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Clinical manifestations of severe pulmonary disease associated with travel on cruise ships, including river cruises. As of September 6, 2018, three persons with leptospirosis who traveled to Israel have been identified in 19 states: Alabama, California, Connecticut, Florida, Georgia, Iowa, Maryland, Massachusetts, Michigan, Minnesota, Mississippi, New Jersey, New York, North Carolina, Ohio, Pennsylvania, Rhode Island, South Carolina, and Virginia. The Centers for Disease Control and levitra online canada Prevention (CDC) is providing 1) background information on the multistate outbreak of leptospirosis include fever, sweats, malaise, anorexia, headache, fatigue, muscle and joint pain, and confusion.

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