Leptospirosis: A Disease Spread by Animal Urine, and Worse After Floods

Leptospirosis is a disease caused by Leptospira bacteria, found in water or soil contaminated by the urine of infected animals. It affects many kinds of animals and people. Untreated, it can cause kidney damage, meningitis (inflammation of the membranes around the brain and spinal cord), liver failure, breathing trouble and death.

It occurs worldwide, including throughout the United States: about 1 million people get it each year, and nearly 60,000 die. Risk often rises after hurricanes and floods, when people touch contaminated water or soil.

Image from CDC's page on leptospirosis.

Symptoms

Symptoms vary widely and are easily mistaken for other diseases, and some people have none:

• fever and chills;
• body or muscle aches;
• headache;
• nausea or vomiting, diarrhea, stomach pain;
• yellow skin and eyes (jaundice);
• fatigue;
• red eyes;
• rash.

Illness usually begins 2 to 30 days after contact with the bacteria and can come in two phases: first fever, chills, headache, aches, vomiting or diarrhea; then, after a lull, a more severe phase for some, with kidney or liver failure or meningitis. It can last days to weeks, and without treatment recovery can take months.

If you think you may have leptospirosis, see a health care provider right away for testing and treatment.

How people catch it

The bacteria can survive in water or soil for weeks to months. People become infected by:

• contact with water or soil holding urine or body fluids of infected animals, especially after hurricanes, floods or heavy rain;
• touching an infected animal's body fluids;
• eating food or drinking water contaminated with infected animals' urine.

It rarely spreads from person to person.

After heavy rain, hurricanes or floods, animal urine on soil and other surfaces can wash into floodwater, rainwater and streams. Image from CDC's page on leptospirosis.

Who is at risk

• people who swim, kayak, canoe or raft in rivers, swamps or creeks;
• hikers and hunters;
• gardeners and people doing yardwork or outdoor cleanup;
• workers in veterinary clinics, dairy farming, butchering and slaughterhouses, sanitation and sewage, animal control, the military and first response;
• people experiencing homelessness or living in shelters where they may contact rodents or animal urine.

Lowering the risk

• Stay out of water that might hold animal urine, especially after hurricanes, floods or heavy rain.
• Avoid contact with animals that may be infected.
• Cover cuts and scratches with waterproof bandages.
• Wear waterproof clothing and boots near floodwater or possibly contaminated water or soil.
• Before water sports, check with your local health department — or CDC Travelers' Health abroad — about leptospirosis where you'll be, and wear shoes where it's known.
• At work: wash hands often; wear gloves, footwear and eye protection; clean and disinfect surfaces and equipment; vaccinate animals and isolate sick ones; and control rodents.

Treatment

Leptospirosis is treated with antibiotics such as doxycycline or penicillin, started as early as possible when a provider suspects it; severe cases may need IV antibiotics. Early treatment can prevent severe illness and shorten it.

In animals

Many wild and domestic animals carry the bacteria: livestock (cows, pigs, horses, sheep, goats), dogs, cats, rodents, marine mammals such as sea lions and seals, and wild and zoo animals. They catch it the same way people do. Some show no signs, and infected animals can keep shedding the bacteria in their urine for months or years.

Sources

Based on "About Leptospirosis," Centers for Disease Control and Prevention; a work of the United States government in the public domain.