Abstract
We report preliminary findings of a large outbreak of human leptospirosis with 36 confirmed/probable and 583 suspected cases from June–August 2018, linked to contaminated water bodies in Northern Israel. There was a travel-associated case in Germany; additional cases are being investigated in other countries. The presumed chain of transmission, implicating wild boar and cattle, raises multiple challenges for risk assessment, risk management and risk communication currently being addressed by a public health response team.
Highlights
We report preliminary findings of a large outbreak of human leptospirosis with 36 confirmed/probable and 583 suspected cases from June–August 2018, linked to contaminated water bodies in Northern Israel
We describe an ongoing outbreak investigation and the public health response to human leptospirosis cases linked to exposure to contaminated recreational water bodies in Northern Israel
The National Reference Laboratory for Leptospirosis (Israel Institute for Biological Research (IIBR), Ness Ziona), mounted a surge response in order to process a large number of clinical samples by means of a duplex real-time polymerase chain reaction (PCR) for pathogenic leptospires and microagglutination test (MAT)
Summary
The epidemic curve depicts clinically suspected cases as well as laboratory-confirmed cases. Table b Characteristics of laboratory-confirmed and probable cases of leptospirosis, Israel, June–August 2018 (n = 36). The seven water bodies linked to suspected leptospirosis cases were closed to the public until further notice and the closure was publicised through a variety of media channels. The National Reference Laboratory for Leptospirosis (Israel Institute for Biological Research (IIBR), Ness Ziona), mounted a surge response in order to process a large number of clinical samples by means of a duplex real-time polymerase chain reaction (PCR) for pathogenic leptospires (targeting the 16S rRNA and the LipL32 genes) and microagglutination test (MAT). As of 31 August 2018, 619 suspected cases of leptospirosis had been notified to the MOH, of which 33 were laboratory-confirmed and three were probable.
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