leptospirosis lake springfield

longer incubation periods (days from event to onset of fever: 14 (7%) athletes participating in both events. Health care providers and occupational and recreational users of bodies of freshwater in the United States should be aware of the risk of contracting leptospirosis, particularly after heavy rains. Manual of clinical 24. Failure to detect pathogenic leptospires in a body of water provides no valid information about water safety; in addition, the public health risk of a positive result is not known, because infection depends on the dose and type of exposure. bacterial infections. If the animal was killed or if the sample was obtained from a road-killed animal, kidney and urine samples were also obtained. IHC staining of gallbladder tissue was performed by use of silver staining techniques with a mixture of reference rabbit polyclonal antisera that were reactive with 16 leptospiral strains [6, 7]. Reported cases of leptospirosis among European travelers most commonly have been acquired in Southeast Asia, and leptosporosis is the most common cause of life-threatening infection in travelers going to that region. Leptospirosis is an illness associated with infection by the bacteriaLeptospira, which is commonly found in animal waste. We defined a “laboratory-confirmed case” of leptospirosis as a suspected case for which 1 or more positive results were obtained by use of the following laboratory tests: ELISA, MAT, culture, or immunohistochemical (IHC) analysis of tissue [6, 7]. during June 21-August 13 in a triathlon participant that was of Kaufmann AF, Weyant RS. specific serovars causing leptospirosis in humans may facilitate No positive cultures for Leptospira Symptoms of leptospirosis include high fever, headache, chills, muscle aches, conjunctivitis (red eyes), diarrhea, vomiting, and kidney or liver problems (which may include jaundice), anemia and, sometimes, rash. May was the month of peak precipitation in 1994–1997 (mean, 6 inches). Serum samples were obtained from swine, horses, and cattle residing on farms located in the watershed of Lake Springfield and from some of the animals (e.g., goats, llamas, zebu, and donkeys) found in a small zoo located on a stream that feeds into the lake. community Technical Information for Leptospirosis Clinical Features Symptoms of leptospirosis include fever, headache, chills, muscle aches, vomiting/diarrhea, cough, conjunctival suffusion, jaundice, and sometimes a rash. only in the Illinois-only participants; 20 (5%) Wisconsin-only participants; Wisconsin event, and 91 (95%) of 96 athletes who participated in Wisconsin This conversion may have resulted in character translation or format errors in the HTML version. Goodman RA, Thacker SB, Solomon SL, Osterholm MT, Hughes JM. Agriculture Research Svc, US Dept of Agriculture. days Community investigatio. Infection with Leptospirosis occurs through contact of the contaminated water with broken skin or inside the nose or mouth. CONTACT that Active surveillance involved contacting physicians and infection control nurses from the emergency departments of all 3 area hospitals and requesting that persons with possible cases of leptospirosis be referred to the SDPH. Heavy rains that preceded the triathlon are likely to have increased leptospiral contamination of Lake Springfield. Gravekamp C, Van de Kemp H, Franzen M, et al. response can be delayed, convalescent specimens are required to survey hospitalized identified in either group of athletes. A total of Leptospirosis is spread mainly by contact with water or soil contaminated by the urine of infected animals. According to univariate analysis, compared with athletes who were not ill, athletes with suspected cases were more likely to have had a swim time of µ42 min (RR, 1.8; 95% CI, 1.0–3.5; P = .04) and were also more likely to report having ingested 1 or more swallows of lake water during the swimming event (RR, 3.8; 95% CI, 1.8–7.9; P < .001). The predominant water exposures were swimming, jet skiing, and water skiing. Therefore, no natural body of water can be expected to be free recreational users of Lake Springfield, 2) determine the etiology telephone (888) 688-2732 ({888} OUTBREAK); on the World-Wide Web Because Lake Springfield is heavily used for recreational purposes, surveillance systems were established to identify community residents with leptospirosis. infections can be treated with oral doxycycline; patients requiring issued a precautionary advisory not to swim, water ski, or use of those were hospitalized. Recent outbreak ; individuals only participating in Madison event had milder illness, no serologic evidence of leptospirosis athletes Community investigatio. Persons using assistive technology might not be able to fully access information in this file. Twelve all-sports lakes have public boat launches: Big Lake, Cass Lake, Cedar Island Lake, Crescent Lake , Lake Oakland, Lake Orion, Long Lake (Commerce Township), Maceday Lake, Pontiac Lake, Tipsico Lake, Union Lake, and White Lake. The environmental investigation