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Abstract

In September 2016, a cluster of seven kayakers with clinical symptoms of leptospirosis with onset since July 2016 was reported to French health authorities. Human and animal investigations were undertaken to describe the outbreak, identify the likely place and source of infection and implement necessary control measures. We identified 103 patients with clinical symptoms of leptospirosis between 1 June and 31 October 2016 who lived in the Ille-et-Vilaine district in Brittany. Of these, 14 (including the original seven) reported contacts with the river Vilaine during the incubation period and were defined as outbreak cases: eight were confirmed by serology tests or PCR and six were probable without a laboratory confirmation for leptospirosis. All 14 cases were kayakers. Three distinct contamination sites were identified on a 30 km stretch of the river Vilaine. Nine cases reported having skin wounds while kayaking. None were vaccinated against leptospirosis. The outbreak was attributed to serogroup Grippotyphosa. Animal investigations did not allow identifying the possible reservoir. Leptospirosis outbreaks associated with freshwater sports are rare in temperate climates. The prevention of such outbreaks requires control of potential animal reservoirs in zones such as the Vilaine valley and that kayakers adopt the recommended individual prevention measures.

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/content/10.2807/1560-7917.ES.2018.23.48.1700848
2018-11-29
2018-12-16
http://instance.metastore.ingenta.com/content/10.2807/1560-7917.ES.2018.23.48.1700848
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References

  1. Levett PN. Leptospirosis. Clin Microbiol Rev. 2001;14(2):296-326.  https://doi.org/10.1128/CMR.14.2.296-326.2001  PMID: 11292640 
  2. Thibeaux R, Iraola G, Ferrés I, Bierque E, Girault D, Soupé-Gilbert ME, et al. Deciphering the unexplored Leptospira diversity from soils uncovers genomic evolution to virulence. Microb Genom. 2018;4(1):4.  https://doi.org/10.1099/mgen.0.000144  PMID: 29310748 
  3. Ashford DA, Kaiser RM, Spiegel RA, Perkins BA, Weyant RS, Bragg SL, et al. Asymptomatic infection and risk factors for leptospirosis in Nicaragua. Am J Trop Med Hyg. 2000;63(5-6):249-54.  https://doi.org/10.4269/ajtmh.2000.63.249  PMID: 11421372 
  4. Phraisuwan P, Whitney EA, Tharmaphornpilas P, Guharat S, Thongkamsamut S, Aresagig S, et al. Leptospirosis: skin wounds and control strategies, Thailand, 1999. Emerg Infect Dis. 2002;8(12):1455-9.  https://doi.org/10.3201/eid0812.020180  PMID: 12498663 
  5. Heymann DL. Control of communicable diseases manual. 20th ed. Washington DC: American Public Health Association; 2015.
  6. Adler B. History of leptospirosis and leptospira. Curr Top Microbiol Immunol. 2015;387:1-9.  https://doi.org/10.1007/978-3-662-45059-8_1  PMID: 25388129 
  7. Bharti AR, Nally JE, Ricaldi JN, Matthias MA, Diaz MM, Lovett MA, et al. Leptospirosis: a zoonotic disease of global importance. Lancet Infect Dis. 2003;3(12):757-71.  https://doi.org/10.1016/S1473-3099(03)00830-2  PMID: 14652202 
  8. Ayral F, Zilber AL, Bicout DJ, Kodjo A, Artois M, Djelouadji Z. Distribution of Leptospira interrogans by multispacer sequence typing in urban Norway rats (Rattus norvegicus): a survey in France in 2011-2013. PLoS One. 2015;10(10):e0139604.  https://doi.org/10.1371/journal.pone.0139604  PMID: 26447693 
  9. Ayral F, Djelouadji Z, Raton V, Zilber AL, Gasqui P, Faure E, et al. Hedgehogs and mustelid species: major carriers of pathogenic Leptospira, a survey in 28 animal species in France (20122015). PLoS One. 2016;11(9):e0162549.  https://doi.org/10.1371/journal.pone.0162549  PMID: 27680672 
  10. Hurd J, Berke O, Poljak Z, Runge M. Spatial analysis of Leptospira infection in muskrats in Lower Saxony, Germany, and the association with human leptospirosis. Res Vet Sci. 2017;114:351-4.  https://doi.org/10.1016/j.rvsc.2017.06.015  PMID: 28668503 
  11. Vein J, Leblond A, Belli P, Kodjo A, Berny JP. The role of the coypu (Myocastor coypus), an invasive aquatic rodent species, in the epidemiological cycle of leptospirosis: a study in two wetlands in the east of France. Eur J Wild Res. 2014;(60):125-33.
