@article{fdi:010066153,
  title = {{I}nvestigation of a leptospirosis outbreak in triathlon participants, {R}eunion {I}sland, 2013},
  author = {{P}ages, {F}. and {L}arrieu, {S}. and {S}imoes, {J}. and {L}enabat, {P}. and {K}urtkowiak, {B}. and {G}uernier, {V}anina and {L}e {M}inter, {G}. and {L}agadec, {E}. and {G}omard, {Y}. and {M}ichault, {A}. and {J}affar-{B}andjee, {M}. {C}. and {D}ellagi, {K}oussay and {P}icardeau, {M}. and {T}ortosa, {P}. and {F}illeul, {L}.},
  editor = {},
  language = {{ENG}},
  abstract = {{W}e report herein the investigation of a leptospirosis outbreak occurring in triathlon competitors on {R}eunion {I}sland, {I}ndian {O}cean. {A}ll participants were contacted by phone or email and answered a questionnaire. {D}etection and molecular characterization of pathogenic {L}eptospira was conducted in inpatients and in rodents trapped at the vicinity of the event. {O}f the 160 athletes competing, 101 (63.1%) agreed to participate in the study. {L}eptospirosis was biologically confirmed for 9/10 suspected cases either by real-time {PCR} or serological tests ({MAT} or {ELISA}). {T}he total attack rate, children's attack rate, swimmers' attack rate, and the attack rate in adult swimmers were respectively estimated at 8.1% [95% confidence interval ({CI}) 4.3-14.7], 0%, 12.7% (95% {CI} 6.8-22.4) and 23.1% (95% {CI} 12.6-33.8). {L}eptospirosis cases reported significantly more wounds [risk ratio ({RR}) 4.5, 95% {CI} 1.6-13], wore complete neoprene suits less often ({RR} 4.3, 95% {CI} 1.3-14.5) and were most frequently unlicensed ({RR} 6.6, 95% {CI} 2.9-14.8). {T}he epidemiological investigation supported that some measures such as the use of neoprene suits proved efficient in protecting swimmers against infection. {PCR} detection in rats revealed high {L}eptospira infection rates. {P}artial sequencing of the 16{S} gene and serology on both human and animal samples strongly suggests that rats were the main contaminators and were likely at the origin of the infection in humans.},
  keywords = {{L}eptospirosis ; outbreak ; {R}eunion {I}sland ; triathlon ; {REUNION}},
  booktitle = {},
  journal = {{E}pidemiology and {I}nfection},
  volume = {144},
  numero = {3},
  pages = {661--669},
  ISSN = {0950-2688},
  year = {2016},
  DOI = {10.1017/s0950268815001740},
  URL = {https://www.documentation.ird.fr/hor/fdi:010066153},
}