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Leptospirosis is a spirochetal infection transmitted to humans by exposure to water contaminated by the urine of infected animals. Outbreaks often occur at times of flooding, when sewage overflow may contaminate water sources. Those who work with animals, such as farmers, animal handlers, and slaughterhouse workers, and those work in sewers are at greatest risk. The disease has also been reported among travelers after swimming, wading, or rafting in contaminated lakes or rivers.
The incubation period usually ranges from 5 to 14 days. Initial symptoms may include fever, chills, headache, muscle aches, conjunctivitis (pink eye), photophobia (light sensitivity), and rash. In most instances, the symptoms subside uneventfully in 4-7 days. However, in a minority of cases, the illness enters a second, more serious phase, characterized by worsening headaches, fevers, chills, and muscle pains. A rash is often observed. Complications may include meningitis, kidney failure, liver failure, and bleeding into the lungs or gastrointestinal tract. The second phase may be separated from the first by several days, during which time the patient appears relatively well. The disease is treated with either oral doxycycline or intravenous penicillin. Severely ill patients require admission to the hospital for intravenous fluids and aggressive supportive care.
In general, most travelers are at low risk for leptospirosis. The risk may be minimized by avoiding exposure to bodies of fresh water that may be contaminated by animal urine. There is no vaccine. Those who are visiting an area where an outbreak is in progress may be given a prophylactic 200 mg dose of doxycycline, either once weekly or as a one-time dose.
From the Centers for Disease Control
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