• Infectious Diseases A-Z: Leptospirosis in Puerto Rico

water pipe with rushing contaminated waste water from a street or factoryAt least 76 confirmed and suspected cases of a bacterial infection called leptospirosis have been reported in Puerto Rico since Hurricane Maria swept through the island in September. Dr. Pritish Tosh, a Mayo Clinic infectious diseases specialist, says, "Leptospirosis is a serious infection that people can often get when they are exposed to contaminated water."

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"There have been cases where people are kayaking or a famous outbreak in Hawaii amongst Ironman triathletes. But the common thing here is that people are exposed to contaminated water, and often it’s contaminated with animal urine, which is a common way to get leptospirosis to infect a person," says Dr. Tosh.

The Centers for Disease Control and Prevention (CDC) says leptospirosis, which is mostly spread through the urine of infected animals can get into water or soil, and survive there for weeks to months. "Leptospirosis is really not transmitted from person to person," says Dr. Tosh. "It’s unlikely that that’s going to come into the U.S. mainland — even if people come back infected — because of routine sewage treatment."

Symptoms of leptospirosis include:

  • Fever
  • Chills
  • Headache
  • Muscle aches
  • Vomiting
  • Diarrhea
  • Abdominal pain
  • Jaundice (yellowing of the skin and eyes)
  • Skin rash
  • Red eyes

Treatment is available, says Dr. Tosh. "We do have antibiotics that are effective against leptospirosis. Unfortunately, this is a very serious infection, and antibiotics should be started as quickly as possible."

For now, public health officials say the infectious disease is contained to the island. "It’s unlikely we’re going to see it in the mainland," says Dr. Tosh. "But it’s important that, when we’re trying to help our fellow citizens in Puerto Rico, we’re mindful that the public health infrastructure has really been destroyed there and that we are conscious about the health impacts of such a public health infrastructure demise."

The CDC recently provided health care providers advice on treating patients in hurricane-affected Puerto Rico and the U.S. Virgin Islands. The agency urges health care providers to remain vigilant for infectious diseases, such as leptospirosis, dengue fever, hepatitis A infection, typhoid fever, vibriosis and influenza.

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