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Leptospirosis is a reemerging infectious disease in California. Leptospirosis is the most widespread zoonosis throughout the world, though it is infrequently diagnosed in the continental United States. From 1982 to 2001, most reported California cases occurred in previously healthy young adult white men after recreational exposures to contaminated freshwater. We report five recent cases of human leptospirosis acquired in California, including the first documented common-source outbreak of human leptospirosis acquired in this state, and describe the subsequent environmental investigation. Salient features in the California cases include high fever with uniform renal impairment and mild hepatitis. Because leptospirosis can progress rapidly if untreated, this reemerging infection deserves consideration in febrile patients with a history of recreational freshwater exposure, even in states with a low reported incidence of infection. [ABSTRACT FROM AUTHOR]

Objective: Medical students at Stanford University established an elective lecture series in reproductive health to teach 10 women's health competencies to preclinical medical students. In the second year, student organizers implemented interactive components to improve the number of competencies students learned., Study Design: We surveyed students from the first two years this series was offered to assess their preferred modes of learning and the number of competencies students perceived they had gained. Students were asked to self-assess their learning of key reproductive health competencies taught in the course., Results: We identified 4 factors associated with statistically significant improvements in the number of competencies students learned, according to self-assessment., Conclusion: Students who felt they learned more competencies agreed that they were active participants in the course, that their preferred style of learning was matched by the course, and that they had received academic credit for the course. Furthermore, students who attended an innovative reproductive health fair organized by students participating in the course perceived that they had learned significantly more competencies. We expect these self-assessed improvements to correlate with increased demonstration of the competencies as students progress to the clinical level.