A bacterial infection that causes flu-like symptoms and is caused by a bacterium known as Leptospira is called leptospirosis. People often get infected with this bacterium after exposure to water or soil contaminated by animal urine. In more severe cases, leptospirosis can worsen into Weil’s syndrome, which is a life-threatening disorder.
Furthermore, leptospirosis is a type of zoonotic disease, which means the bacterium spreads between animals and humans. Leptospirosis often occurs through direct contact with urine or reproductive fluids from infected animals, exposure to contaminated water or soil, or eating contaminated foods or drinking contaminated water.
Leptospirosis Phases
Typically, this bacterial infection has two phases, including the leptospiremic (acute) phase and the immune (delayed) phase. While people experience mild or no symptoms in the leptospiremic phase, the immune phase can cause severe symptoms.
Leptospiremic Phase
Sometimes, this phase is called the septicemic phase. In this case, the bacterium starts to move to the organs through the bloodstream. That’s why some people may suddenly experience flu-like symptoms. Most of the time, they start within 14 days after exposure to Leptospira.
Immune Phase
During this phase, the bacterium moves from the blood to the organs (in most cases, to the kidneys). Only a small number of people develop Weil’s syndrome in this phase. This is a serious condition that causes internal bleeding, kidney damage, and severe jaundice. Usually, blood tests can show antibodies to Leptospira in the blood.
What Are The Symptoms of Leptospirosis?
In most cases, people who are infected with this bacterium experience flu-like symptoms in the early stages of the infection. Check some of them below:
- Chills
- Headaches
- Nausea
- Vomiting
- Red eyes
- High fever
- Abdominal pain
- Muscle aches
- Rash
- Jaundice (yellowing of the eyes and skin)
- Diarrhea
In more severe cases, people may experience additional symptoms that often appear within 10 days after exposure to Leptospira. Examples include:
- Coughing up blood
- Black or tarry stools
- Hematuria (blood in the urine)
- Low urine amount
- Petechiae (red or dark spots on the skin that look similar to a rash)
- Severe jaundice
- Chest pain
- Breathing problems
Immediately contact your healthcare professional if any of the previous symptoms occur. Otherwise, it may lead to serious and even life-threatening complications.
Causes
Leptospirosis occurs when a bacterium called Leptospira enters the body through the mouth, nose, or eyes. However, it may enter the body through small cuts or cracks in the skin. Typically, Leptospira travels to the kidneys through the blood and collects there. Thereafter, it leaves the body in the urine.
Commonly, people get this bacterium from animal pee that contains it. Some examples include cows, pigs, horses, dogs, rats, and other mammals that can carry this bacterium. However, these animals often do not have any symptoms. Sometimes, people may get the bacterium from the soil or water that is contaminated by these animals’ urine. Generally, many people get infected with leptospirosis after heavy rain and flooding because floodwaters wash into rivers, lakes, and canals, which bring the bacteria with them.
This infection rarely spreads from one person to another, but in rare cases, outbreaks occur among people who are living in a closely shared living space.
Risk Factors
It is important to understand that you can get this bacterium no matter where you live. It is more common in tropical areas and warmer climates. Thus, people who travel to these places are at increased risk for leptospirosis. Examples include:
- Certain parts of Latin America
- The Caribbean
- Oceania (including New Zealand, Australia, and the Pacific Islands)
- South and Southeast Asia
- Sub-Saharan Africa
Moreover, there have been outbreaks in the U.S. after flooding in Hawaii, Florida, and Puerto Rico.
Additionally, people who are involved in recreational freshwater activities are also at increased risk for leptospirosis. Examples include:
- Boating
- Hiking
- Hunting
- Gardening
- Swimming
- Working in a veterinary office or a dairy farm
What Are The Possible Complications of Leptospirosis?
People who leave this infection untreated may also experience some complications. Check some examples below:
- Organ damage or failure (especially the kidneys or liver)
- Respiratory failure
- Meningitis (inflammation around the brain and spinal cord)
- ARDS (acute respiratory distress syndrome)
- Acute kidney injury
- Weil’s syndrome
- Encephalitis
- Cognitive problems (rarely)
- Interstitial myocarditis
- Arrhythmia (irregular heart rhythm)
- Uveitis
- Vision problems
This document does not contain a full list of complications. However, you can consult with your physician about measures to reduce the risk or even prevent them.
