In the month after Hurricane Maria, Puerto Rico has reported at least 76 cases of suspected and confirmed leptospirosis, including a handful of fatalities, said Dr. Carmen Deseda, the state epidemiologist for Puerto Rico.
Not an epidemic
In 90% of cases, leptospirosis only causes mild flu-like symptoms, such as a headache, chills and muscle pain.
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.
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.
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.
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