Investigation of a leptospirosis outbreak in triathlon participants, Réunion Island, 2013

Pagès, F., Larrieu, S., Simoes, J., Lenabat, P., Kurtkowiak, B., Guernier, V., Le Minter, G., Lagadec, E., Gomard, Y., Michault, A., Jaffar-Bandjee, M.C., Dellagi, K., Picardeau, M., Tortosa, P., and Filleul, L. (2016) Investigation of a leptospirosis outbreak in triathlon participants, Réunion Island, 2013. Epidemiology and Infection, 144 (3). pp. 661-669.

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Abstract

We report herein the investigation of a leptospirosis outbreak occurring in triathlon competitors on Réunion Island, Indian Ocean. All participants were contacted by phone or email and answered a questionnaire. Detection and molecular characterization of pathogenic Leptospira was conducted in inpatients and in rodents trapped at the vicinity of the event. Of the 160 athletes competing, 101 (63·1%) agreed to participate in the study. Leptospirosis was biologically confirmed for 9/10 suspected cases either by real-time PCR or serological tests (MAT or ELISA). The total attack rate, children's attack rate, swimmers' attack rate, and the attack rate in adult swimmers were respectively estimated at 8·1% [95% confidence interval (CI) 4·3–14·7], 0%, 12·7% (95% CI 6·8–22·4) and 23·1% (95% CI 12·6–33·8). Leptospirosis cases reported significantly more wounds [risk ratio (RR) 4·5, 95% CI 1·6–13], wore complete neoprene suits less often (RR 4·3, 95% CI 1·3–14·5) and were most frequently unlicensed (RR 6·6, 95% CI 2·9–14·8). The epidemiological investigation supported that some measures such as the use of neoprene suits proved efficient in protecting swimmers against infection. PCR detection in rats revealed high Leptospira infection rates. Partial sequencing of the 16S gene and serology on both human and animal samples strongly suggests that rats were the main contaminators and were likely at the origin of the infection in humans.

Item ID: 44758
Item Type: Article (Refereed Research - C1)
Keywords: Leptospirosis, outbreak, Réunion Island, triathlon
ISSN: 1469-4409
Funders: European Regional Development Funds (ERDF)
Projects and Grants: EDRF POCT Réunion, LeptOI project
Date Deposited: 26 Jul 2016 00:23
FoR Codes: 11 MEDICAL AND HEALTH SCIENCES > 1117 Public Health and Health Services > 111706 Epidemiology @ 100%
SEO Codes: 92 HEALTH > 9201 Clinical Health (Organs, Diseases and Abnormal Conditions) > 920120 Zoonoses @ 50%
92 HEALTH > 9201 Clinical Health (Organs, Diseases and Abnormal Conditions) > 920109 Infectious Diseases @ 50%
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