a laboratory confirmed case of leptospirosis is defined by a positive 16S rRNA PCR result only. An IgM enzyme-linked immunoabsorbent assay (EIA) continues to be performed on all samples of suspected leptospirosis cases. A case with a positive leptospirosis IgM result will usually be treated clinically on the basis of this result, even in the absence of a positive PCR result. A case with a positive IgM but without a confirmatory PCR result is therefore reported as a probable case for surveillance purposes.
There were 11 confirmed cases of leptospirosis reported in the second quarter of 2022, compared to 5 cases reported in the same quarter of 2021. There were 21 probable cases reported in the second quarter of 2022, compared to 12 in the same quarter of 2021. Figure 1 shows the number of confirmed cases reported by quarter over the past 5 years (2018 to 2022).
Figure 1. Laboratory confirmed and probable cases of leptospirosis by quarter, Q1 2018 to Q2 2022
In the second quarter of 2022, 9 confirmed cases (9/11; 82%) were male (aged 24 to 83 years) and 2 cases (2/11; 18%) were female (aged 46 and 56). Cases were reported in London (3), the East of England (2), the South West (2), the North East (1), the West Midlands (1) and Yorkshire and Humber (1). There was also one case reported in Wales.
Of the confirmed cases, 5 (45%) reported recent travel abroad. Of these, 2 cases had visited southeast Asia only, one case had visited South America, one case had visited Western Africa and one case had visited southeast Asia and the Middle East.
Of the 11 confirmed cases, 8 reported potential exposures (some cases reported more than one exposure):
- 4 cases had an exposure linked to a water source. Of these, 3 cases reported swimming in a lake, river or cave, and one reported rafting
- 3 cases had an exposure linked to animals; all reported contact with rats
- 2 cases also reported having visited a jungle in southeast Asia
Lyme disease
Data for Lyme disease was obtained from the Rare and Imported Pathogens Laboratory (RIPL, UKHSA Porton Down). The total number of confirmed Lyme disease cases reported in the second quarter of 2022 (n=232) was similar to the same time period in 2021 (n=225). The total number of acute cases was higher in the second quarter of 2022 (n=185) compared to the same time period in 2021 (n=146).
Figure 2 shows how the number of cases continue to peak during the summer months (third quarter), which corresponds to the peak times of exposures to ticks in the UK in the spring and summer months.
Figure 2. Laboratory confirmed cases of Lyme disease by quarter, Q1 2018 to Q2 2022
Of the total cases, 185 (80%) were acute (including 11 with neurological Lyme disease), and 47 (20%) were longstanding. Of the acute cases, 96 were male (aged 4 to 83, median 45) and 89 were female (aged 3 to 89, median 48). Table 2 shows the age group and sex distribution.
Table 2. Laboratory confirmed acute cases of Lyme disease by age group and sex, Q2 2022
| Age group | Male | Female | Total |
|---|---|---|---|
| 0 to 14 | 16 | 12 | 28 |
| 15 to 24 | 2 | 10 | 12 |
| 25 to 34 | 13 | 9 | 22 |
| 35 to 44 | 15 | 9 | 24 |
| 45 to 54 | 19 | 17 | 36 |
| 55 to 64 | 18 | 15 | 33 |
| 65 to 74 | 11 | 12 | 23 |
| Over 75 | 2 | 5 | 7 |
| Total | 96 | 89 | 185 |
The regions that reported the most acute cases in the second quarter of 2022 were the South East (n=56), the South West (n=53) and London (n=30) (Table 3). Only 4 of the acute cases in the second quarter of 2022 reported foreign travel: 2 to eastern Europe and 2 to southern Europe.
