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CASE STUDY IN ASSESSMENT POLICY DEVELOPMENT AND ASSURANCE OF LAKE BUENA VISTA LEPTOSPIROSIS OUTBREAK Andrea Danner Fellow Beverly Darsie Fellow Steven Mier Fellow Meg Rauschenberger Fellow George Rudis Fellow Marcia Franklin Mentor A Introduction Explanation In July of 1998 1100 athletes participated in triathlon events in two states Michigan and Indiana A triathlon is an athletic event in which the competitors swim bike and run and at the end of the event jump in the lake to cool off Four of the 1100 athletes were hospitalized with suspected leptospirosis The Michigan Department of Health notified the Indiana Department of Public Health of the possible outbreak It was concluded Lake Buena Vista Puerto Vallarta Indiana was the site of infection Local state and federal agencies convened to discuss issues surrounding the case and coordination among all involved All athletes were contacted via telephone survey to assess possible signs and symptoms of illness An environmental investigation was performed to identify the origin and degree of bacterial contamination of Lake Buena Vista Leptospirosis is a bacterial disease that affects humans and animals In humans it causes wide range of symptoms and some infected persons may have no symptoms at all Symptoms of leptospirosis include high fever severe headache chills muscle aches and vomiting and may include jaundice yellow skin and eyes red eyes abdominal pain diarrhea or a rash If the disease is not treated the patient could develop kidney damage meningitis inflammation of the membrane around the brain and spinal cord liver failure and respiratory distress In rare cases death occurs Many of these symptoms can be mistaken for other diseases Leptospirosis is confirmed by laboratory test of the blood or urine B Case Chronology There were 1 100 athletes from 44 states and seven countries participated in the event On June 21 another triathlon had been held in St Charles Michigan On Monday August 1 hospital laboratories as



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