Leptospirosis

Leptospirosis is a bacterial infection caused by contact with the urine (or some other body fluids) of infected animals either directly, or from soil or water containing their urine (pee).

Animals that can become infected include cattle, pigs, horses, dogs, rodents and wild animals.

Who is at risk of leptospirosis?

Workers in the meat processing industry are most at risk, followed by farmers working with animals. Veterinarians are also at risk of leptospirosis. In Aotearoa New Zealand leptospirosis is the most common infectious disease caught in the workplace. About 50 to 100 cases are reported each year.

Symptoms can range from minor flu-like symptoms to serious illness needing hospital admission, eg, meningitis and kidney or lung failure. It can be fatal.

The first symptoms of leptospirosis may include:

• fever
• chills
• cough
• headache
• muscle aches
• red eyes
• tummy pain
• diarrhoea (runny poos) 
• nausea (feeling sick)
• vomiting (being sick)
• jaundice (yellowing of skin and eyes)
• rash. 

Leptospirosis can occur in 2 phases – you might experience these initial symptoms and recover before becoming unwell again. The second phase is often more serious and may include meningitis or kidney or liver failure.

The flu‐like symptoms usually start 5–14 days after exposure, but can appear as soon as 2 days or up to 30 days after contact with the infected urine. 

How long does it last?

The illness can last from a few days to several weeks and without treatment it may take you several months to recover.

Leptospirosis spreads from animals to humans. Leptospira bacteria live in the kidneys of some animals (eg, rats, hedgehogs, possums or farm animals) and are present in their urine (pee). You get infected through contact with the urine of these animals or with water that's been contaminated by infected urine. The bacteria enter your body through cuts in your skin or through the inside surfaces of your nose, mouth and eyes.

You're most likely to get it when working directly with animals in the meat processing, farming or veterinary industries.

You may also get it from:

• hunting
• gardening in farm soil
• walking barefoot in paddocks or gardens
• touching sick animals
• eating or drinking contaminated food or water
• smoking without washing your hands after animal contact
• cleaning out sheds where rats, mice or hedgehogs live
• working in forests
• wading in flood waters
• playing in contaminated rivers or lakes.

It's unusual for leptospirosis to be spread from one person to another.

You don’t have to come into direct contact with the urine or tissue of an infected animal. Even a splash or fine spray of urine or indirect contact with urine-contaminated water (eg, water used to clean down a cowshed) can spread a large number of  the spiral-shaped bacteria (leptospires).

Note: Flood waters may become infected when rivers overflow onto nearby farmland, so it's important to protect yourself if you're working or living in flooded areas. Read more about how to protect yourself in the 'how to prevent leptospirosis' section below. 

Image credit: Canva

Diagnosis

Leptospirosis is diagnosed by blood tests to check for the presence of antibodies or to detect the bacteria in your blood.

Treatment

You will need antibiotics as the treatment for leptospirosis. Depending on whether your illness is mild or serious, you may get oral antibiotics (by mouth) or need to be admitted to hospital to get antibiotics through your vein.

You may also need dialysis or breathing support through a ventilator machine if you have serious complications.

It’s important to see your healthcare provider if you have symptoms or think you may have leptospirosis. Early treatment will stop the illness from becoming severe.

There are 2 reasons why it’s important that you see your healthcare provider if you think you might have leptospirosis.

• Getting treatment will mean that your symptoms are less severe, and you’ll recover more quickly.
• Leptospirosis is a notifiable disease in Aotearoa New Zealand which means that any case has to be reported to the local Medical Officer of Health. This is so that other people who may also have become infected can be informed, and the source of the infection can be identified. For this reason you may be asked about your employment, and recent contact with farm animals, recreational water activities and travel.

You can protect yourself by being careful in risky environments and not touching animal urine.

Things you can do include:

• covering and cleaning any cuts on your skin
• wearing personal protective equipment in high-risk workplaces, (eg, meat processing facilities, farms, veterinary clinics, forests or the bush
• avoiding high risk areas if you have open wounds, broken skin (eg, eczema), and if you're pregnant or trying to become pregnant
• washing your hands after animal contact and before you eat, drink or smoke
• getting animals vaccinated (there's no vaccine for humans)
• avoiding swimming in ponds, lakes or rivers that could be contaminated.