  12. Bourhy P, Septfons A, Picardeau M. Diagnostic, surveillance et épidémiologie de la leptospirose en France. [Diagnosis, surveillance and epidemiology of leptospirosis in France]. Bull Epidemiol Hebd. 2017;(8-9):131-7. French. Available from: http://invs.santepubliquefrance.fr/beh/2017/8-9/2017_8-9_1.html
  13. Baranton G, Postic D. Trends in leptospirosis epidemiology in France. Sixty-six years of passive serological surveillance from 1920 to 2003. Int J Infect Dis. 2006;10(2):162-70.  https://doi.org/10.1016/j.ijid.2005.02.010  PMID: 16298537 
  14. European Centre for Disease Prevention and Control (ECDC). Leptospirosis - Annual epidemiological report. Stockholm: ECDC; 2017. Available from: https://ecdc.europa.eu/en/publications-data/leptospirosis-annual-epidemiological-report-2016-2014-data
  15. Nardone A, Capek I, Baranton G, Campèse C, Postic D, Vaillant V, et al. Risk factors for leptospirosis in metropolitan France: results of a national case-control study, 1999-2000. Clin Infect Dis. 2004;39(5):751-3.  https://doi.org/10.1086/423272  PMID: 15356794 
  16. Hochedez P, Escher M, Decoussy H, Pasgrimaud L, Martinez R, Rosine J, et al. Outbreak of leptospirosis among canyoning participants, Martinique, 2011. Euro Surveill. 2013;18(18):20472. PMID: 23725775 
  17. Pagès F, Larrieu S, Simoes J, Lenabat P, Kurtkowiak B, Guernier V, et al. Investigation of a leptospirosis outbreak in triathlon participants, Réunion Island, 2013. Epidemiol Infect. 2016;144(3):661-9.  https://doi.org/10.1017/S0950268815001740  PMID: 26211921 
  18. Perra A, Servas V, Terrier G, Postic D, Baranton G, André-Fontaine G, et al. Clustered cases of leptospirosis in Rochefort, France, June 2001. Euro Surveill. 2002;7(10):131-6.  https://doi.org/10.2807/esm.07.10.00361-en  PMID: 12631991 
  19. Mérien F, Amouriaux P, Perolat P, Baranton G, Saint Girons I. Polymerase chain reaction for detection of Leptospira spp. in clinical samples. J Clin Microbiol. 1992;30(9):2219-24. PMID: 1400983 
  20. Postic D, Riquelme-Sertour N, Merien F, Perolat P, Baranton G. Interest of partial 16S rDNA gene sequences to resolve heterogeneities between Leptospira collections: application to L. meyeri. Res Microbiol. 2000;151(5):333-41.  https://doi.org/10.1016/S0923-2508(00)00156-X  PMID: 10919513 
  21. Chappel RJ, Goris M, Palmer MF, Hartskeerl RA. Impact of proficiency testing on results of the microscopic agglutination test for diagnosis of leptospirosis. J Clin Microbiol. 2004;42(12):5484-8.  https://doi.org/10.1128/JCM.42.12.5484-5488.2004  PMID: 15583270 
  22. Salaün L, Mérien F, Gurianova S, Baranton G, Picardeau M. Application of multilocus variable-number tandem-repeat analysis for molecular typing of the agent of leptospirosis. J Clin Microbiol. 2006;44(11):3954-62.  https://doi.org/10.1128/JCM.00336-06  PMID: 17088367 
  23. Picardeau M. Diagnosis and epidemiology of leptospirosis. Med Mal Infect. 2013;43(1):1-9.  https://doi.org/10.1016/j.medmal.2012.11.005  PMID: 23337900 
