{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,31]],"date-time":"2026-10-31T09:29:02Z","timestamp":1793438942253,"version":"4.5.0"},"reference-count":40,"publisher":"Oxford University Press (OUP)","issue":"3","license":[{"start":{"date-parts":[[2016,11,11]],"date-time":"2016-11-11T00:00:00Z","timestamp":1478822400000},"content-version":"vor","delay-in-days":680,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"name":"Clinical Research Priority Program: Viral Infectious Diseases"},{"DOI":"10.13039\/501100006447","name":"University of Zurich","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100006447","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2015,9,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p>Background. \u2003In 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.<\/jats:p>\n               <jats:p>Methods. \u2003Detailed 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.<\/jats:p>\n               <jats:p>Results. \u2003We 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.<\/jats:p>\n               <jats:p>Conclusions. \u2003Insufficient 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.<\/jats:p>","DOI":"10.1093\/ofid\/ofv102","type":"journal-article","created":{"date-parts":[[2015,7,8]],"date-time":"2015-07-08T01:10:39Z","timestamp":1436317839000},"source":"Crossref","is-referenced-by-count":21,"title":["Cluster of Leptospirosis Acquired Through River Surfing in Switzerland"],"prefix":"10.1093","volume":"2","author":[{"given":"Peter W.","family":"Schreiber","sequence":"first","affiliation":[{"name":"Division of Infectious Diseases and Hospital Epidemiology, University Hospital Zurich"},{"name":"University of Zurich, Institute of Medical Virology"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leonardo","family":"Aceto","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, Triemli Hospital Zurich"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raphael","family":"Korach","sequence":"additional","affiliation":[{"name":"Internal Medicine, Waid City Hospital Zurich"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nelson","family":"Marreros","sequence":"additional","affiliation":[{"name":"University of Bern, Centre for Fish and Wildlife Health, Vetsuisse Faculty, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marie-Pierre","family":"Ryser-Degiorgis","sequence":"additional","affiliation":[{"name":"University of Bern, Centre for Fish and Wildlife Health, Vetsuisse Faculty, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Huldrych F.","family":"G\u00fcnthard","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases and Hospital Epidemiology, University Hospital Zurich"},{"name":"University of Zurich, Institute of Medical Virology"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2015,7,7]]},"reference":[{"key":"2020081009164794700_OFV102C1","doi-asserted-by":"crossref","first-page":"376","DOI":"10.1097\/01.qco.0000178824.05715.2c","article-title":"Leptospirosis","volume":"18","author":"McBride","year":"2005","journal-title":"Curr Opin Infect Dis"},{"key":"2020081009164794700_OFV102C2","doi-asserted-by":"crossref","first-page":"351","DOI":"10.1016\/j.ijid.2007.09.011","article-title":"The globalization of leptospirosis: worldwide incidence trends","volume":"12","author":"Pappas","year":"2008","journal-title":"Int J Infect Dis"},{"key":"2020081009164794700_OFV102C3","article-title":"Human leptospirosis: guidance for diagnosis, surveillance and control","author":"World Health Organization","year":"2003"},{"key":"2020081009164794700_OFV102C4","doi-asserted-by":"crossref","first-page":"843","DOI":"10.1086\/650578","article-title":"Outbreak of leptospirosis among Adventure Race participants in Florida, 2005","volume":"50","author":"Stern","year":"2010","journal-title":"Clin Infect Dis"},{"key":"2020081009164794700_OFV102C5","doi-asserted-by":"crossref","first-page":"1593","DOI":"10.1086\/340615","article-title":"Outbreak of leptospirosis among triathlon participants and community residents in Springfield, Illinois, 1998","volume":"34","author":"Morgan","year":"2002","journal-title":"Clin Infect Dis"},{"key":"2020081009164794700_OFV102C6","doi-asserted-by":"crossref","first-page":"e40","DOI":"10.1086\/339942","article-title":"Leptospirosis, water sports, and chemoprophylaxis","volume":"34","author":"Haake","year":"2002","journal-title":"Clin Infect Dis"},{"key":"2020081009164794700_OFV102C7","doi-asserted-by":"crossref","first-page":"702","DOI":"10.3201\/eid0906.020751","article-title":"Leptospirosis in \u201cEco-Challenge\u201d athletes, Malaysian Borneo, 2000","volume":"9","author":"Sejvar","year":"2003","journal-title":"Emerg Infect Dis"},{"key":"2020081009164794700_OFV102C8","doi-asserted-by":"crossref","first-page":"399","DOI":"10.4269\/ajtmh.1999.61.399","article-title":"Increase of leptospirosis in dengue-negative patients after a hurricane in Puerto Rico in 1996 [correction of 1966]","volume":"61","author":"Sanders","year":"1999","journal-title":"Am J Trop Med Hyg"},{"key":"2020081009164794700_OFV102C9","doi-asserted-by":"crossref","first-page":"1457","DOI":"10.1086\/314424","article-title":"Epidemic leptospirosis associated with pulmonary hemorrhage-Nicaragua, 1995","volume":"178","author":"Trevejo","year":"1998","journal-title":"J Infect Dis"},{"key":"2020081009164794700_OFV102C10","doi-asserted-by":"crossref","first-page":"121","DOI":"10.1080\/00325481.1986.11699636","article-title":"A point-source epidemic of leptospirosis. 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