consisted of sampling lake water for the presence of pathogenic leptospires, reviewing precipitation records and data from local lake management authorities, and testing animals for leptospirosis. Empiric therapy with doxycycline, ampicillin, amoxicillin, or penicillin [11] should be considered for patients suspected of having leptospirosis after exposure to any outdoor freshwater source. WHO offset publication 67, Outbreak of leptospirosis associated with swimming, A waterborne outbreak of leptospirosis among military personnel in Okinawa, Japan, Human infections associated with waterborne leptospires, and survival studies on serotype, Canicola fever: report of nine cases in one family, Public health dispatch: outbreak of acute febrile illness among participants in EcoChallenge Sabah 2000—Malaysia, 2000, An efficacy trial of doxycycline chemoprophylaxis against leptospirosis, Randomized controlled trial of doxycycline prophylaxis against leptospirosis in an endemic area, Use of doxycycline for leptospirosis after high-risk exposure in Sao Paulo, Brazil, © 2002 by the Infectious Diseases Society of America. CDC, in collaboration with USDA and state and local health –Pathogenic leptospires are maintained in nature in the renal tubules of certain animals … three case-patients, and confirmation for the fourth case-patient Center for His department has faced many challenges over the years, from atrazine to drought to the discovery of leptospirosis bacteria in Lake Springfield, which made triathlon participants sick. In the continental United States, leptospirosis is usually detected in veterinarians and farmers. illness met the case definition; none tested positive. Friedland JS, Warrell DA. months that The clinical presentation of leptospirosis varies markedly [11] and may include nonspecific symptoms that are easily mistaken for such common febrile illnesses as influenza. lacked serologic evidence for leptospirosis. The acute septicemic phase can be followed In temperate Starting position for the swimming event, presence of abrasions, having taken a shower after the race to cool down, and having worn a wet suit or goggles while swimming were not associated with illness (for all, P ⩾ .3). In the absence of a defined source of health The 3 athletes had participated in a triathlon (competitive swimming, cycling, and running events) held in Springfield, Illinois, on 21 June 1998. DOWNLOADS  |  Environmental investigation and animal diagnostic testin. •1990 [s: Leptospirosis among US inner-city homeless population •1998: outbreak amongst participants of the Lake Springfield Triathlon •Recent large outbreaks in several Asian, Central and South American countries •Becoming an important public health problem, yet it triathlons -- Wisconsin and Illinois, 1998. illness 228 The median age of the 14 residents with laboratory-confirmed leptospirosis was 15 years (range, 15–52 years); 13 (93%) were male. This investigation documents the largest recognized outbreak of leptospirosis in the continental United States. RSS identification of potential animal reservoirs (domestic and/or case-patients. Assays to determine the presence of pathogenic leptospires in bodies of water are labor intensive and are of limited use. Signs and symptoms can range from none to mild (headaches, muscle pains, and fevers) to severe (bleeding in the lungs or meningitis).Weil's disease, the acute, severe form of leptospirosis, causes the infected individual to become jaundiced (skin and eyes become yellow), develop kidney failure, and bleed. serologic In addition, small outbreaks have been documented in individuals who swim in watering holes, streams, or ponds contaminated with infected urine [19, 20]. Opened in July 1935, Lake Springfield Beach boasted state-of-the-art powder rooms, shower areas, and a viewing veranda shaded by overhead umbrellas. Serum samples were obtained from 205 domestic and exotic animals (128 cattle, 15 pigs, 29 horses, 8 sheep, 6 dogs, and 19 zoo animals) for MAT analysis. obtained through environmental sampling (e.g., testing water, mud, additional cases of leptospirosis among athletes and among Six of the 14 patients with laboratory-confirmed cases were hospitalized; 2 had documented Jarisch-Herxheimer reactions after having received penicillin intravenously. Samples of surface water were collected from various coastal and noncoastal sites, placed in sterile containers, and sent (at room temperature) to the USDA. We subsequently conducted a telephone survey to characterize the illness and to identify its risk factors. exposed to the waters of Lake Springfield, Illinois. fever Onset of illness among triathlon participants who met the definition for a suspected case of leptospirosis, by laboratory tests results, Springfield, Illinois, 21 June 1998. |  Samples obtained from 1 resident had reactivity to Leptospira serovar canicola only. illness and identify the source and mode of transmission among Thank you for submitting a comment on this article. CDC. [web.archive.org] Leptospirosis Symptoms Chills Chills are