  24. Jackson LA, Kaufmann AF, Adams WG, Phelps MB, Andreasen C, Langkop CW, et al. Outbreak of leptospirosis associated with swimming. Pediatr Infect Dis J. 1993;12(1):48-54.  https://doi.org/10.1097/00006454-199301000-00012  PMID: 8417426 
  25. Morgan J, Bornstein SL, Karpati AM, Bruce M, Bolin CA, Austin CC, et al. Outbreak of leptospirosis among triathlon participants and community residents in Springfield, Illinois, 1998. Clin Infect Dis. 2002;34(12):1593-9.  https://doi.org/10.1086/340615  PMID: 12032894 
  26. Rock C, Horgan M. Leptospirosis--on the increase due to global warming. Ir Med J. 2010;103(10):317. PMID: 21563357 
  27. Conseil supérieur d’hygiène publique de France. Nouvelles recommandations relatives à la prévention du risque chez les personnes exposées à la leptospirose. [New recommandations concerning the risk prevention for people exposed to leptospira]. Paris; 2005. 1-42 p. French.
  28. Levett PN. Usefulness of serologic analysis as a predictor of the infecting serovar in patients with severe leptospirosis. Clin Infect Dis. 2003;36(4):447-52.  https://doi.org/10.1086/346208  PMID: 12567302 
  29. Desai S, van Treeck U, Lierz M, Espelage W, Zota L, Sarbu A, et al. Resurgence of field fever in a temperate country: an epidemic of leptospirosis among seasonal strawberry harvesters in Germany in 2007. Clin Infect Dis. 2009;48(6):691-7.  https://doi.org/10.1086/597036  PMID: 19193108 
  30. Mori M, VAN Esbroeck M, Depoorter S, Decaluwe W, Vandecasteele SJ, Fretin D, et al. Outbreak of leptospirosis during a scout camp in the Luxembourg Belgian province, Belgium, summer 2012. Epidemiol Infect. 2015;143(8):1761-6.  https://doi.org/10.1017/S0950268814002763  PMID: 25311398 
  31. Picardeau M. Virulence of the zoonotic agent of leptospirosis: still terra incognita? Nat Rev Microbiol. 2017;15(5):297-307.  https://doi.org/10.1038/nrmicro.2017.5  PMID: 28260786 
  32. Andre-Fontaine G, Aviat F, Thorin C. Waterborne leptospirosis: survival and preservation of the virulence of pathogenic Leptospira spp. in fresh water. Curr Microbiol. 2015;71(1):136-42.  https://doi.org/10.1007/s00284-015-0836-4  PMID: 26003629 
  33. Ayral FC, Bicout DJ, Pereira H, Artois M, Kodjo A. Distribution of Leptospira serogroups in cattle herds and dogs in France. Am J Trop Med Hyg. 2014;91(4):756-9.  https://doi.org/10.4269/ajtmh.13-0416  PMID: 25092816 
  34. Aviat F, Blanchard B, Michel V, Blanchet B, Branger C, Hars J, et al. Leptospira exposure in the human environment in France: A survey in feral rodents and in fresh water. Comp Immunol Microbiol Infect Dis. 2009;32(6):463-76.  https://doi.org/10.1016/j.cimid.2008.05.004  PMID: 18639932 
  35. Michel V, Ruvoen-Clouet N, Menard A, Sonrier C, Fillonneau C, Rakotovao F, et al. Role of the coypu (Myocastor coypus) in the epidemiology of leptospirosis in domestic animals and humans in France. Eur J Epidemiol. 2001;17(2):111-21.  https://doi.org/10.1023/A:1017931607318  PMID: 11599683 
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