Leptospirosis
Introduction
Leptospirosis is a bacterial infection transmitted to humans from infected animals (often rodents) and their urine. Infection often occurs from water contaminated by infected animal urine.
Recommendations for Travellers
Travellers at increased risk include:
- those involved in outdoor water sports such as white-water rafting, adventure racing, kayaking or triathlon events, particularly following heavy rains or flooding
- individuals wading/swimming through flood water or swimming or washing in contaminated water
Farmers, veterinarians, sewage workers and fish farmers are at occupational risk.
All travellers should:
- be aware of the risk and avoid exposure to fresh water especially after heavy rains and floods, when contamination is more likely.
- always protect the skin when travelling, particularly in tropical climates. All cuts, scratches and open skin lesions should be covered with waterproof plasters.
- avoid swallowing or drinking water that could be infected.
- wear protective clothing (wet suits and goggles) especially footwear, for example, waders if the risk is considered high and exposure unavoidable,.
- careful washing and showering after possible exposure may be helpful.
There is no vaccine available in the UK to protect against leptospirosis.
Overview of Disease
Leptospirosis infection is widespread throughout the world but is particularly common in tropical climates, especially areas with poor standards of hygiene and those prone to flooding. The disease is carried by animals especially rats. Animals shed the bacteria in their urine.
Infection enters the body through cut or grazed skin, the eyes, nose or mouth when they are in contact with flood water, fresh water, moist soil or vegetation contaminated by infected animal urine.
The Illness
Most infections result in no or only mild symptoms.
The time between the infection entering the body and symptoms starting is usually 5 to 14 days. In those with symptoms the illness usually lasts from a few days to 3 weeks but can be longer.
Symptoms include a sudden onset of a flu-like illness, muscle and joint pains and red eyes. In a minority these progress to jaundice (yellowing of the whites of the eyes, and skin), bleeding abnormalities and kidney/liver failure. Recovery of untreated cases can take several months.
Treatment
Antibiotics can help shorten the illness if given early. Supportive hospital treatment with intensive care is needed for the management of liver and kidney failure.