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

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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.

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          Author and article information

          Journal
          Epidemiol. Infect.
          Epidemiology and infection
          Cambridge University Press (CUP)
          1469-4409
          0950-2688
          Feb 2016
          : 144
          : 3
          Affiliations
          [1 ] Regional Office of the French Institute for Public Health Surveillance (Institut de Veille Sanitaire),Saint-Denis,Réunion,France.
          [2 ] Health Agency of the Indian Ocean,Saint-Denis,Réunion,France.
          [3 ] Hospital Gabriel Martin,St Paul,Ile de la Réunion,France.
          [4 ] Centre de Recherche et de Veille sur les Maladies Emergentes dans l'océan Indien,Plateforme de recherché CYROI,97490 Ste Clotilde,Réunion,France.
          [5 ] Laboratory of Biology,Centre Hospitalier Universitaire,Saint-Pierre,Réunion,France.
          [6 ] Laboratory of Virology,Centre Hospitalier Universitaire,Saint-Denis,Réunion,France.
          [7 ] National Reference Center and the WHO Collaborating Center for Leptospirosis,Institut Pasteur,Paris,France.
          Article
          S0950268815001740
          10.1017/S0950268815001740
          26211921

          Leptospirosis, outbreak, triathlon, Réunion Island

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