Leptospirosis

People with symptoms of leptospirosis most often have mild flu-like symptoms, however occasionally severe illness resulting in liver or kidney damage can occur. Symptoms of leptospirosis in people include:

• Fever
• Headache
• Chills
• Severe muscle pain (especially calves and thighs)
• Red eyes
• Rash, yellow eyes and skin, vomiting, diarrhea, confusion, and liver and/or kidney damage can also occur.

People typically get sick about a week after they are exposed but it can take as little as 2 days and as long as 30 days for someone to show symptoms. Most people do not show any signs of illness. Certain types of leptospirosis can be more severe, especially for people who are older or have underlying medical conditions.

Prevention

• Wear protective clothing (such as gloves and gowns/coveralls) and waterproof shoes or boots to avoid exposure to contaminated urine or urine-contaminated water or soil.
• Cover any cuts or wounds with waterproof dressings before potential exposure to contaminated infected animals, or contaminated urine or water.
• Avoid swimming and other recreational activities in water that may be contaminated with animal urine, or drinking potentially contaminated water.
• Avoid contact with rodents and wildlife to reduce exposure to the bacteria.
• Avoid exposure to urine and urine-contaminated soil, water, grass, food or bedding from infected animals (such as rodents, wildlife, farm animals, and other dogs). Wash your hands after handling or cleaning up animal waste.
• People who have depressed immune systems or are pregnant should avoid contact with potentially infected animals.

Additional Materials

• Factsheet for Pet Owners [PDF]

Infection control recommendations for animal facilities (veterinary clinics and boarding facilities)

• Avoid contact with urine from infected dogs
• Pregnant or immunocompromised individuals especially should avoid contact with potentially infected dogs and their urine
• Wear protective equipment such as gloves, face shield or mask, and gown when caring for ill patients or cleaning up their urine or other body fluids
• Wash hands with soap and water after interacting with patients or cleaning up their urine/body fluids
• Infected dogs should be placed in floor-level cages, if possible, and housed away from high-traffic areas to limit urine-contamination.
• Infected dogs should be walked in a designated and easy to clean area, with hard, non-permeable surfaces, away from other dogs.
• Use 1:10 (1 part bleach and 9 parts water) solution or other antibacterial disinfectant cleaning solutions to clean areas where infected dogs are housed, where they have urinated or other areas contaminated by body fluids
• Normal laundering of urine-contaminated bedding and towels will inactivate the bacteria
• Avoid aerosolization of bacteria through activities such as pressure washing runs where dogs are housed
• Notify public health and seek medical attention if staff that have been caring for infected dogs develop signs of illness
• Start infection control procedures for any dog suspected of having leptospirosis (while awaiting laboratory confirmation)
• Kennels should be clearly marked with warning label to alert people to the presence of a leptospirosis positive or suspect dog.
• Ask owners if their dog has been recently ill or been previously vaccinated against leptospirosis.

If a dog owner, family member, or veterinary or boarding/daycare staff develops flu-like illness, they should seek medical care from their doctor and notify their local public health official.

Additional Materials

• Factsheet for Boarding Facilities [PDF]

• Factsheet for Veterinarians [PDF]

• Keep leptospirosis on the differential for people with compatible symptoms, especially for those with a dog with recent illness or diagnosis of leptospirosis
  • The incubation period ranges from 2–30 days, with illness usually occurring between 5–14 days of exposure.
  • The majority of people who are infected with leptospirosis are asymptomatic. Diagnostic testing is not currently recommended for asymptomatic individuals.
  • Those who have symptoms typically experience flu-like illness including fever, headache (can be severe and include retro orbital pain and photophobia), myalgia (especially calves and lower back), conjunctivitis without purulent discharge, nausea/vomiting, diarrhea, cough, abdominal pain, and a rash (rare).
  • Severe disease occurs in up to10% of symptomatic persons and can involve renal and hepatic failure, meningitis, and/or respiratory distress. Approximately 5-15% of severe cases are fatal.
• If you suspect that a person has leptospirosis, begin appropriate antimicrobial treatment as soon as possible (without awaiting diagnostic test results), as early treatment may help decrease the severity and duration of disease. Doxycycline (oral) or penicillin (IV) is usually the antibiotic of choice, however other options are available.
• Confirmatory diagnostic tests for leptospirosis include PCR on blood or urine specimens, and serology with the microscopic agglutination test (MAT). Serology by ELISA is a screening test, and positive results should be confirmed by MAT.
• Report suspect leptospirosis cases to the Maricopa County Department of Public Health at 602-506-6767