Monitoring of Leishmania infantum in captive non-human primates in Spain

Cases of Leishmania infantum infection have recently been reported in non-human primates (NHPs) in Spain causing severe clinical disease in critically endangered orangutans (Pongo pygmaeus pygmaeus). The aim of this study was to determine exposure and risk factors associated with L. infantum infection in NHPs housed in zoos and wildlife rescue centers (WRC) in Spain. Between 2007 and 2023, sera from 252 NHPs belonging to 47 different species were collected at 15 centers. Indirect immunofluorescence was used to detect the presence of antibodies against L. infantum (cut-off ≥1:80). In addition, hair samples from 78 individuals were tested for Leishmania kDNA by real-time quantitative PCR (qPCR). Anti-Leishmania antibodies were detected in 4.0 % (10/252; 95 %CI: 1.6-6.4) of the NHPs tested at 26.7 % (4/15) of the centers sampled. Twenty-two NHPs were longitudinally sampled between 2010 and 2023: one ring-tailed lemur (Lemur catta) seroconverted and a seropositive orangutan increased antibody titers during the study period. Leishmania infantum kDNA was found in 62.8 % (49/78; 95 %CI: 52.1-73.6) of animals and at all centers sampled (100 %; 7/7). Phylogenetic analysis revealed high homology between the sequence obtained and strains previously isolated in humans, dogs and captive and free-living wildlife species in Spain. To the authors´ knowledge, this is the first report of Leishmania kDNA detection in NHP hair samples. The results indicate that hair samples could be a useful, non-invasive method of detection of L. infantum infection in these species. This is also the first large-scale survey of L. infantum conducted in NHP species in Europe. We report for the first time the presence of Leishmania kDNA in nine different NHP species belonging to the families Cercopithecidae, Lemuridae, and Hylobatidae, expanding the host range for this parasite. The main risk factors associated with L. infantum infection were: age (≥5 years old) and body size (large). Our results demonstrate widespread circulation of this parasite among NHPs housed in Spain, which could be of conservation and public health concern. Monitoring and control programs should be implemented in zoos and WRCs to minimize the risk of NHP exposure to L. infantum in endemic areas worldwide.