Is There a Way to Prevent Leptospirosis?
The best way to prevent this bacterial infection is to avoid swimming or wading in water that may contain animal urine. However, physicians may recommend additional tips that often help prevent this infection. For example:
- Preventive medicines
- Avoid infected animals
- Wear protective equipment if you are working with or around animals
- Do not participate in water sports and swimming in lakes and rivers (especially after floods)
- Avoid drinking water from lakes, rivers, and canals without boiling it first. Doctors often recommend choosing bottled water only.
- Cover open cuts or wounds with a waterproof dressing
Diagnosis
Usually, the diagnosis of this bacterial infection starts with a physical examination in which doctors try to identify irregularities linked to the disease. They may also ask some questions about your symptoms and medical history to get more clues about it. However, to confirm or rule out this infection, doctors will perform blood and urine tests. In more severe cases, you may need CT (computerized tomography) scans or a chest X-ray.
Treatment
Healthcare professionals often prescribe antibiotics that should be taken for a week to clear this infection. If you develop a severe form of leptospirosis, you will receive treatment at a hospital. These include IV (intravenous) antibiotics and fluids.
Frequently Asked Questions
When should I go to the ER?
Immediately call 911 or go to the nearest emergency room (ER) if any of the following symptoms occur. For example:
- Hematuria
- Rash-like red or dark spots on the skin
- Chest pain
- Dyspnea (shortness of breath)
- Little or no urine
- Severe jaundice
How long does it last?
While mild forms of leptospirosis disappear within 10 days, in severe cases, you will receive treatment in the hospital for several weeks. People often recover from severe leptospirosis within a few months.
Can you survive leptospirosis?
Yes, most people who develop this infection survive. Moreover, mild forms of leptospirosis do not cause symptoms or cause mild ones that disappear without treatment. In general, approximately 1% of people with leptospirosis develop Weil’s syndrome. This is a life-threatening complication that requires immediate treatment. Those who do not get treatment right away may die.
Can leptospirosis spread from person to person?
Person-to-person transmission is extremely rare. Most people become infected after contact with water, soil, or food contaminated with the urine of infected animals. In rare cases, transmission has been reported through sexual contact, breastfeeding, or from a pregnant person to their baby.
Which animals commonly carry Leptospira bacteria?
Many mammals can carry Leptospira bacteria without appearing sick. Common carriers include rats, mice, dogs, cattle, pigs, horses, raccoons, and other wild animals. Rodents are among the most important sources of infection because they can shed the bacteria in their urine for long periods.
Can leptospirosis be prevented with antibiotics?
In certain high-risk situations, healthcare professionals may prescribe preventive antibiotics before or shortly after exposure to contaminated water or environments. However, preventive antibiotics are not recommended for everyone and should only be taken under the guidance of a healthcare provider.
Who is at the highest risk of developing severe leptospirosis?
People with weakened immune systems, older adults, and those with chronic liver or kidney disease may have a higher risk of developing severe illness. Individuals who delay treatment after symptoms begin are also more likely to experience serious complications, including Weil’s syndrome.
Can pets get leptospirosis?
Yes. Dogs are particularly susceptible to leptospirosis and can become seriously ill. Signs may include fever, vomiting, loss of appetite, lethargy, jaundice, and kidney problems. Vaccination is available for dogs and can significantly reduce their risk of infection. If you suspect your pet has leptospirosis, contact a veterinarian promptly.
Can I get leptospirosis more than once?
Yes. Recovering from leptospirosis does not always provide lifelong immunity because there are many different types of Leptospira bacteria. Therefore, it is possible to become infected again after future exposure to a different strain.
Is there a vaccine for leptospirosis?
Vaccines are available for animals, including dogs and livestock, in many countries. However, there is no widely available vaccine for the general public in most countries. Therefore, avoiding contaminated water, wearing protective clothing, practicing good hygiene, and controlling rodent populations remain the most effective ways to prevent infection. Ask your healthcare professional if you have additional questions.