Table 3. Laboratory confirmed acute cases of Lyme disease by region, Q1 2021 to Q2 2022
| UKHSA Centre | Q1 2021 | Q2 2021 | Q3 2021 | Q4 2021 | Total 2021 | Q1 2022 | Q2 2022 | Total 2022 |
|---|---|---|---|---|---|---|---|---|
| East Midlands | 2 | 2 | 5 | 1 | 10 | 4 | 1 | 5 |
| East of England | 7 | 11 | 24 | 14 | 56 | 4 | 12 | 16 |
| London | 21 | 27 | 83 | 45 | 176 | 22 | 30 | 52 |
| North East | 3 | 6 | 15 | 5 | 29 | 2 | 2 | 4 |
| North West | 4 | 24 | 52 | 19 | 99 | 12 | 19 | 31 |
| South East | 11 | 30 | 150 | 36 | 227 | 18 | 56 | 74 |
| South West | 6 | 31 | 115 | 36 | 188 | 16 | 53 | 69 |
| West Midlands | 3 | 3 | 7 | 6 | 19 | 6 | 0 | 6 |
| Yorkshire and Humber | 1 | 8 | 20 | 11 | 40 | 5 | 8 | 13 |
| Wales | 1 | 4 | 6 | 7 | 18 | 3 | 4 | 7 |
| Total | 59 | 146 | 477 | 180 | 862 | 92 | 185 | 277 |
Note: specimens sent for Lyme disease referral testing should be accompanied by a completed referral form.
Toxoplasmosis
Data for toxoplasmosis was obtained from the Toxoplasma Reference Unit (TRU, Public Health Wales Swansea). Toxoplasmosis surveillance data between the first quarter of 2020 and the second quarter of 2021 is currently unavailable due to the lasting impact of pressures on the laboratory as a result of the COVID-19 pandemic and therefore reporting on recent trends is not possible at this stage. The data will be published retrospectively as soon as available.
There were a total of 39 confirmed toxoplasmosis cases reported in the second quarter of 2022. Of the total confirmed cases, 13 were male (aged 19 to 77, median 45) and 26 were female (aged 2 to 86, median 32). Table 4 shows the age group and sex distribution. It is likely that reported numbers are an underestimate, biasing towards severe infections as individuals with severe or symptomatic disease are more likely to be tested.
Table 4. Laboratory confirmed cases of toxoplasmosis by age group and sex, Q2 2022
| Age group | Male | Female | Total |
|---|---|---|---|
| Under 15 | 0 | 3 | 3 |
| 15 to 24 | 3 | 3 | 6 |
| 25 to 44 | 3 | 15 | 18 |
| 45 to 64 | 6 | 4 | 10 |
| Over 64 | 1 | 1 | 2 |
| Total | 13 | 26 | 39 |
Other zoonotic organisms (provisional data)
There were 20 reports of Capnocytophaga spp. infection in the second quarter of 2022. Of these, 11 were further speciated; 10 to C. canimorsus and one to C. ochracea. Of those speciated, 6 were male and 5 were female, and cases were reported in the East of England (1), the North East (2), the North West (1), the South East (3), the West Midlands (1), Yorkshire and Humber (1) and Wales (2). Capnocytophaga spp. are frequently carried in the mouths of companion animals (cats and dogs) or humans and may be associated with an animal or human, bite, or opportunistic infections in those with impaired immune systems.
There were 7 reports of Mycobacterium marinum infection in the second quarter of 2022. Of these, 4 cases were male and 3 cases were female; all were aged 40 years or older. All cases were reported in England.
There were no reports of Erysipelothrix rhusiopathiae infection in the second quarter of 2022.
There was one report of toxigenic Corynebacterium ulcerans infection in the second quarter of 2022. The case, reported in England, was a male over 70 years of age who reported contact with companion animals. Two companion animals linked to the case were swabbed and toxigenic C. ulcerans was identified in one of the animals. In England, contact with companion animals remains the most frequently reported exposure for individuals with confirmed toxigenic C. ulcerans infections, however, the animals may not show evidence of infection and it is not always possible to confirm the carriage of C. ulcerans in animals.
There were 5 reports of Taeniasis in the second quarter of 2022, 3 of which were further speciated – 2 to T. saginata and one to T. solium.
There were no reports of Toxocariasis in the second quarter of 2022.