title: Strikes, flooding, rats, and leptospirosis in Marseille, France.
abstract: OBJECTIVE
  The aim of this study was to examine the mechanisms by which weather conditions, the incidence of Leptospira in reservoir populations, and various socio-ecological factors are driving the emergence of leptospirosis in Marseille, France.
  
  
  METHODS
  Over the last 30 years our laboratory has surveyed all human cases of leptospirosis in Marseille using clinical, epidemiological, serological, and molecular tools. Data for the weather conditions in Marseille were collected from the official meteorological station, and garbage management strikes were monitored through the local press. Rats were trapped in alleys near to where the patients may have acquired leptospirosis.
  
  
  RESULTS
  Three new cases of autochthonous leptospirosis are reported. The global tendency for rainfall showed a slight increase over the period under analysis. The index case of leptospirosis occurred after a heavy rainfall with flooding. Over the last 10 years Marseille has undergone 82 days of garbage management strikes. Leptospira DNA was detected in two of 11 rats.
  
  
  CONCLUSIONS
  The emergence of leptospirosis has become a public health problem in Marseille, and is associated with a combination of heavy rainfall and garbage collection strikes in which garbage is left on the street and thereby contributes to the expansion of the rat population on the surface.
authors.affiliation: Université de la Méditerranée, URMITE UMR 6236, CNRS-IRD, Faculté de Médecine et de Pharmacie, 27 Bd Jean Moulin, 13385 Marseille cedex 05, France.
authors.forename: Cristina
authors.initials: C
authors.lastname: Socolovschi
authors.forename: Emmanouil
authors.initials: E
authors.lastname: Angelakis
authors.forename: Aurélie
authors.initials: A
authors.lastname: Renvoisé
authors.forename: Pierre-Edouard
authors.initials: PE
authors.lastname: Fournier
authors.forename: Jean Lou
authors.initials: JL
authors.lastname: Marié
authors.forename: Bernard
authors.initials: B
authors.lastname: Davoust
authors.forename: Andreas
authors.initials: A
authors.lastname: Stein
authors.forename: Didier
authors.initials: D
authors.lastname: Raoult
mesh_terms: D000368:Aged; D000818:Animals; D002648:Child; D021821:Communicable Diseases, Emerging / Q000175:diagnosis / Q000453:epidemiology / Q000635:transmission*; D005260:Female; D055868:Floods; D005602:France / Q000453:epidemiology; D006801:Humans; D007919:Leptospira / Q000235:genetics / Q000302:isolation & purification*; D007922:Leptospirosis / Q000175:diagnosis / Q000453:epidemiology / Q000635:transmission*; D008297:Male; D008875:Middle Aged; D051381:Rats; D012307:Risk Factors; D016036:Seroepidemiologic Studies; D013317:Strikes, Employee; D014887:Weather