Abstract
In September 2016, a cluster of seven kayakers with clinical symptoms of leptospirosis with onset since July 2016 was reported to French health authorities. Human and animal investigations were undertaken to describe the outbreak, identify the likely place and source of infection and implement necessary control measures. We identified 103 patients with clinical symptoms of leptospirosis between 1 June and 31 October 2016 who lived in the Ille-et-Vilaine district in Brittany. Of these, 14 (including the original seven) reported contacts with the river Vilaine during the incubation period and were defined as outbreak cases: eight were confirmed by serology tests or PCR and six were probable without a laboratory confirmation for leptospirosis. All 14 cases were kayakers. Three distinct contamination sites were identified on a 30 km stretch of the river Vilaine. Nine cases reported having skin wounds while kayaking. None were vaccinated against leptospirosis. The outbreak was attributed to Leptospira kirschneri serogroup Grippotyphosa. Animal investigations did not allow identifying the possible reservoir. Leptospirosis outbreaks associated with freshwater sports are rare in temperate climates. The prevention of such outbreaks requires control of potential animal reservoirs in zones such as the Vilaine valley and that kayakers adopt the recommended individual prevention measures.
Highlights
Leptospirosis is an important zoonotic disease caused by bacteria of the Leptospira genus after an incubation period of 4 to 21 days
Case description In total, we identified 103 patients residing in the Ille-et-Vilaine administrative district, with symptoms compatible with leptospirosis between 1 June and 31 October 2016
This investigation identified in mainland France an outbreak of 14 leptospirosis cases among kayakers on the river Vilaine (Brittany)
Summary
Leptospirosis is an important zoonotic disease caused by bacteria of the Leptospira genus after an incubation period of 4 to 21 days. The Leptospira genus contains 35 species, including 13 which are pathogenic and more than 300 serovars grouped into at least 24 serogroups [1,2]. Leptospirosis typically presents as a nonspecific acute febrile disease. 60–70% of human infections have been reported as asymptomatic or pauci-symptomatic [3,4]. Symptomatic infections are generally non-severe (shivers, fever, headaches, muscular and joint pain). Severe clinical forms represent 5–10% of clinical forms and include kidney or liver failure, neurological complications and pulmonary and digestive bleeding. Death is reported for 5–15% of severe infections [5]
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