Outbreak of leptospirosis among triathlon participants in Langau, Austria, 2010

Abstract

We report on the first documented outbreak of leptospirosis in Austria. In July 2010, four cases of serologically confirmed leptospirosis occurred in athletes after a triathlon held in Langau. Heavy rains preceded the triathlon (rainfall: 22 mm). The index case (Patient A) was a 41-year-old previously healthy male, who was admitted to hospital A on July 8 with a four-day history of fever up to 40°C that began 14 days after attending the triathlon event. On July 7, patient B, a 42-year-old male, was admitted to the same hospital, with signs and symptoms of kidney failure. Hemodialysis was performed every other day for 3 weeks. While the serum drawn on the day of admission was negative for antibodies against Leptospira, a specimen from July 28 tested positive with Leptospira interrogans. On July 11, patient C, a 40-year-old male, was admitted to hospital B for nephritis. On July 14, patient D, a 44-year-old male, was admitted to hospital C with a ten days history of intermittent fever, mild dry cough and headache. Our report underlines that in Austria recreational users of bodies of freshwater must be aware of an existing risk of contracting leptospirosis, particularly after heavy rains. The suppressive influence of a triathlon on the immune system is well documented and therefore an outbreak in this population group can be seen as a sensitive indicator concerning possible risk for the general population.

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

“…Studies on other European rivers show comparable results [6][7][8]. Outbreak sof zoonosis among sporting events in rivers and the evidence of multiresistant bacteria underline the improper quality of river water for recreational purposes [9][10][11]. This discrepancy between the good status of the Mur River according to the saprobic system and the high values of FIB provided the impulse for the present study.…”

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

High prevalence of antibodies against Leptospira spp. in male Austrian adults: a cross-sectional survey, April to June 2009

“…The predominance of men among clinical cases is well recognised [12,13] and has been explained by their greater tendency to participate in outdoor activities at high risk for exposure [5,13]. Similarly, case rates among adults between 20 and 50 years of age are also consistently the highest reported [12,13].…”

“…Sera were stored at -20°C until testing at the National Reference Laboratory for Leptospirosis at the Austrian Agency for Health and Food Safety (AGES) [5,[8][9][10]]. In the MAT, two doubling dilutions of each serum, 1:25 and 1:50, were used in an initial screening test.…”

“…Similarly, large outbreaks have occurred worldwide after heavy rainfalls or floods, particularly in south-east Asian countries and Central and South America [2]. Furthermore, leptospirosis has been recognised as a potential hazard of recreational exposure to contaminated water, including swimming, canoeing, rafting, fishing, and similar sports [1,4,5].…”