Objective:
The objective of this cooperative research project is the identification of risk factors in the transmission of leptospirosis in the Azores, in particular, the islands of Sao Miguel and Terceira, through the development of a predictive model and scenarios for a program of control in the areas of public health and animal production. This project is part of the Azores Cooperative Initiatives Program (ACIP), as jointly decided in May 2003 by the ACIP Technical Working Group held by the United States Government and the Regional Government of the Azores. ACIP, or rather the requirement to engage in cooperative initiatives with the Azores, Portugal, is mandated in the 1995 U.S.-Portugal Agreement on Cooperation and Defense and further defined in the Final Minute to that agreement. ACIP was created and has been implemented through Department of Defense (DOD) financial resources and relationships with civilian federal agencies and other non-governmental institutions as part of the U.S Government's commitment to the agreement. DOD has requested and funded the U.S. Department of Agriculture's Agricultural Research Service (USDA/ARS) to serve as the lead civilian agency and facilitator for ACIP.The agreement calls for the strengthening of the economic and social development of the Azores; the identification of areas within which cooperative activities and programs can promote this development; and this cooperation shall be in various areas outlined in the Final Minute, such as agriculture, education, environment, tourism and cultural exchange, civil protection, and social security and health. This cooperative project directly meets these objectives, addressing the serious health concern about leptospirosis in the Azores.

Approach:
This project will be implemented through a multifaceted approach aimed at monitoring the epidemiology of leptospirosis in humans, livestock, and wildlife, especially rats, and through the definition of the main risk factors for the transmission of the disease in order to implement a comprehensive campaign on leptospirosis through the efficient control of the natural reservoirs and a public health initiative for the local population. This will be accomplished through a variety of collaborations in the following areas: a. Evaluation of the epidemiology of the diagnosised cases of leptospirosis in the past years on Terceira and Sao Miguelb. Practical evaluation of the knowledge and attitudes of the population facing exposure to leptospirosis, aimed at the implementation a comprehensive program for the prevention of the illnessc. Define and implement the capability for rapid diagnosis of suspicious cases of leptosprisosis in the Regional Services of Health. d. Improve the confirmation techniques in the Azores for culture and research through PCR. e. Identify and characterize the areas with the greatest occurrence of rodents, reservoirs of leptospirosis. f. Characterize the biodiversity of the reservoirs for leptospirosis. g. Develop predictive models of the risk of transmission of leptospirosis in the studied zones. h. Investigate the identified areas of greater risk for the occurrence of leptospirosis, in relation to the level of the local human population and livestock. i. Analyze the genetic and non gentic biodiversity of the isolated lineages of the kidneys of the examined domestic animals in the selected risk areas. j. Identify and characterize population parameters of the rodents with greatest probability to transmit the disease (population structure, reproduction and capacity of dispersion). k. Establish and define direction for an adopted epidemiological monitoring program, to provide information on the level of rodent populations in the short, medium and long term. l. Define the mechanisms and resources for a sustainable program in the short, medium and long term for the the two islands, and in particular the zones of risk.