AN OUTBREAK OF LEPTOSPIROSIS AMONG ISRAELI TROOPS NEAR THE JORDAN RIVER

E. HADAD Department of Internal Medicine C, Chaim Sheba Medical Center, Tel Hashomer, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; Medicine Branch, Ground Forces Command, Israeli Defense Forces, Kiryat Mal’achi, Israel; Infectious Disease Institute, Soroka University Medical Center, Beer-Sheva, Israel; Leptospirosis Reference Laboratory, Israel Institute for Biological Research, Ness Ziona, Israel; Army Health Branch, Israel Defense Forces Medical Corps, Ramat Gan, Israel

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A. PIROGOVSKY Department of Internal Medicine C, Chaim Sheba Medical Center, Tel Hashomer, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; Medicine Branch, Ground Forces Command, Israeli Defense Forces, Kiryat Mal’achi, Israel; Infectious Disease Institute, Soroka University Medical Center, Beer-Sheva, Israel; Leptospirosis Reference Laboratory, Israel Institute for Biological Research, Ness Ziona, Israel; Army Health Branch, Israel Defense Forces Medical Corps, Ramat Gan, Israel

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C. BARTAL Department of Internal Medicine C, Chaim Sheba Medical Center, Tel Hashomer, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; Medicine Branch, Ground Forces Command, Israeli Defense Forces, Kiryat Mal’achi, Israel; Infectious Disease Institute, Soroka University Medical Center, Beer-Sheva, Israel; Leptospirosis Reference Laboratory, Israel Institute for Biological Research, Ness Ziona, Israel; Army Health Branch, Israel Defense Forces Medical Corps, Ramat Gan, Israel

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J. GILAD Department of Internal Medicine C, Chaim Sheba Medical Center, Tel Hashomer, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; Medicine Branch, Ground Forces Command, Israeli Defense Forces, Kiryat Mal’achi, Israel; Infectious Disease Institute, Soroka University Medical Center, Beer-Sheva, Israel; Leptospirosis Reference Laboratory, Israel Institute for Biological Research, Ness Ziona, Israel; Army Health Branch, Israel Defense Forces Medical Corps, Ramat Gan, Israel

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A. BARNEA Department of Internal Medicine C, Chaim Sheba Medical Center, Tel Hashomer, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; Medicine Branch, Ground Forces Command, Israeli Defense Forces, Kiryat Mal’achi, Israel; Infectious Disease Institute, Soroka University Medical Center, Beer-Sheva, Israel; Leptospirosis Reference Laboratory, Israel Institute for Biological Research, Ness Ziona, Israel; Army Health Branch, Israel Defense Forces Medical Corps, Ramat Gan, Israel

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S. YITZHAKI Department of Internal Medicine C, Chaim Sheba Medical Center, Tel Hashomer, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; Medicine Branch, Ground Forces Command, Israeli Defense Forces, Kiryat Mal’achi, Israel; Infectious Disease Institute, Soroka University Medical Center, Beer-Sheva, Israel; Leptospirosis Reference Laboratory, Israel Institute for Biological Research, Ness Ziona, Israel; Army Health Branch, Israel Defense Forces Medical Corps, Ramat Gan, Israel

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I. GROTTO Department of Internal Medicine C, Chaim Sheba Medical Center, Tel Hashomer, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; Medicine Branch, Ground Forces Command, Israeli Defense Forces, Kiryat Mal’achi, Israel; Infectious Disease Institute, Soroka University Medical Center, Beer-Sheva, Israel; Leptospirosis Reference Laboratory, Israel Institute for Biological Research, Ness Ziona, Israel; Army Health Branch, Israel Defense Forces Medical Corps, Ramat Gan, Israel

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R. D. BALICER Department of Internal Medicine C, Chaim Sheba Medical Center, Tel Hashomer, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; Medicine Branch, Ground Forces Command, Israeli Defense Forces, Kiryat Mal’achi, Israel; Infectious Disease Institute, Soroka University Medical Center, Beer-Sheva, Israel; Leptospirosis Reference Laboratory, Israel Institute for Biological Research, Ness Ziona, Israel; Army Health Branch, Israel Defense Forces Medical Corps, Ramat Gan, Israel

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E. SCHWARTZ Department of Internal Medicine C, Chaim Sheba Medical Center, Tel Hashomer, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; Medicine Branch, Ground Forces Command, Israeli Defense Forces, Kiryat Mal’achi, Israel; Infectious Disease Institute, Soroka University Medical Center, Beer-Sheva, Israel; Leptospirosis Reference Laboratory, Israel Institute for Biological Research, Ness Ziona, Israel; Army Health Branch, Israel Defense Forces Medical Corps, Ramat Gan, Israel

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An outbreak of leptospirosis that involved 7 of a team of 27 Israeli troops occurred following a military exercise in northern Israel near the Jordan River. The organism implicated in the outbreak was Leptospira interrogans serovar Hardjo. The clinical course was uncomplicated and all patients fully recovered. There were no cases of asymptomatic infection. Military personnel should be recognized as having an occupational risk for contracting leptospirosis, especially when military activity takes place near natural water sources inhabited by cattle, taking into account the local epidemiology of this disease. Moreover, outbreaks among military personnel may serve as a sentinel for leptospiral illness in areas in which civilian exposure takes place, such as the Jordan River, which is an important site that involves immersion in the context of both pilgrimage and civilian recreational activities.

“Bathe and you will become clean. So he went down and immersed himself seven times in the Jordan, as Elisha had told him to do. And his flesh became clean once more like the flesh of a small child.”

II Kings 5:14

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