Freshwater swimming can lead to

Leptospirosis Leptospires excreted in urine and can survive in water for many months, water is an impoant vehicle in their transmissionBabesiosis Veical transmission, blood transfusion, or tick bitebrucellosisOccupational or domestic exposure to infected animals or their products by ingestion, inhalation, or mucosal or percutaneous exposureLassa feverAerosols from infected rodents, capturing or eating these animals, close person to person contact(ref: Harrison's 18/e p1393)