What is Leptospirosis?
Leptospirosis is a bacterial infection caused by Leptospira bacteria. It is commonly known as "rat fever" in Sri Lanka because it is primarily spread through water or soil contaminated with the urine of infected animals, especially rats.
It is a significant health problem in Sri Lanka, particularly during the rainy season and floods, and among paddy farmers, sewer workers, and people exposed to contaminated flood water.
How Do You Get Leptospirosis?
The bacteria enter the body through:
- Cuts or wounds on the skin that come in contact with contaminated water or soil
- Eyes, nose, or mouth exposure to contaminated water
- Prolonged wading in flood water or stagnant water
- Working in paddy fields, farms, or areas with rat infestation
- Contact with urine, blood, or tissues of infected animals (rats, dogs, cattle)
Risk Factors (Common in Sri Lanka)
Occupational
- Paddy farmers
- Sewer and drainage workers
- Garbage collectors
- Livestock handlers
- Military personnel in jungle areas
Environmental
- Exposure to flood water
- Living near canals or waterways
- Walking barefoot in contaminated areas
- Rainy/monsoon season
- Areas with rat infestation
Symptoms
Symptoms usually appear 7 to 14 days after exposure (range: 2-30 days). The disease can range from mild to life-threatening.
| Mild Disease | Severe Disease (Weil's Disease) |
|---|---|
|
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Diagnosis
Your doctor will suspect leptospirosis based on your symptoms and exposure history. Tests include:
- Full Blood Count (FBC) — may show increased white cells, low platelets
- CRP — usually elevated
- Liver function tests — often abnormal
- Kidney function tests (creatinine) — may be elevated
- Leptospira IgM antibody test — confirms the diagnosis
- Urine analysis
Treatment
Medical Treatment
- Antibiotics: Essential and most effective when started early. Commonly used: Doxycycline, Amoxicillin, or IV Penicillin for severe cases.
- Fluids: Adequate hydration is critical. IV fluids may be needed.
- Paracetamol: For fever and pain. Avoid NSAIDs (ibuprofen) as they can worsen kidney problems.
- Hospital admission: Required for severe cases with jaundice, kidney failure, or bleeding.
- Dialysis: May be needed if kidney failure develops.
Prevention
- Avoid wading in flood water — if unavoidable, wear boots and gloves
- Cover wounds with waterproof dressings before exposure to water or soil
- Wear protective footwear in paddy fields and muddy areas
- Control rat populations — proper waste disposal, rat traps, keeping food covered
- Prophylactic antibiotics: Doxycycline 200mg weekly may be prescribed for high-risk workers during rainy seasons (consult your doctor)
- Wash hands and feet thoroughly after exposure to potentially contaminated water
- Avoid drinking untreated water
When to See a Doctor
Seek medical attention immediately if:
- You develop fever with muscle pain within 2-4 weeks of exposure to flood water, paddy fields, or contaminated areas
- Yellowing of eyes (jaundice)
- Reduced or no urine output
- Red eyes without discharge
- Severe calf muscle pain
- Any bleeding
- Confusion or extreme weakness
- Difficulty breathing
Important: This information is for educational purposes only. If you are unsure about your symptoms or they are severe, please consult a doctor. Our doctors are available for home visits and telemedicine consultations.