Leptospirosis
(Lepto)
March 2010
What is Leptospirosis?
Leptospirosis is a bacterial disease spread through contact with water, soil or food contaminated by urine from infected animals, or by direct contact with infected animals. The bacteria can live in the ground for days and favour humid and moist conditions. It is common to see leptospirosis outbreaks in rice-growing areas or following floods in the tropics.
Bacteria of the genus Leptospira
Depends on location, rainfall, activities, and exposure to animals.
Increased risk among travellers who:
- visit wet, tropical areas where leptospirosis transmission is more common
- engage in fresh water activities such as rafting or swimming in streams or ponds, or working in rice paddies or cane fields
- work on farms in close contact with animals and/or animal urine, particularly rats.
Leptospirosis can range from mild to fatal.
In 5-10% of those infected, patients develop a more severe form of leptospirosis called Weil’s Disease. About 5-15% of those with Weil’s Disease die.
There is no vaccine licensed for use in Canada.
Avoid swimming or wading in water that may be contaminated. Cover cuts and wounds.
Practice personal hygiene and frequent hand-washing.
Wear proper clothing and footwear when walking or working in wet soil, and during farm work.
Don’t drink local water.
Avoid rodents.
Doxycycline may be used as a preventative drug in areas where risk of exposure is high.
Antibiotics can be administered to reduce length of infection.
Symptoms
- Can present 2 days to 3 weeks after infection.
- Commonly include sudden fever, headache, chills, nausea, vomiting, diarrhea, muscle pain (particularly in the calves and thighs), and sore eyes lasting 4-9 days.
- In some cases, leptospirosis only presents as a mild flu-like illness.
- In more severe cases, may worsen to include stiff neck, rash, bleeding under the skin, kidney and/or liver failure, jaundice (yellow skin and eyes), meningitis, mental confusion, and chest pains (Weil’s Disease).
- Leptospirosis is hard to diagnose as many of the symptoms look like many other tropical diseases.
Transmission
- Leptospirosis is carried by many wild and domestic animals, including rodents, raccoons, dogs, cows, pigs, horses, sheep and goats.
- Rodents are the main carriers, especially rats. When infected animals urinate, the leptospirosis bacteria goes into the soil or nearby water.
- Leptospirosis can survive for days in moist soil, or for weeks in water.
- High temperatures, heavy rains, and flooding provide good conditions for leptospirosis bacteria to replicate and survive.
- People get leptospirosis when they come into contact with the bacteria. The bacteria enter through the skin, usually cuts or scratches, or through mucous membranes like the nose, mouth, or eyes.
- Indirect exposure through contaminated water, soil or foods is most common, but people who work with animals may become infected through direct exposure to the animals or by inhaling small droplets (aerosols).
Where is Leptospirosis a Concern?
- Leptospirosis occurs worldwide, but most commonly infects people in wet, tropical climates.
- In 2009, there were outbreaks of leptospirosis reported in the Dominican Republic, India, and Fiji.
Related Travel Health Notices
None.
Recommendations to Travellers
- Take precautions to avoid exposure to water that may be contaminated
- Avoid wading in flood water;
- Avoid swimming in fresh water where leptospirosis outbreaks are known to occur;
- Cover cuts and scrapes if wading or swimming;
- Don’t drink local water;
- Practice personal hygiene and frequent hand-washing
- Take precautions to avoid exposure to soil that may be contaminated
- Wear proper clothing and footwear when walking or working in wet soil;
- Avoid rodents and other carrier animals
- Ensure garbage is removed from campsites and dwellings;
- Consider your accommodations and rodent access;
- Wear protective clothing when working with farm animals;
- Discuss the benefits of taking pre-exposure prophylaxis with a health care professional before departure
- Travellers at high risk of exposure, such as humanitarian workers, rice or cane farmers, veterinarians or animal caretakers, may wish to try antibiotics to prevent infection;
- No antibiotic is 100% effective in preventing the disease;
- There is no vaccine;
- Travellers should visit a travel health clinic at least six weeks before travel;
- Know the symptoms of leptospirosis and see a health care provider if they develop
- Seek medical attention immediately if a fever and any other symptoms arise during or after travel;
- Be sure to tell your healthcare provider that you have travelled to a region where leptospirosis was present.
Don’t Forget …
Other Related Information
World Health Organization (WHO) –
Fact Sheet: Leptospirosis
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