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Schreiber PW, Aceto L, Korach R, et al. Cluster of Leptospirosis Acquired Through River Surfing in Switzerland. Open Forum Infect Dis. 2015;2(3):ofv102doi: 10.1093/ofid/ofv102.
Schreiber, P. W., Aceto, L., Korach, R., Marreros, N., Ryser-Degiorgis, M. P., & Günthard, H. F. (2015). Cluster of Leptospirosis Acquired Through River Surfing in Switzerland. Open forum infectious diseases, 2(3), ofv102. https://doi.org/10.1093/ofid/ofv102
Schreiber, Peter W, et al. "Cluster of Leptospirosis Acquired Through River Surfing in Switzerland." Open forum infectious diseases vol. 2,3 (2015): ofv102. doi: https://doi.org/10.1093/ofid/ofv102
Schreiber PW, Aceto L, Korach R, Marreros N, Ryser-Degiorgis MP, Günthard HF. Cluster of Leptospirosis Acquired Through River Surfing in Switzerland. Open Forum Infect Dis. 2015 Jul 07;2(3):ofv102. doi: 10.1093/ofid/ofv102. eCollection 2015 Sep. PMID: 26269796; PMCID: PMC4531225.
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Open Forum Infect Dis. 2015 Jul 07;2(3):ofv102. doi: 10.1093/ofid/ofv102. eCollection 2015 Sep.

Cluster of Leptospirosis Acquired Through River Surfing in Switzerland.

Open forum infectious diseases

Peter W Schreiber, Leonardo Aceto, Raphael Korach, Nelson Marreros, Marie-Pierre Ryser-Degiorgis, Huldrych F Günthard

Affiliations

  1. Division of Infectious Diseases and Hospital Epidemiology , University Hospital Zurich ; University of Zurich, Institute of Medical Virology.
  2. Division of Infectious Diseases , Triemli Hospital Zurich.
  3. Internal Medicine , Waid City Hospital Zurich.
  4. University of Bern, Centre for Fish and Wildlife Health, Vetsuisse Faculty , Switzerland.

PMID: 26269796 PMCID: PMC4531225 DOI: 10.1093/ofid/ofv102

Abstract

Background.  In Switzerland, leptospirosis is still considered as a travel-associated disease. After the surprising diagnosis of leptospirosis in a patient who was initially suspected as having primary human immunodeficiency virus infection, we recognized that acquisition of leptospirosis occurred through recreational activities and we identified additional affected individuals. Methods.  Detailed anamnesis, excluding occupational exposure, acquisition abroad, and pet contacts, enabled us to detect the source of infection and identify a cluster of leptospirosis. Convalescent sera testing was performed to confirm Leptospira infection. Microscopic agglutination tests were used to determine the infecting serovar. Results.  We identified a cluster of leptospirosis in young, previously healthy persons. Acquisition of leptospirosis was traced back to a surfing spot on a river in Switzerland (Reuss, Aargau). Clinical presentation was indistinct. Two of the 3 reported cases required hospitalization, and 1 case even suffered from meningitis. Serologic tests indicated infection with the serovar Grippotyphosa in all cases. With the exception of the case with meningitis, no antibiotics were administered, because leptospirosis was diagnosed after spontaneous resolution of most symptoms. Despite a prolonged period of convalescence in 2 cases, full recovery was achieved. Recent reports on beavers suffering from leptospirosis in this region underline the possible water-borne infection of the 3 cases and raise the question of potential wildlife reservoirs. Conclusions.  Insufficient awareness of caregivers, which may be promoted by the missing obligation to report human leptospirosis, combined with the multifaceted presentation of the disease result in significant underdiagnosis. More frequent consideration of leptospirosis as differential diagnosis is inevitable, particularly as veterinary data suggest re-emergence of the disease.

Keywords: Leptospira; leptospirosis; recreational activities; water-borne; zoonosis

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