National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
Clin Infect Dis. 2010 Mar 15;50(6):843-9. doi: 10.1086/650578.
On 21 November 2005, a 32-year-old male resident of New York was hospitalized with suspected leptospirosis. He had participated in an endurance-length swamp race on 4-5 November 2005 outside of Tampa, Florida.
We interviewed racers to assess illness, medical care, and race activities. A suspected case was defined as fever plus > or = 2 signs or symptoms of leptospirosis occurring in a racer after 4 November 2005. Individuals with suspected cases were referred for treatment as needed and were asked to submit serum samples for microscopic agglutination testing (MAT) and for rapid testing by the dot enzyme-linked immunosorbent assay dipstick immunoglobulin M immunoassay.
The Centers for Disease Control and Prevention and participating state health departments interviewed 192 (96%) of 200 racers from 32 states and Canada. Forty-four (23%) of 192 racers met the definition for a suspected case. The median age of the patients was 37 years (range, 19-66 years), and 128 (66.7%) were male. Fourteen (45%) of the 31 patients with suspected cases who were tested had their cases confirmed by serological testing (a single sample with MAT titer > or = 400), including the index case patient. Organisms of a potential novel serovar (species Leptospira noguchii) were isolated in culture from 1 case patient. Factors associated with increased risk of leptospirosis included swallowing river water (odds ratio [OR], 3.4; 95% confidence interval [CI], 1.6-7.0), swallowing swamp water (OR, 2.4; 95% CI, 1.1-5.2), and being submerged in any water (OR, 2.3; 95% CI, 1.1-4.7).
This report describes a leptospirosis outbreak that resulted in a high rate of symptomatic infection among adventure racers in Florida. The growing popularity of adventure sports may put more people at risk for leptospirosis, even in areas that have not previously been considered areas of leptospirosis endemicity.
2005 年 11 月 21 日，一名纽约 32 岁男性居民因疑似钩端螺旋体病住院。他曾于 2005 年 11 月 4 日至 5 日在佛罗里达州坦帕市外参加了一场耐力赛。
我们采访了参赛者，以评估疾病、医疗和比赛活动。疑似病例的定义为 2005 年 11 月 4 日后，参赛者出现发热和/或钩端螺旋体病的>或=2 种症状或体征。有疑似病例的个人根据需要转诊治疗，并要求他们提交血清样本进行显微镜凝集试验（MAT）和斑点酶联免疫吸附试验（dot ELISA）快速检测。
疾病控制和预防中心及参与的州卫生部门对来自 32 个州和加拿大的 192 名（200 名参赛者的 96%）参赛者进行了采访。192 名参赛者中有 44 名（23%）符合疑似病例的定义。患者的中位年龄为 37 岁（范围，19-66 岁），128 名（66.7%）为男性。31 名疑似病例中有 14 名（45%）经血清学检测证实了病例（单个样本的 MAT 滴度>或=400），包括索引病例患者。从 1 例患者的培养物中分离出一种潜在新型血清型（种属钩端螺旋体属 noguchii）的生物体。钩端螺旋体病风险增加的相关因素包括吞咽河水（比值比[OR]，3.4；95%置信区间[CI]，1.6-7.0）、吞咽沼泽水（OR，2.4；95% CI，1.1-5.2）和浸入任何水（OR，2.3；95% CI，1.1-4.7）。
本报告描述了佛罗里达州一项冒险运动引起的钩端螺旋体病暴发，导致参赛运动员出现高比例的症状性感染。冒险运动的日益普及可能使更多人面临钩端螺旋体病的风险，即使在以前未被认为是钩端螺旋体病流行地区的地区也是如此。
