Leptospirosis is found worldwide. Exposures are most common when traveling to tropical and sub-tropical countries where the organism is more common.
Leptospirosis is a widespread bacterial
zoonotic disease that is particularly common in tropical and sub-tropical areas of the world. The bacteria is found in rodents and other mammals and is shed in the animals’ urine. It can survive in the environment for days to months. People can be exposed to the bacteria in soil and water. Outbreaks are known to occur after heavy rainfall or flooding that causes soil or sewage to mix with water, especially in areas with poor sanitation.
People with leptospirosis may show a range of symptoms. They can be asymptomatic (without symptoms) or experience severe illness. Most cases are mild, and people usually recover fully. In Canada, a small proportion of people die from leptospirosis (1-5%). In under-resourced countries up to 20% of people die in outbreaks.
Leptospirosis can cause many symptoms including:
- fever
- chills
- headache
- muscle aches
- malaise (feeling unwell)
- conjunctivitis (pink eye)
- vomiting
- Jaundice (yellow skin or eyes)
- stomach pain
- a rash may also occur
Serious consequences are also possible, including:
- kidney and liver failure
- meningitis
- respiratory problems
The infection may start with mild symptoms that become severe over a few days. Symptoms start an average of 10 days (range 2 to 30 days) after exposure to the bacteria and last from a few days to several weeks. Sometimes a person can be infected and have no symptoms.
Leptospirosis is caused by a bacterium called Leptospira.
Leptospirosis occurs when:
- people with cuts or scraped skin come in contact with water or soil that is contaminated with infected animal urine (for example, swimming, wading, boating or taking part in other recreational activities in water)
- farm workers come into direct contact with the body fluids of infected pregnant animals while aiding in birthing
- contaminated aerosols are inhaled or contaminated water or fluids come in contact with the eyes or nose
- the bacteria are ingested through contaminated drinking water or food (for example, drinking untreated water from lakes, streams or rivers)
Animals known to carry or be infected with Leptospira include:
- rats and other rodents
- deer
- foxes
- skunks
- cattle
- dogs
- pigs
- horses
Leptospirosis is most common in people who work outdoors or with animals, including:
- livestock farmers
- farmers working in sugar cane fields
- sewage workers
- veterinary staff
- abattoir workers
- fish farmers
- hunters
- trappers
Leptospirosis also occurs in adventure racers who swim or wade through contaminated water.
Dogs and other animals can get leptospirosis through drinking, swimming or walking through contaminated water or coming into contact with infected wildlife. Cats seem less prone to infection.
Leptospirosis does not easily spread from person to person.
The more serious forms of leptospirosis include meningitis, kidney and liver failure, and miscarriage in pregnant people.
Leptospirosis is diagnosed by testing blood, urine, and/or cerebrospinal fluid.
If you think you have leptospirosis, see a doctor or health care provider immediately for testing, advice and treatment. If you have participated in activities in which you may have been exposed to animal urine or contaminated water, tell your health care provider or call 811 for advice.
Early treatment with antibiotics is important.
There is no commercially available vaccine for humans. People who are at very high risk of becoming infected with leptospirosis may discuss the use of antibiotics before a known leptospirosis exposure with their health care provider. These include:
- soldiers training in tropical regions
- adventure tourists who will have freshwater exposure (especially tropical)
- veterinarians who will be working with infected animals
Antibiotic use after exposure may be indicated for persons who have encountered the bacteria and are highly likely to become infected. Antibiotic prophylaxis is NOT routinely offered to protect owners of infected animals because the risk of transmission through normal human contact with infected animals is usually low.
If your pet is healthy
- Discuss getting your dog vaccinated with your veterinarian
- Do not leave pet food and water outside where it can attract wildlife
-
Wash your hands after:
- petting or handling your pet
- cleaning up urine accidents from pets
- washing your pet
- cleaning bedding that is contaminated with urine
- if you are bitten, nipped or licked by your pet
- Do not let children crawl or play in areas of the yard where there may be fresh animal urine
- Do not let your pet in areas where food is being prepared or grown
- Do not allow your pet on your bed
If you think your pet has leptospirosis
- Immediately take your pet to a veterinarian for diagnosis and treatment
- When cleaning surfaces that may be contaminated with urine from an infected pet, use an antibacterial cleaning solution, detergent or a solution of 1 part household bleach in 10 parts water
- Use gloves to handle your pet’s urine, blood, and tissues
- Wash your hands after touching your pet
- Cover cuts and abrasions with waterproof dressings
- Pregnant or breastfeeding/chestfeeding people, the elderly, and young children should avoid cleaning up animal waste and contact with sick animals during periods of peak transmissibility (up to three weeks after the animal first gets sick).
- Cover skin cuts or wounds with waterproof bandages before entering the water
- Eco and adventure tourists should take measures to protect their exposed skin (even if it is intact), eyes and mucous membranes during activities that involve contact with water in tropical areas, such as wading, swimming, or boating.
- Eco adventure tourists and others should discuss pre-exposure prophylaxis (see pre-exposure below) with a travel clinic or their health care provider if they will be participating in high-risk activities
- Do not swim, wade or participate in activities in water that may be contaminated with animal urine, for example, where there are streams draining pastureland, especially after a rainstorm
- Shower after swimming or being exposed to surface water
- Wear protective clothing, footwear and gloves to prevent exposure if you have contact with potentially contaminated water, soil, or animals.
- Pet shop owners should wear rubber gloves when cleaning up animal waste, especially from dogs or any animal that appears sick. Wash hands after cleaning up.
- Veterinarians may consider pre- or post-exposure prophylaxis if working with infected animals or if an exposure to infected fluids or tissue has occurred.
- Prevent contact between livestock and rodents, wild animals or other livestock, which could be infected.
- Clean, disinfect, and dry the living areas of infected livestock before allowing healthy animals to enter those spaces.
- Discuss the possibility of vaccination and antibiotic use with your veterinarian to prevent and minimize outbreaks in your livestock.
- Reduce exposure of livestock to contaminated water by preventing urine from entering water sources and draining swampy land.
