Leptospirosis

Leptospirosis: An infectious disease caused by a particular type of bacteria called a spirochete transmitted by rats as well as by skunks, opossums, raccoons, foxes, and other vermin. Leptospirosis occurs worldwide but is most commonly acquired in the tropics. About 100 cases of leptospirosis are reported each year in the US. The disease is becoming a greater risk as more people travel to undeveloped areas of the world. (Athletes who participated in the Eco-Challenge-Sabah 2000 multisport expedition in Borneo, Malaysia, in August 2000 contracted leptospirosis after coming in contact with the Segama River.).

Symptoms begin from 2 to 25 days after, initial direct exposure to the urine or tissue of an infected animal. This can even occur via contaminated soil or water. Veterinarians and farm workers are at particularly high risk.

The illness typically progresses through three phases. The first phase of symptoms includes headaches, muscle aches, eye pain with bright lights, followed by chills and fever. Watering and redness of the eyes occur and symptoms seem to improve by day 5 to 9. The second phase of illness begins after a few days of feeling pretty well. The initial symptoms recur with fever and aching with stiffness of the neck. Some patients develop serious inflammation of the nerve to the eye, brain, spinal column (meningitis), or other nerves. The final third phase, from 2 to 4 weeks after the initial infection, features recurrent fever and muscle aching.

Leptospirosis with liver disease is called Weil's syndrome and is characterized by yellowing of the eyes (jaundice) from liver disease. Patients with Weil's syndrome can also develop kidney disease and have more serious involvement of the organs affected.

Treatment involves high doses of antibiotics which are most effective when initiated early in the course of the illness. Doxycycline and penicillin are examples of antibiotics commonly used.

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