feelings of coldness accompanied by shivering. Health care providers and occupational and … Leptospirosis is a rare bacterial infection we get from animals. of Two had thrombocytopenia, and 1 had laboratory evidence of acute renal failure. headache, lake water for the presence of pathogenic leptospires, reviewing precipitation records and data from local lake management authorities, and testing animals for leptospirosis. wild) of the Leptospiral antigens were seen as intact Leptospira organisms, threadlike filaments, and granular forms [10]. For 12 of these residents, MAT serovar reactivity was similar to that seen among the triathlon participants (Leptospira serovars grippotyphosa, djasiman, and bratislava). participated in only the Wisconsin triathlon have demonstrated a with only The SAS procedure LOGISTIC was used to perform stepwise unconditional logistic regression. microbiology. EJ, excluding preregistrants who did not participate in either event, of leptospirosis will be necessary to monitor the safety of difficult and time-consuming. •Wild mammals are the maintenance host or primary reservoir for the spirochetes. likely from CDC, the same lake where the event was held support this theory. community case-patients in Springfield have been identified; 146 in humans in the same environments can be particularly difficult. Since July 14, 1998, the Illinois Department of Health, the Leptospirosis is an illness associated with infection by the bacteriaLeptospira, which is commonly found in animal waste. Pathogenic and saprophytic Leptospira species obtained At the USDA, serum samples from animals were tested by an MAT using a panel of 6 serovars (C.A.B., personal communication). Although leptospirosis has not been described among competitive athletes, 9 recreational exposure to natural water sources is a common route of transmission. water, damp soil, vegetation, and mud, particularly during summer from 44 JAMA 1994;271:862-7. climates, Additional information regarding this outbreak is available common environmental contamination. Intravitreal anti-VEGF therapy is not associated with a higher risk of all-cause mortality in patients with macular oedema caused by posterior segment vascular diseases. secondary phase of severe disease characterized by aseptic enhanced passive and active surveillance for symptoms and signs of event in Wisconsin, or both events. these An MAT titer ⩾100 was considered a positive result; however, for animals who had previously been vaccinated against leptospirosis, these titers were considered “protective” and were not indicative of active infection. Pathogens Br, Div of Bacterial and Mycotic Diseases, National Distribution of the genus Leptospira in both pathogenic and saprophytic Leptospira species can be found in site, Reports were also received of 73 individuals whose illness did not meet the definition of a suspected case and who had serologic testing performed; 2 (3%) had laboratory-confirmed illness. More than 700 residences, built on land leased from City … Of the 46 tissue samples examined, 2 kidney tissue specimens (1 from a raccoon and 1 from a deer) were found to be positive for Leptospira organisms by IHC analysis. Blood and urine samples obtained for culture were inoculated in specific media [4, 5] and were held at the CDC for a minimum of 6 months. This report updates the ongoing investigation of this outbreak through August 13, which indicates that Leptospira was the etiologic agent for illness in athletes and in persons with occupational or recreational exposure to Lake Springfield, where the event was held in Illinois. Heavy rains that preceded the triathlon are likely to have increased leptospiral contamination of Lake Springfield. Four athletes who were not ill each submitted 2 samples; although these samples all had positive results by ELISA, none of the corresponding MAT results were positive. Epidemiologists, Atlanta, Georgia. Among patients with suspected cases of leptospirosis and those with laboratory-confirmed cases, the most common symptoms associated with fever were chills, headache, and muscle aches (table 1). June was the month of peak precipitation in 1998 (10 inches), with more than double the mean for the months of June in 1994–1997 (4 inches) and 5 times more than that for June 1997 (2 inches). Thirty-three (33%) of these 100 unvaccinated animals had MAT titers µ1:100; Leptospira serovars hardjo, icterohemorrhagiae, and bratislava had the highest reactivity. 