Leptospirosis hits New York- but what is it?

One person has died and two others have been infected by an outbreak of leptospirosis – a rare bacterial infection frequently spread by rat urine.

The New York City Department of Health and Mental Hygiene (DOHMH) have identified the cases – which occurred in the past 2 months in a one block section of the Bronx (Grand Concourse).

The three (male) patients were admitted to hospital severely ill with acute kidney and liver failure. One of the patients died, according to the DOHMH, but the other two survived and were discharged.

In 90% of cases, leptospirosis only causes mild flu-like symptoms, such as a headache, chills and muscle pain. The grouping of 3 patients with the illness together in one area is very unusual, as there are generally only 1-3 sporadic cases reported per year in New York City, with only 26 cases in NYC from 2006-2016, according to reports from the DOHMH.

little-rat-water

Haemorrhagic jaundice

Leptospirosis is spread to humans by animals and is also known sewerman’s flu, swamp fever, haemorrhagic jaundice, mud fever and swineherd’s disease.

‘Weil’s disease’ is diagnosed in patients exhibiting a more severe form of Leptospirosis, with symptoms including jaundice (with hepatocellular necrosis), liver failure and acute kidney injury.

The lungs are involved in approximately 70% of cases of leptospirosis. Pulmonary symptoms vary from cough, dyspnoea, and haemoptysis to adult respiratory distress syndrome and massive pulmonary haemorrhage.

leptospira-sp-bacteria-cnri

Leptospira Sp. by Cnri

Urine trouble

It’s possible to become infected by touching soil or water contaminated with the urine of wild animals infected with the leptospira bacteria.

The bacteria usually enters the body through cuts or grazes, or via the lining of the nose, mouth, throat or eyes. Very few patients suffer the life-threatening illness known as Weil’s disease, thought to kill two or three people a year in Britain.

It was widely reported to have been the cause of death of Olympic gold medal-winning rower Andy Holmes.

rat-in-the-grass

Naturally aquatic

Animals known to be carriers of the leptospira bacteria include cattle, pigs, dogs and rodents, particularly rats. Infected animals carry the bacteria in their kidneys, often without symptoms.

They can excrete leptospires in their urine for some time. The spirochaetes are shed from the urine and can survive in the environment for several months in moist, warm conditions.

Leptospires are naturally aquatic organisms and are found in fresh water, damp soil, vegetation, and mud. Flooding may spread the organism because, as water saturates the soil, leptospires pass directly into surface waters

The condition is uncommon in the UK, but people who regularly deal with animals, such as farmers and vets, have a higher risk of developing leptospirosis. A diagnosis of leptospirosis can be confirmed by running a series of blood and urine tests to check for specific antibodies.

There’s no available human vaccine effective against leptospirosis, but an animal vaccine is available.

If you live in New York, it’s probably wise not to go barefoot while disposing of garbage in a basement or while staggering through dirty back alleys. Aside from that, the risks are minimal.



Categories: Feature Articles

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