Leptospirosis

Overview

Leptospirosis is an infection caused by bacteria found in the urine of animals such as rats, cattle, and pigs. People can get it from contact with contaminated water or soil, especially through cuts or if contaminated water splashes into the eyes, nose, or mouth.

Leptospirosis is rare in most parts of the world, but cases can increase after floods or in rural and tropical areas.

Anyone can get it, but it is more common in farmers, sewage workers, veterinarians, and people who swim or wade in freshwater lakes and rivers that may be contaminated.

Symptoms

Common symptoms

• High fever
• Headache
• Muscle aches, especially in the calves and thighs
• Chills
• Red eyes
• Nausea and vomiting
• Diarrhea
• Abdominal pain

Symptoms in children

• Children can have the same symptoms as adults, plus stomach pain, vomiting, and sometimes a rash.

Symptoms in older adults

• Older adults may have more severe symptoms, and the infection can cause confusion, extreme tiredness, and a higher risk of dehydration.

Causes

Main causes

• Leptospira bacteria from the urine of infected animals, such as rats, cattle, pigs, and dogs
• Contact with contaminated water, soil, or food
• Bacteria entering the body through broken skin, or through the eyes, nose, or mouth

Risk factors

• Occupations like farming, veterinary work, plumbing, and sewage work
• Recreational activities in freshwater lakes, rivers, or flooded areas
• Living in areas with poor sanitation or rodent problems
• Travel to tropical or subtropical regions

When to see a doctor

See a doctor urgently if:

• If you have a fever and have been around floodwater, freshwater, or potentially contaminated animal urine, see a doctor the same day.
• If you develop jaundice, severe headache, or reduced urine, seek urgent medical care.

Book a routine appointment if:

• If you feel unwell with mild fever, body aches, or fatigue and think you might have been exposed, make an appointment with your doctor.

Diagnosis

Your doctor will ask about your symptoms and any contact with contaminated water or animals, then order tests to check for the bacteria or your body's immune response.

Tests that may be done

• Blood tests
• Urine tests
• In severe cases, a sample of spinal fluid may be tested

What to expect at your appointment

You may be asked to rest and wait for results. In some cases, treatment is started before the results come back, because early treatment is important.

Treatment

Leptospirosis is treated with antibiotics. Early treatment increases the chance of a fast and full recovery. Some people with more severe illness need hospital care for fluids and close monitoring.

Self-care at home

• Rest as much as possible until your energy returns
• Drink plenty of fluids unless you are told otherwise
• Use fever or pain relief exactly as recommended by your doctor or pharmacist
• Keep any follow-up appointments for repeat tests

Medical treatments

Antibiotics are given by mouth or through a drip in the hospital. For severe cases, supportive care in the hospital — such as fluids through a drip, oxygen, or monitoring of kidneys and liver — may be needed. Your doctor will decide the best treatment plan for you.

When is surgery considered?

Surgery is not used to treat leptospirosis.

Living with this condition

After treatment, you may feel tired for several weeks. Give your body time to recover and do not rush back to heavy activity.

Lifestyle tips

• Avoid alcohol while your liver is recovering
• Stay hydrated with water or clear fluids
• Take precautions to avoid re-exposure, such as staying away from possibly contaminated water

Diet and exercise

Eat a balanced diet with plenty of fruits and vegetables to support recovery. Start with light activities such as walking and gradually increase them as you feel better.

Mental health and emotional wellbeing

Dealing with an infection can feel stressful. Some people feel anxious about being exposed again or about their health. Talking to others can help.

Prevention

Yes, the risk can be reduced by avoiding contact with contaminated water, controlling rodent populations, and wearing protective clothing in high-risk settings.

Vaccines

There is no widely available vaccine for people in most countries. Ask your local health authority or travel clinic about any recommendations.

Screening programmes

Routine screening is not recommended for everyone. People at high risk, such as certain workers, may be checked by their employer or health service.

Complications

If left untreated

• Kidney damage
• Liver failure (yellowing of the skin and eyes)
• Meningitis (swelling of the lining around the brain)
• Breathing problems
• Severe bleeding

Long-term outlook

With early treatment, most people recover within a few weeks, though tiredness can last longer. Rarely, severe cases can be life-threatening, but prompt medical care greatly improves the chances of a good recovery.

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