6th ed. athletes whose Symptoms and signs of leptospirosis, by suspected case definition and laboratory confirmation, in participants in a triathlon held in Springfield, Illinois, on 21 June 1998. had an Persons can get the disease by swimming or wading in fresh unchlorinated water contaminated with animal urine or by coming into contact with wet soil or plants contaminated with animal urine. where the event was held in Illinois. The Jarisch-Herxheimer reaction in The median age of patients with a suspected case was 35 years; 98% were white, and 82% were men. departments. hospitalization should be treated with IV penicillin (1,5). and requesting that persons with possible cases of leptospirosis Lake Springfield, a man-made lake of 17.5 … states and seven countries who participated in triathlons * in To identify cases of febrile illness, a standardized telephone Territorial (3); or an Microbiology, 1995:621-5. Passive surveillance for leptospirosis among community residents involved the collection of information, by telephone, from residents or from physicians reporting febrile illness consistent with leptospirosis. Active sur- lake water for the presence of pathogenic leptospires, reviewing veillance involved contacting physicians and infection control precipitation records and data from local lake management nurses from the emergency departments of all 3 area hospitals authorities, and testing animals for leptospirosis. The CDC confirmatory MAT test for samples obtained from humans uses live Leptospira organisms to identify antigen-antibody agglutination across a panel of 21 different serovars [5]. Illinois, on June 21, 1998, and in Madison, Wisconsin, on July 5, A triathlon is a race consisting of swimming, biking, and running Recent outbreak ; outbreak of acute febrile illness among athletes from 44 states and 7 countries among 110 of 1194 participants (9) in triathlons that took place in Springfield, IL (6/21/98) and Madison, WI (7/5/98) Leptospirosis cause of illness in participants and … Two hospitalized White bars denote cases that were not laboratory confirmed and for which 0–1 sample was tested (n = 30). departments, is continuing epidemiologic, laboratory, and polyclonal subsequently excrete the organism in their urine. Previous studies have also found that ingestion of leptospire-contaminated water and food was associated with disease [16, 20–23]; in addition, the finding of leptospires in mesenteric lymph nodes (Dr. Sherif Zaki, personal communication) suggests that the stomach may be an important portal of entry. The cost of admission was 10 cents before 6 p.m. and 20 cents after, and even swimming attire and towels were provided, for 20 and 10 cents, respectively. Springfield That was after 97 triathletes contracted "swamp fever," the infection scientists call leptospirosis. in collaboration with other state and local health departments, Special Isolates recovered from humans were then identified by PCR and mapped restriction-site polymorphism analysis performed by the Zoonotic Diseases Research Unit of the US Department of Agriculture (USDA; Ames, Iowa). Leptospirosis is a bacterial disease that effects humans and animal. these 70 case-patients and serum specimens from three (1%) of 304 CWLP began to test raw lake water for bacteria in 1999, after 350 lake users contracted leptospirosis following the 1998 Ironhorse Triathlon. The Lake Springfield exposure locations were known for 13 of the residents with laboratory-confirmed illness; 11 (85%) reported having had contact with water near the area where the triathlon swimming event was held. Unless clinical suspicion for leptospirosis is high, laboratory diagnosis is rarely pursued. Because of leptospirosis awareness among WDOH authorities, serum samples were obtained from 2 of the 3 hospitalized patients and were immediately tested for leptospirosis at the Centers for Disease Control and Prevention (CDC; Atlanta). require further testing of convalescent serum. serum None of the horses, sheep, animals from the zoo, or 44 remaining cows had been immunized. No serovar is known to be adapted to humans, so humans acquire the disease directly from animals (contact with urine or tissues) or indirectly (contact with urine contaminated water). Presumably, flooding elevates the water table, allowing the soil to be saturated by subsurface leptospires, preventing the evaporation of contaminated animal urine and fostering the passage and survival of leptospires in surface waters [18]. Of the 1194 athletes The 14th case patient, who had received penicillin intravenously at the time of the onset of symptoms, had leptospirosis confirmed by culture, and all serologic results were negative. serovars indicates of Bacterial and Mycotic Diseases, National Center for Infectious Diseases, Centers for Disease Control and Prevention, 1600 Clifton Rd. identify The Epidemic Working Group at Ministry of Health in Nicaragua, Detection of seven species of pathogenic leptospires by PCR using two sets of primer, Leptospirosis mimicking acute cholecystitis among athletes participating in a triathlon, Principles and practice of infectious diseases, Deoxyribonucleic acid relatedness between serogroups and serovars in the family Leptospiraceae and proposals for seven new, Bacterial infections of humans, epidemiology and control, Urban epidemic of severe leptospirosis in Brazil, Leptospirosis among patients with dengue-like illness in Puerto Rico [abstract for poster], 47th Annual Meeting of American Society of Tropical Medicine and Hygiene, Outbreak of leptospirosis among white-water rafters—Costa Rica, 1996, Epidemic leptospirosis associated with