Disease Information Sheets
Leptospirosis
Introduction
Leptospirosis is found all over the world, including Europe although it is most common in tropical regions. It is a bacterial infection that is acquired through direct contact with the urine of infected animals, via contaminated fresh water or soil or by drinking contaminated water. The bacteria enter the body through a cut or graze on the skin, or via the mucous membranes such as the conjunctiva of the eye.
Most cases in the UK are acquired through leisure activities (inland water sports) or travel abroad. Animals known to carry the infection are rodents (mainly rats), cattle, pigs and dogs.
How common is it?
Leptospirosis is uncommon in the UK, but globally it is estimated that 7-10 million people fall ill with it each year. Deaths are difficult to estimate as many remain unreported. It is predicted that the number of cases will rise as global warming increases the occurrence of flooding.
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Areas at higher risk of leptospirosis
Are travellers and/or expat workers at risk?
Yes. Overseas travel to South East Asia and Central America, engaging in water-related activities such as swimming, white water rafting or wading in inland waters, especially following periods of heavy rainfall, enhances the risk of acquiring the disease. Jungle trekking is also a high risk activity. People with occupational risks include outdoor instructors (watersports or caving instructors, raft, jungle or fishing guides), people who work with animals, farmers, drainage workers, soldiers etc.
What is the illness?
Symptoms develop between 2 and 30 days - but usually 7 to 14 days - after exposure. Nine out of ten cases are mild, with flu-like symptoms of fever, chills, headache, nausea and vomiting, loss of appetite and muscle pains. There may be conjunctivitis, cough and a short-lived rash. These symptoms usually resolve after 5-7 days.
In 10% of cases more serious illness then develops - Weil’s disease - affecting the brain (meningitis or encephalitis), lungs (severe bleeding into the lungs) or liver, kidneys and heart (organ failure). Weil’s disease can be fatal.
How is it treated?
Leptospirosis is treated with antibiotics. Most cases resolve quickly and completely, but severe cases (Weil’s disease) may require extensive and prolonged hospital treatment.
How can it be prevented?
Cover cuts and grazes with a waterproof dressing and shower or bathe after freshwater activities. Clean any cuts or grazes as soon as possible. Drink only treated, boiled or filtered water. Avoid exposure to animal urine by avoiding dead animals and animal bedding. Wash your hands thoroughly if you may have touched a contaminated surface.
Antibiotics can be taken to prevent leptospirosis, however it is uncertain how effective this is. Preventative treatment is usually only offered to specific groups of people, such as soldiers deployed to high risk areas, aid or disaster relief staff working in an outbreak area or animal workers.
No vaccine is available for humans, although cattle, dogs and some other animals can be vaccinated.