Leptospirosis

article057At the 1995 Raid Gauloises (held in Sarawak, Borneo), the 1998 Eco Challenge Borneo (held in Sabah) and Borneo-based Outdoor Quest races, competitors contracted leptospirosis. As with malaria, the degree of infection and the severity of symptoms do vary from person to person. Fortunately, as proven at last year’s Outdoor Quest, preventative medication is effective.

Leptospirosis is a bacterial disease resulting from contact with contaminated water, food or soil. Severe infection causes a systemic illness that often leads to renal and hepatic dysfunction.

The infectious agents, Leptospira bacteria, are carried by a variety of wild and domestic (cattle, pigs, horses, dogs, rodents) animals. They are most commonly transmitted indirectly to humans; through food, soil and water contaminated by urine excreted by the infected animals. Infection occurs when contaminated food or water is consumed or when contaminated water and soil comes into contact with cut or abraded skin, mucous membranes (nose) and conjunctivae (eyes).

Although leptospirosis occurs worldwide, it is common in temperate and tropical climates where the bacteria proliferate in fresh water, damp soil and vegetation.

Also known as swamp fever, mud fever and swineherd’s disease, leptospirosis is predominantly an occupational disease (sewer workers, plumbers, veterinarians, rice-field workers). But, it is increasingly recognised as a recreational disease contracted by those travelling to tropical and equatorial regions. Risky activities include swimming, caving (soil contaminated by infected bat guano), hiking, wading through rivers, white-water rafting, mountain biking through mud and puddles, and other outdoor sports played in contaminated water. The risk of infection is increased during heavy rainfall and periods of flooding when water saturates the environment spreading Leptospira present in contaminated soil directly into surface waters.

The incubation period (time from exposure to the presentation of symptoms) varies from 2-days to 4-weeks. In the first phase of the illness, the infected person will preset with fever, chills, headache, muscle aches, vomiting and/or diarrhoea – symptoms also associated with other infections like malaria and Dengue fever. In this first phase the patient may recover, feeling well for 2-3 days before becoming ill again. During this more severe Phase Two (Weil’s Disease) meningitis, renal (kidney) dysfunction, hepatic (liver) necrosis and pulmonary (lung) dysfunction are characteristic. Patients are only likely to develop full-blown Weil’s Disease if contamination is high and treatment is delayed.

The illness usually lasts from a few days to 3 weeks but may last up to 3-months if the infection progresses to Phase Two. Recovery takes several months and may take up to 2-years if you’re trying to get back into racing condition. A blood test will confirm infection (be sure to notify your doctor of your exposure risk).

Antibiotic, usually doxycycline, treatment should be started immediately.

PREVENTION
In the case of leptospirosis, behavioural actions like not walking around barefoot, keeping wounds clean and covered, and regularly cleaning your hydration mouthpiece – especially after it has been lying on the ground – will limit exposure and risk.

Although no preventative vaccine exists, chemoprophylaxis is available. Outdoor Quest’s medical team provided each competitor at the 2003 and 2004 events with the antibiotic doxycycline, which is most commonly taken as an anti-malarial drug. Effective in preventing leptospirosis, doxycycline also offers protection from regular stomach upsets caused by bacterial infections.

APPROPRIATE TREATMENT
Where bacterial and viral infections are to blame for illnesses, appropriate treatment is all-important. One of the big problems when returning from an exotic location, host to a tropical disease, is that doctors back home don’t recognise the symptoms for what they represent. Give your home-town doctor the necessary information (countries visited, duration of stay) to make an accurate diagnosis and provide appropriate and immediate treatment.

Visiting and competing in foreign countries exposes competitors to health risks, which through increased awareness and preventative protocols are greatly reduced

At the 1995 Raid Gauloises (held in Sarawak, Borneo), the 1998 Eco Challenge Borneo (held in Sabah) and Borneo-based Outdoor Quest races, competitors contracted leptospirosis. As with malaria, the degree of infection and the severity of symptoms do vary from person to person. Fortunately, as proven at last year’s Outdoor Quest, preventative medication is effective.

Leptospirosis is a bacterial disease resulting from contact with contaminated water, food or soil. Severe infection causes a systemic illness that often leads to renal and hepatic dysfunction.

The infectious agents, Leptospira bacteria, are carried by a variety of wild and domestic (cattle, pigs, horses, dogs, rodents) animals. They are most commonly transmitted indirectly to humans; through food, soil and water contaminated by urine excreted by the infected animals. Infection occurs when contaminated food or water is consumed or when contaminated water and soil comes into contact with cut or abraded skin, mucous membranes (nose) and conjunctivae (eyes).

Although leptospirosis occurs worldwide, it is common in temperate and tropical climates where the bacteria proliferate in fresh water, damp soil and vegetation.

Also known as swamp fever, mud fever and swineherd’s disease, leptospirosis is predominantly an occupational disease (sewer workers, plumbers, veterinarians, rice-field workers). But, it is increasingly recognised as a recreational disease contracted by those travelling to tropical and equatorial regions. Risky activities include swimming, caving (soil contaminated by infected bat guano), hiking, wading through rivers, white-water rafting, mountain biking through mud and puddles, and other outdoor sports played in contaminated water. The risk of infection is increased during heavy rainfall and periods of flooding when water saturates the environment spreading Leptospira present in contaminated soil directly into surface waters.

The incubation period (time from exposure to the presentation of symptoms) varies from 2-days to 4-weeks. In the first phase of the illness, the infected person will preset with fever, chills, headache, muscle aches, vomiting and/or diarrhoea – symptoms also associated with other infections like malaria and Dengue fever. In this first phase the patient may recover, feeling well for 2-3 days before becoming ill again. During this more severe Phase Two (Weil’s Disease) meningitis, renal (kidney) dysfunction, hepatic (liver) necrosis and pulmonary (lung) dysfunction are characteristic. Patients are only likely to develop full-blown Weil’s Disease if contamination is high and treatment is delayed.

The illness usually lasts from a few days to 3 weeks but may last up to 3-months if the infection progresses to Phase Two. Recovery takes several months and may take up to 2-years if you’re trying to get back into racing condition. A blood test will confirm infection (be sure to notify your doctor of your exposure risk).

Antibiotic, usually doxycycline, treatment should be started immediately.

PREVENTION
In the case of leptospirosis, behavioural actions like not walking around barefoot, keeping wounds clean and covered, and regularly cleaning your hydration mouthpiece – especially after it has been lying on the ground – will limit exposure and risk.

Although no preventative vaccine exists, chemoprophylaxis is available. Outdoor Quest’s medical team provided each competitor at the 2003 and 2004 events with the antibiotic doxycycline, which is most commonly taken as an anti-malarial drug. Effective in preventing leptospirosis, doxycycline also offers protection from regular stomach upsets caused by bacterial infections.

APPROPRIATE TREATMENT
Where bacterial and viral infections are to blame for illnesses, appropriate treatment is all-important. One of the big problems when returning from an exotic location, host to a tropical disease, is that doctors back home don’t recognise the symptoms for what they represent. Give your home-town doctor the necessary information (countries visited, duration of stay) to make an accurate diagnosis and provide appropriate and immediate treatment.

Visiting and competing in foreign countries exposes competitors to health risks, which through increased awareness and preventative protocols are greatly reduced.

Author: Lisa de Speville