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Leptospirosis 

Introduction

Leptospirosis is a bacterial infection transmitted to humans from infected animals.

Leptospirosis infection is widespread throughout the world. The disease is carried mainly by rodents, especially rats and similar small animals. Human cases are more common in tropical climates, areas with poor standard of hygiene and in areas subject to flooding.

Transmission

Infection enters the body when cut or grazed skin, or the eyes, nose or mouth are in contact with flood water, fresh water, moist soil or vegetation contaminated by infected animal urine.

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.

The Illness

Most infections result in no or only mild symptoms.

The time between the infection entering the body and symptoms starting is usually 5-14 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 fever, chills, headache, red eyes, muscle and joint pain. 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.

Recommendations for Travellers

  • 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.
  • 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, for example, 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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