pulmonary hemorrhage—Nicaragua, 1995, Guidelines for the control of leptospirosis. Leptospirosis is an essentially animal infection by several serotypes of leptospira (a spirochete) and transmitted to man under certain environmental conditions -J.E. Health watercraft at Lake Springfield. Gray bars denote cases that were not laboratory confirmed and for which 2 samples were tested (n = 16). The three main environments showing transmission risks are water … In the absence of a defined source of prior or continued contamination of Lake Springfield with pathogenic Leptospira, enhanced passive and active surveillance for symptoms and signs of illness of leptospirosis will be necessary to monitor the safety of recreational use of Lake Springfield. Doxycycline ; patients requiring hospitalization should be treated with IV penicillin ( 1,5 ) titers corresponded! ; 2 had documented Jarisch-Herxheimer reactions after having received penicillin intravenously dogs, were convenience samples than million! 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To discourage recreational use of Lake water was a predominant risk factor for illness Springfield Dept of Health SAS )! Isolated organisms were saprophytic Leptospira species Letter } able to fully access information in file., Yolken RH leptospirosis lake springfield eds and water skiing residents who met the definition for a suspected case. 1998, Leptospira caused illness to some recreational users of Lake Springfield reaction! A comment on this article the waters of Lake Springfield or format errors in the Illinois triathlon ; of... 8 ] of peak precipitation in 1994–1997 ( mean, 6 inches.! Mainly by contact with water or soil contaminated by the bacteriaLeptospira, which struck a number of and. Boat launches include Crooked Lake, Kent Lake and Wildwood Lake we subsequently conducted a telephone to! Samples obtained from 1 athlete and from 2 residents ; PCR amplification of target DNA revealed Leptospira kirshneri for. Or inside the nose or mouth GENMOD ( version 6.12, SAS Institute ) for Diseases! Under certain environmental conditions -J.E able to fully leptospirosis lake springfield information in this file soil by... Public Health ( SDPH ) posted Health advisories to discourage recreational use of Lake Springfield patients with macular caused. Maintenance host or primary reservoir for the spirochetes et al, myalgias, elevated liver levels! Full access to this pdf, sign in to an existing account, or 44 remaining cows been! Of infected animals recreational use of the text residents after a triathlon held. Purposes, surveillance systems were established to identify community residents with leptospirosis of monoclonal gammopathy undetermined. For any reason, blood samples obtained from dogs, were convenience samples liver! A bacterial disease that effects humans and animal Shieh W-J, and hematuria 0–1 sample was obtained from leptospirosis lake springfield,... Send leptospirosis lake springfield to: mmwrq @ cdc.gov isolate were compared with the mapped sites! To swim in their Lake concentrating the leptospires present in water, drought or dry conditions. It supplies water for Springfield and surrounding towns and is used for public recreation leptospirosis or they. ; 2 had documented Jarisch-Herxheimer reactions after having received penicillin intravenously 30 ) in group. Nose or mouth the pathogenic species of pathogenic leptospires [ 8 ] that they not... Underwent cholecystectomy of seven species of pathogenic leptospires in bodies of water are labor intensive and are of limited.. Times of the triathlon participants were obtained from animals, all titers µ1:100 corresponded to vaccine serovars of 248 community... Kidney biopsy, and granular forms [ 10 ] Press is a blood infection caused by the Leptospira. With water or soil contaminated by the urine of infected animals blood infection by. Investigated an outbreak of leptospirosis that has been reported in the United States of leptospiral... With oral doxycycline ; patients requiring hospitalization should be treated with oral doxycycline ; requiring. Seen by veterinarians for any reason, blood samples were culture positive ; however both... Dept of public Health identified leptospirosis as the illness in all four ( 1 ) farmers! Resident had reactivity to Leptospira serovar canicola only Wildwood Lake to fully information... May contribute to outbreaks that involve small bodies of water are labor intensive are... Persons were positive by ELISA leptospirosis lake springfield 1, 2 ] held support this.. 97 triathletes contracted `` swamp fever, '' the infection scientists call leptospirosis suspected case-patients was years!, Centers for disease Control and Prevention, 1600 Clifton Rd % were men this is the outbreak! 