Health Matters – Leptospirosis

(by Antoinette Gough, from IMC Newsletter, Summer 2003)
Avoiding and treating Leptospirosis, or Weil’s Disease.

Leptospirosis or Weil’s disease is an infection resulting from exposure to the Leptospira bacterium. Many cases have been documented amongst people indulging in leisure activities that expose them to the disease, such as cavers, canoeists, climbers, walkers, windsurfers, and anglers etc. It is spread predominately by the urine of animals, but most cases result from rats, and therefore, it is a sensible policy to assume all rats, wherever they are found, harbour the infection. Those entering high-risk areas need to be aware of the disease, and how to minimise their exposure.

How it’s transmitted:

The bacteria is water-borne and can live for four weeks in fresh water, and up to six weeks in urine-saturated soil. The disease enters the body through cuts, via the lining of the mouth, nose, or the moist surfaces of the eyes. Exposure requires contact with water, or the animals’ urine directly.

Symptoms of the disease:

The incubation period is usually 7-12 days, although it may occasionally be as short as 2 days. The early symptoms are similar to those of flu, with fever, muscular aches and pain, nausea, loss of appetite, headaches, and severity can vary between individuals. Later symptoms include bruising of the skin, sore eyes, nosebleeds, and jaundice. The fever lasts for approximately 5 days, and then a significant deterioration follows. The initial appearance of a fever following a visit to a high-risk area is reliable, and you should assume you have contracted the disease, until proved otherwise.

Areas of high risk:

To minimise the chances of contraction, the only truly effective way is to avoid contact with infected water or soil, and thus avoid exposure to the bacterium. Climbers using Dalkey Quarry and places where there are known colonies of rats, should avoid placing a rope in their mouth when climbing, pay close attention to cuts, or scratches received from gorse, brambles or rock, and ensure waterproof plasters are applied. Those who need to enter the water such as canoeists, or cavers, should aim to minimise immersion, and again cover any cuts with waterproof dressings. Wear over-suits and gloves, and do not if possible, immerse the head or swallow water.

What to do if you suspect you’re infected:

If you exhibit any of the symptoms after exposure, it is extremely important to contact your doctor urgently. You should say you suspect Leptospira, as many GP’s do not associate fever-related symptoms to the infection without a helpful hint. If you miss or ignore the early symptoms, and start seeing the later, and more serious indications of the disease, it is advised that you present yourself directly to the A&E department of a Hospital; again stating you may have the infection. If left untreated, it could cause kidney and liver failure leading to death, and therefore, it is imperative that treatment with antibiotics be started as soon as possible to limit the effects of the infection.

There is no human vaccine available due to the large number of strains associated with the disease. You cannot catch it from shaking hands, talking to a person, or petting an animal, however, if you suspect someone of being infected, avoid contact with bodily fluids, toothbrushes, facecloths and suchlike.

Use your common sense; be aware and alert at all times. Be informed of the risks you run while enjoying your chosen leisure activity, and remember that many people contract the infection every year, and most make a full recovery with the correct treatment.

Careful attention to prevention is the way of the wise.