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Leptospirosis by Diana Kohnle

Definition

Leptospirosis is a rare and contagious bacterial infection that can be very serious. The infection is caused by the bacterium called Leptospira . Leptospirosis is most common in warm, tropical conditions and can affect any part of the body. With prompt and proper treatment, prognosis is usually good. If untreated, complications may develop that can potentially be fatal.

Causes

Leptospirosis is caused by contact with fresh water, wet or dampened soil, or vegetation that has been soiled by urine from an infected animal.

When contact is made with the contaminated material, the bacteria enter the body through open sores or wounds in the skin, or through mucous membranes. People can also contract leptospirosis by drinking water that has been contaminated by the urine of an infected animal.

Once the bacterium has entered the body, it flows into the bloodstream and throughout the body, causing infection.

Risk Factors

A risk factor is something that increases your chance of getting a disease or condition. Anyone can contract leptospirosis, but the following people are at an increased risk of developing leptospirosis:

Canoeists
Rafters
Swimmers (in lakes, rivers, and streams)
Workers in flood plains
Workers in wet agricultural settings
People who have pets, particularly dogs or livestock
People who work with the land, including farmers, ranchers, loggers, and rice-field workers
People who work with animals, including veterinarians

Symptoms

Symptoms typically appear about 10 days after infection and may include one or more of the following:

Sudden fever, rigors, pain, and headache
Dry cough
Nausea, vomiting, and diarrhea
Conjunctivitis (pink eye)
Aching joints
Sore throat
Painful bones
Abdominal pain
Enlarged spleen, liver, or lymph glands
Rigid muscles
Rash on the skin

Diagnosis

Your doctor will ask about your symptoms and medical history, and perform a physical exam.

Tests may include the following:

Blood test to determine the presence of antibodies to the Leptospira bacterium
Cultures or other laboratory tests

Treatment

Talk with your doctor about the best treatment plan for you. Treatment options include:

Antibiotics, including:
- Penicillin
- Tetracycline
- Chloramphenicol
- Erythromycin

Prevention

To help reduce your chances of getting leptospirosis, take the following steps:

Reduce contact with soil, vegetation, and water that could possibly be contaminated with infected animal urine, including urine from rodents.
If working with materials that could potentially be contaminated, wear protective clothing that covers the skin, including waterproof boots or waders.
If working in an especially high-risk area, talk to your doctor about beginning antibiotic treatment before potential exposure.

RESOURCES:

The Leptospirosis Information Center http://www.leptospirosis.org
United States National Library of Medicine http://www.nlm.nih.gov/

CANADIAN RESOURCES:

Canadian Health Network http://www.canadian-health-network.ca/
Capital Health http://www.cdha.nshealth.ca/

References:

Ellis T, Imrie A, Katz AR, Effler PV. Underrecognition of leptospirosis during a dengue fever outbreak in Hawaii, 2001-2002. Vector Borne Zoonotic Dis . 2008;8(4):541-7.
Hartskeerl RA, Collares-Pereira M, Ellis WA. Emergence, control and re-emerging leptospirosis: dynamics of infection in the changing world. Clin Microbiol Infect. 2011;17(4):494-501.
Katz AR, Buchholz AE, Hinson K, Park SY, Effler PV. Leptospirosis in Hawaii, USA, 1999-2008. Emerg Infect Dis. 2011;17(2):221-226.
Leptospirosis. Division of Bacterial and Mycotic Diseases. Centers for Disease Control and Prevention website. Available at: http://www.cdc.gov/ncidod/dbmd/diseaseinfo/leptospirosis_g.htm . Accessed April 19, 2007.
Leptospirosis (Weil's disease). New York State Department of Health website. Available at: http://www.health.state.ny.us/diseases/communicable/leptospirosis/fact_sheet.htm . Accessed April 19, 2007.
MacAllister C. Leptospirosis. Oklahoma Cooperative Extension Fact Sheet. Oklahoma Cooperative Extension Service website. Available at: http://osuextra.okstate.edu/pdfs/F-9130web.pdf . Accessed April 19, 2007.
Stern EJ, Galloway R, Shadomy SV, et al. Outbreak of leptospirosis among Adventure Race participants in Florida, 2005. Clin Infect Dis . 2010;50(6):843-9.

Last reviewed December 2011 by Lawrence Frisch, MD, MPH

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