Leptospirosis isn’t common, but ten million people catch it every year. It’s a bacterial infection caused the Leptospira bacterium, usually transmitted from animals to humans through open wounds, the nose, eyes and mouth. People who come into contact with water or soil contaminated by rat, skunk, opossum, cattle, pig, fox or raccoon urine are most at risk, and the bacteria can survive in soil and water for months.

The WHO believes the death rate is anywhere between 5-25% in places where healthcare is sub-standard. But provided you get proper treatment, the risk of death is a lot lower.

About Leptosporosis – Mild and severe

There are two kinds of Leptospirosis, mild and severe. The mild type comes with muscle pains, chills and headaches, and affects 90% of people who catch the disease. Severe Leptospirosis can kill.

Why do some people develop the severe form? Nobody really knows. But it could turn out worse if you’re already ill, under five years old or elderly.

How people catch the disease

  • Drinking contaminated water
  • When open wounds like cuts come into contact with contaminated water
  • When the eyes, nose or mouth come into contact with contaminated water or soil
  • Through contact with infected animal blood

Which countries are most at risk?

The illness is found in tropical places but these days it’s also cropping up in towns and cities in cooler parts of the developing world, especially where sanitation is poor and most often in summer and autumn. It arises when humans and carrier animals are in close and frequent contact and when there’s been flooding, which puts aid workers at particular risk.

Leptospirosis in the developed world

  • England saw 33 cases in 2009, 14 of which the patients caught when abroad
  • France saw 209 cases the same year
  • Cases have arisen in New Zealand, Hawaii, Barbados and Australia
  • Experts think there may be as many as 1000 cases a year in the USA

How did people in developed nations catch the disease? Usually sewerage and farm workers, those in frequent close contact with animals, infected water or soil, or people who had been sailing, swimming or canoeing in fresh water.

The signs and symptoms of mild leptospirosis

The symptoms usually appear fast, 7 to 14 days after infection

  • Chills and coughing
  • Diarrhoea
  • Sudden headaches and a high fever
  • Muscle pain, in the lower back and calves in particular
  • Nausea and loss of appetite
  • Irritated, red eyes
  • Painful skin

People tend to recover within a week without treatment. A few go on to develop the severe version.

About the severe version

When the heart, liver and kidneys are affected:

  • Tiredness and chest pain
  • Irregular and / or faster heartbeat
  • Muscle pains
  • Nausea and nosebleeds
  • Difficulty breathing – often panting
  • No appetite and dramatic weight loss
  • Swollen hands, feet or ankles
  • The whites of your eyes go yellow, as do the tongue and skin (jaundice)
  • Kidney failure

When the the brain is affected, the symptoms are very like meningitis. See our meningitis page for details.

When the lungs are affected, the most serious severe version of the disease :

  • High fever
  • Panting
  • Coughing up a lot of blood

How to diagnose leptospirosis

This disease is a challenge to diagnose in the early stages, simply because it looks so much like a bad cold, flu and all sorts of other common infections. Diagnosis only happens when doctors begin to suspect they’re looking at severe leptospirosis and order special blood and urine tests.

How to treat the disease

  • Mild: it should clear up on its own – you probably won’t realise you had it, suspecting a simple bout of flu
  • Acute: a 5 – 7 day course of a tetracycline antibiotic, potentially intravenously in hospital, plus a ventilator if your breathing is affected, dialysis if the kidneys are involved and intravenous fluids as required. Hospital stays can last as long as several months

How to avoid catching it

  • The risk in developed nations is very low, for example just one in ten million in Britain
  • If you frequently swim in fresh water, make sure you cover any cuts or grazes with a waterproof dressing and shower in hot soapy water afterwards
  • If you’re in contact with animals for work, make sure you protect yourself properly when near water or soil that might be contaminated – better safe than sorry
  • In countries where it’s common, avoid swimming in fresh water unless you’re wearing protective gear. Stick to bottled and boiled water, and cover all cuts and wounds with waterproof dressings

Advice for aid workers

If you’re an emergency aid worker or in the military serving somewhere the disease is common, you might want to discus taking antibiotics just in case. On the other hand taking them without a very good reason is not recommended these days, with antibiotic-resistant strains of all sorts of dreadful diseases on the rise. We’ll be delighted to talk things over with you – contact us for expert advice.