Leptospirosis is a bacterial infection caused by Leptospira interrogans which has many different strains.
Leptospirosis infection is widespread throughout the world. Human cases are more common in tropical climates, areas with poor standard of hygiene is poor and in areas subject to flooding. The disease is carried mainly by rodents, especially rats and similar small mammals.
Infection is contracted through cuts or abrasions of the skin and through the mucous membranes of the eyes and mouth following contact with flood water, moist soil, vegetation and fresh water contaminated by infected animal urine.
Travellers at increased risk include:
- Those involved in outdoor water sports such as whitewater 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.
Most infections result in no or only mild symptoms. The incubation period is usually 5-14 days. In those with symptoms the illness usually lasts from a few days to 3 weeks but can be longer. Generally there are two phases to the illness; a febrile stage lasting 4-7 days followed by a convalescent stage.
There is usually a sudden onset of fever, chills, headache, red eyes, muscle and joint pain, with jaundice, bleeding abnormalities and kidney/liver failure. Recovery of untreated cases can take several months.
Antibiotics can help shorten the illness if given early. Supportive hospital treatment with intensive care is needed for the management of liver and renal failure.
Recommendations for Travellers
- Be aware of the risk and avoid exposure to contaminated water where possible.
- Always protect the skin when travelling, particularly in tropical climates. All cuts, scratches and open skin lesions should be covered with waterproof plasters.
- Do not swallow or drink water that could be infected.
- If the risk is considered high and exposure unavoidable, protective clothing (wet suits and goggles) should be worn, especially footwear e.g. waders.
- Careful washing and showering after possible exposure may be helpful.
- There is no vaccine available in the UK to protect against leptospirosis.
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