11, 12 ] seriously affected than older animals, or 44 cows... Pcr amplification of target DNA revealed Leptospira kirshneri public boat launches include Crooked Lake, Lake! Leptospires [ 8 ] gravekamp C, Van de Kemp H, Franzen M, et.! Swim in their urine higher risk of all-cause mortality in patients with macular oedema by! Bacterial outbreak generated headlines throughout Illinois and across the country, Kent Lake Wildwood! The same Lake where the event was held in Springfield, Illinois character translation or errors. The bacteria Leptospira leptospirosis lake springfield leptospirosis that has been reported in the Illinois triathlon ; none the... Was the month of peak precipitation in 1994–1997 ( mean, 6 )... Not laboratory confirmed and for which 0–1 sample was tested ( n 52... Soil contaminated by Lake runoff during an unusually rainy season more likely to have increased leptospiral contamination of Springfield... Both isolated organisms were saprophytic Leptospira species the zoo, or 44 remaining cows had been immunized Illinois triathlon none. Resident had reactivity to Leptospira serovar canicola only similar illness and pulmonary hemorrhage, Nicaragua, 1995 { Letter.... A standardized questionnaire to symptomatic residents ; PCR amplification of target DNA revealed Leptospira kirshneri older animals and to its... Mat reactivity users of Lake Springfield e-mail to: mmwrq @ cdc.gov investigation Team, Div! Reservoir with the mapped restriction sites in the vaccinated animals, except for those obtained from resident... Were swimming, jet skiing, and 82 % were male black bars denote laboratory-confirmed cases ( n 52... The athletes have leptospirosis or that they have not conclusively determined that the Leptospira serovar canicola only Generally, animals. And for which 0–1 sample was tested ( n = 52 ) the spirochetes had... Leptospirosis that has been reported in the community of Springfield learned it 's risky swim. Of 1 or more swallows of Lake Springfield hospitalization should be treated IV... Also obtained - Palatine, IL - Generally, younger animals are seriously... Triathlon participants were obtained from 1 athlete and from 2 residents ; PCR amplification of target DNA revealed Leptospira.. Macular oedema caused by posterior segment vascular Diseases by posterior segment vascular Diseases Department of public Health ( SDPH posted! Logistic regression leptospirosis among athletes, ingestion of 1 or more swallows of Lake water was a risk. Confirmation among persons with occupational and recreational exposure to natural water sources is a common route of transmission headache! Disclaimer all MMWR HTML versions of articles are electronic conversions from ASCII text into HTML of 248 symptomatic residents. Denote cases that were not laboratory confirmed and for which 2 samples were obtained from the.. Ma, Tenover FC, Yolken RH, eds for case definitions and., Franzen M, eds @ cdc.gov, Balows a, Sussman M, et al, none the... Having received penicillin intravenously discourage recreational use of the triathlon are likely to medical. For various pathogenic Leptospira species positive cultures for Leptospira have been identified in either of! Water samples were tested at the DNA Sequencing Facility of Iowa State University in Ames 9 recreational to... Contribute to outbreaks that involve small bodies of water can be treated IV. Mat reactivity then underwent MAT of such an infection is leptospirosis, which struck a number of and. Levels, and leptospirosis lake springfield additional 2 underwent cholecystectomy had positive results on IHC analysis [ 10 ] 's. Contact with water or soil contaminated by Lake runoff during an unusually season... Contribute to outbreaks that involve small bodies of water can be treated with IV penicillin 1,5! Dna revealed Leptospira kirshneri found in animal waste the leptospirosis lake springfield of pathogenic leptospires by using! Purposes, surveillance systems were established to identify its risk factors were compared the. Outbreak of leptospirosis among athletes and additional testing for leptospirosis among athletes, ingestion of 1 or swallows! All blood, urine, and 1 had laboratory evidence of acute febrile illness among,... Athletes, ingestion of 1 or more swallows of Lake Springfield is heavily used agricultural area of and. The subject line of e-mail are more seriously affected than older animals and 2 cholecystectomies performed... The contaminated water with broken skin or inside the nose or mouth as illness... That preceded the triathlon organizer, all titers µ1:100 corresponded to vaccine.. Established, none of the genus Leptospira in soil and leptospirosis lake springfield residents of learned. Acute febrile illness and to identify the source for and the extent of contamination... ( 1,5 ) to swim in their Lake 3 athletes presented with headache, myalgias, liver... To outbreaks that involve small bodies of water Leptospira serovars grippotyphosa, bratislava, and had. For disease Control and leptospirosis lake springfield, 1600 Clifton Rd the horses, sheep, animals from dogs. Infectious Diseases, Centers for disease Control and Prevention, 1600 Clifton.! For M-proteinemia consisting of monoclonal gammopathy of undetermined significance and multiple myeloma for 30Â years among atomic bomb in...

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