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Investigation of a leptospirosis outbreak in triathlon participants, Réunion Island, 2013.
Epidemiol Infect. 2016 Feb; 144(3):661-9.EI

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.

Authors+Show Affiliations

Regional Office of the French Institute for Public Health Surveillance (Institut de Veille Sanitaire),Saint-Denis,Réunion,France.Regional Office of the French Institute for Public Health Surveillance (Institut de Veille Sanitaire),Saint-Denis,Réunion,France.Health Agency of the Indian Ocean,Saint-Denis,Réunion,France.Hospital Gabriel Martin,St Paul,Ile de la Réunion,France.Health Agency of the Indian Ocean,Saint-Denis,Réunion,France.Centre de Recherche et de Veille sur les Maladies Emergentes dans l'océan Indien,Plateforme de recherché CYROI,97490 Ste Clotilde,Réunion,France.Centre de Recherche et de Veille sur les Maladies Emergentes dans l'océan Indien,Plateforme de recherché CYROI,97490 Ste Clotilde,Réunion,France.Centre de Recherche et de Veille sur les Maladies Emergentes dans l'océan Indien,Plateforme de recherché CYROI,97490 Ste Clotilde,Réunion,France.Centre de Recherche et de Veille sur les Maladies Emergentes dans l'océan Indien,Plateforme de recherché CYROI,97490 Ste Clotilde,Réunion,France.Laboratory of Biology,Centre Hospitalier Universitaire,Saint-Pierre,Réunion,France.Laboratory of Virology,Centre Hospitalier Universitaire,Saint-Denis,Réunion,France.Centre de Recherche et de Veille sur les Maladies Emergentes dans l'océan Indien,Plateforme de recherché CYROI,97490 Ste Clotilde,Réunion,France.National Reference Center and the WHO Collaborating Center for Leptospirosis,Institut Pasteur,Paris,France.Centre de Recherche et de Veille sur les Maladies Emergentes dans l'océan Indien,Plateforme de recherché CYROI,97490 Ste Clotilde,Réunion,France.Regional Office of the French Institute for Public Health Surveillance (Institut de Veille Sanitaire),Saint-Denis,Réunion,France.

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

26211921

Citation

Pagès, F, et al. "Investigation of a Leptospirosis Outbreak in Triathlon Participants, Réunion Island, 2013." Epidemiology and Infection, vol. 144, no. 3, 2016, pp. 661-9.
Pagès F, Larrieu S, Simoes J, et al. Investigation of a leptospirosis outbreak in triathlon participants, Réunion Island, 2013. Epidemiol Infect. 2016;144(3):661-9.
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., & Filleul, L. (2016). Investigation of a leptospirosis outbreak in triathlon participants, Réunion Island, 2013. Epidemiology and Infection, 144(3), 661-9. https://doi.org/10.1017/S0950268815001740
Pagès F, et al. Investigation of a Leptospirosis Outbreak in Triathlon Participants, Réunion Island, 2013. Epidemiol Infect. 2016;144(3):661-9. PubMed PMID: 26211921.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Investigation of a leptospirosis outbreak in triathlon participants, Réunion Island, 2013. AU - Pagès,F, AU - Larrieu,S, AU - Simoes,J, AU - Lenabat,P, AU - Kurtkowiak,B, AU - Guernier,V, AU - Le Minter,G, AU - Lagadec,E, AU - Gomard,Y, AU - Michault,A, AU - Jaffar-Bandjee,M C, AU - Dellagi,K, AU - Picardeau,M, AU - Tortosa,P, AU - Filleul,L, Y1 - 2015/07/27/ PY - 2015/7/28/entrez PY - 2015/7/28/pubmed PY - 2016/5/18/medline KW - Leptospirosis KW - Réunion Island KW - outbreak KW - triathlon SP - 661 EP - 9 JF - Epidemiology and infection JO - Epidemiol Infect VL - 144 IS - 3 N2 - 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. SN - 1469-4409 UR - https://www.unboundmedicine.com/medline/citation/26211921/Investigation_of_a_leptospirosis_outbreak_in_triathlon_participants_Réunion_Island_2013_ L2 - https://www.cambridge.org/core/product/identifier/S0950268815001740/type/journal_article DB - PRIME DP - Unbound Medicine ER -