Leptospirosis (Lepto)

March 2011

What is Leptospirosis?

Leptospirosis is a bacterial disease spread through contact with water, soil or food contaminated by urine from infected animals, or by direct contact with infected animals. The bacteria can live in the ground for days and favour humid and moist conditions. It is common to see leptospirosis outbreaks in rice-growing areas or following floods in the tropical regions.

 

 

 

 

Symptoms

• Can present 2 days to 3 weeks after infection.
• Commonly include sudden fever, headache, chills, nausea, vomiting, diarrhea, muscle pain (particularly in the calves and thighs), skin rash, and sore eyes lasting 4-9 days..
• In some cases, leptospirosis only presents as a mild flu-like illness.
• In more severe cases, symptoms may worsen to include bleeding under the skin, jaundice (yellow skin and eyes), kidney and/or liver failure, meningitis, and chest pains. The severe form of leptospirosis is known as Weil's disease.
• Leptospirosis is often misdiagnosed as meningitis, encephalitis or influenza.

Transmission

• Leptospirosis is carried by many wild and domestic animals, including rodents, raccoons, dogs, cows, pigs, horses, sheep and goats.
• Rodents are the main carriers, especially rats. When infected animals urinate, the leptospirosis bacteria goes into the soil or nearby water.
• Leptospirosis can survive for days in moist soil, or for weeks in water.
• High temperatures, heavy rains, and flooding provide good conditions for leptospirosis bacteria to replicate and survive.
• People get leptospirosis when they come into contact with the bacteria. The bacteria enter through the skin, usually cuts or scratches, or through mucous membranes like the nose, mouth, or eyes.
• Indirect exposure through contaminated water, soil or foods is most common, but people who work with animals may become infected through direct exposure to the animals or by inhaling small droplets (aerosols).

Where is Leptospirosis a Concern?

• Leptospirosis occurs worldwide, but most commonly infects people in wet, tropical climates.
• In 2009, there were outbreaks of leptospirosis reported in the Dominican Republic, India, and Fiji.

Related Travel Health Notices

None.

Recommendations to Travellers

1. Take precautions to avoid exposure to water that may be contaminated
   1. Avoid wading in flood water;
   2. Avoid swimming in fresh water where leptospirosis outbreaks are known to occur;
   3. Cover cuts and scrapes if wading or swimming;
   4. Don’t drink local water.
2. Practise personal hygiene and frequent hand-washing
3. Take precautions to avoid exposure to soil that may be contaminated
   1. Wear proper clothing and footwear when walking or working in wet soil.
4. Avoid rodents and other carrier animals
   1. Ensure garbage is removed from campsites and dwellings;
   2. Consider your accommodations and rodent access;
   3. Wear protective clothing when working with farm animals.
5. Discuss the benefits of taking pre-exposure prophylaxis with a health care professional before departure
   1. Travellers at high risk of exposure, such as humanitarian workers, rice or cane farmers, veterinarians or animal caretakers, may wish to try antibiotics to prevent infection;
   2. No antibiotic is 100% effective in preventing the disease;
   3. There is no vaccine;
   4. Travellers should visit a travel health clinic at least six weeks before travel.
6. Know the symptoms of leptospirosis and see a health care provider if they develop
   1. Seek medical attention immediately if a fever and any other symptoms arise during or after travel;
   2. Be sure to tell your healthcare provider that you have travelled to a region where leptospirosis was present.

Don’t Forget …

• Consult a doctor, nurse or health care provider or visit a travel health clinic at least six weeks before you travel.
• What to do if you get sick when you are travelling.
• What to do if you get sick after you return to Canada.
• Know what vaccines you need and when to get them.

Other Related Information

World Health Organization (WHO) – Fact Sheet: Leptospirosis