The association between rainfall and human leptospirosis in Aotearoa New Zealand.

Leptospirosis remains a significant occupational zoonosis in New Zealand, and emerging serovar shifts warrant a closer examination of climate-related transmission pathways. This study aimed to examine whether total monthly rainfall is associated with reported leptospirosis in humans in New Zealand. Poisson and negative binomial models were developed to examine the relationship between rainfall at 0-, 1-, 2-, and 3-month lags and the incidence of leptospirosis during the month of the report. Total monthly rainfall was positively associated with the occurrence of human leptospirosis in the following month by a factor of 1.017 (95% CI: 1.007-1.026), 1.023 at the 2-month lag (95% CI:1.013-1.032), and 1.018 at the 3-month lag (95% CI: 1.009-1.028) for every additional cm of rainfall. Variation was present in the magnitude of association for each of the individual serovars considered, suggesting different exposure pathways. Assuming that the observed associations are causal, this study supports that additional human cases are likely to occur associated with increased levels of rainfall. This provides the first evidence for including rainfall in a leptospirosis early warning system and to design targeted communication and prevention measures and provide resource allocation, particularly after heavy rainfall in New Zealand.