Outbreak of leptospirosis among triathlon participants in Germany, 2006

Abstract

BackgroundIn August 2006, a case of leptospirosis occurred in an athlete after a triathlon held around Heidelberg and in the Neckar river. In order to study a possible outbreak and to determine risk factors for infection an epidemiological investigation was performed.MethodsParticipants of the triathlon were contacted by e-mail and were asked to fill out a standardized questionnaire. In addition, they were asked to supply a serum sample for laboratory diagnosis of leptospirosis. A confirmed case patient was defined as a clinical case (i.e. fever and at least one additional symptom suggestive for leptospirosis) with at least two of the following tests positive: ELISA IgM, latex agglutination testing, or microscopic agglutination testing. Rainfall and temperature records were obtained.ResultsA total of 142 of 507 triathletes were contacted; among these, five confirmed leptospirosis cases were found. Open wounds were identified as the only significant risk factor for illness (p = 0.02). Heavy rains that preceded the swimming event likely increased leptospiral contamination of the Neckar River.DiscussionThis is the first outbreak of leptospirosis related to a competitive sports event in Germany. Among people with contact to freshwater, the risk of contracting leptospirosis should be considered by health care providers also in temperate countries, particularly in the summer after heavy rains.

Interactions between environment, wild animals and human leptospirosis

“…Several leptospirosis outbreaks worldwide were related to recreational activities (63)(64)(65). In 1987, in São José dos Campos, São Paulo state, Brazil, an outbreak of human leptospirosis was associated with water activities.…”

“…This was the first leptospirosis outbreak in sportive competitions in Germany. Although sporadic cases of leptospirosis occur in European countries, they are more frequent in tropical climate countries (64).…”

Impact of Combined Sewer Overflow on Wastewater Treatment and Microbiological Quality of Rivers for Recreation

“…Also, the repeated outbreaks of leptospirosis among sporting events underline the improper microbiological quality of river water for recreational purposes [10,31].…”

Testing wild small mammals and water samples for pathogen leptosires using real-time PCR

“…Die Leptospirose ist eine Zoonose, die in früheren Zeiten (Gochenour et al 1958, Gsell 1968, Hupka und Behrens 1951, Kathe 1959, Krampitz 1967, Mino 1941, Schüffner u. Bohlander 1943, Wolter 1939, Zwierzchowski 1967a, aber auch heute noch, bei Mensch und Tier, mit inapparentem bis perakutem Verlauf vorkommt (Brockmann et. al.…”