Leptospirosis Outbreak In NYC Spread By Rat Urine, 13 Hospitalized, One Dead - Forbes
Rats. New York City (NYC) has had more cases of leptospirosis in 2021 than in any other prior year. And 2020 still has a little over two months to go.
That's according to a recent NYC Department of Health and Mental Hygiene advisory. So far this year, the Big Apple has already had 14 reported cases of people infected with the spirochete bacteria Leptospira interrogans. And leptospirosis isn't the "it's just leptospirosis, I should be able to make our date" type of infectious disease. Of the 14 cases, 13 have landed in the hospital with liver and kidney failure, two had severe lung disease, and one ended up dying.
What's probably the most common way of getting infected with Leptospira interrogans in NYC? Well, urine for a surprise. It's rat urine.
Yep, who would have known that rat urine could be a bad thing? When rats are infected with the bacteria, they can excrete the microbes through urine. That can leave soil, water, food, or anything else around them contaminated with Leptospira interrogans. After all, news flash, rats don't tend to pee in little rat toilets. Instead, they pee wherever they feel like doing so. Apparently, rats like their freedom and don't listen to mandates to use toilets or wear clothes for that matter.
When anything contaminated with such infectious rat urine comes into contact with your mucous membranes or open wounds, the bacteria can enter your body. Eating or drinking anything contaminated can introduce the Leptospira interrogans into your body too. This is yet another reason why you shouldn't drink rat urine or eat soil. The good news is that human-to-human transmission of the bacteria has been quite rare. So it is OK to hang around your friend after he or she has eaten soil at least from a leptospirosis standpoint.
Once you are infected, it typically takes two days to four weeks for symptoms to emerge, if you do end up having symptoms. The Centers for Disease Control and Prevention (CDC) warns that leptospirosis can result in a wide range of symptoms, many of which can be mistaken for other diseases. Such symptoms include high fever, headache, chills, muscle aches, vomiting, jaundice (yellow skin and eyes), red eyes, abdominal pain, diarrhea, and rash. As you can imagine, the next time you have a headache, don't automatically assume that it is leptospirosis, unless, of course, it developed about a week after downing that rat urine cocktail.
The illness may have two phases. The first phase may consist of symptoms like fever, chills, headaches, muscle aches, vomiting, or diarrhea. You may seemingly recover from this phase just to get sick again later. If you do end up having a second phase, this next phase tends to be much more severe. This is when liver or kidney failure or severe respiratory problems may occur. Another possible life-threatening consequence is meningitis, which is inflammation of the membranes surrounding your brain.
Here is a scanning electron micrograph of Leptospira bacteria. (Photo By BSIP/UIG Via Getty Images)
It's important to diagnose and treat leptospirosis as early as possible. Doctors can diagnose leptospirosis by detecting presence of the bacteria in your blood, urine, or spinal fluid. They also may detect antibodies against the bacteria in your blood. When administered early enough, treatment with antibiotics, such as doxycycline or penicillin, can prevent more severe disease and hasten recovery. When you already have severe disease, intravenous antibiotics may be necessary to prevent even worse complications such as death.
Apparently all but one of the 14 cases this year caught Leptospira interrogans in NYC. The exception was a person who got it while traveling. The cases all appear to be unrelated with one another and not clustered. All cases seemed to be associated with rat-infested environments. Clearly rats are more common in lower income neighborhoods and places that don't maintain good sanitation. It's not common to hear the words "billionaire's mansion infested with rats," at least not when you are referring to non-human rats.
Although 14 may not sound like a lot of cases, it is again much higher than previous years. From 2006 to 2020, NYC had only 57 cases of leptospirosis. Take away the 13 related to international travel, and that leaves you with 44 originating from NYC. During this time span, the most reported cases in one year was seven. The age of people infected ranged from 20 to 80 years with 46 being the median age. The vast majority (90%) of the cases were male, although the bacteria doesn't necessarily prefer men.
Why have the leptospirosis numbers been higher in 2021? Well, as I reported for Forbes last year, rats did become more aggressive in 2020 during the restaurant closures, apparently because they had to find other sources of food. During the pandemic, sanitation has suffered too. Recently, a report by Stacey Sager for ABC7 had the following wonderful headline: "Coronavirus Update NYC: Neighborhoods hit hardest by Covid now buried under garbage." While other animals can carry Leptospira interrogans, in NYC, rats are probably the most common carrier.
So how do you avoid getting leptospirosis? First, maintain good sanitation around you. If you have to use the words "rat infestation" when describing your apartment or home, things have gone too far in the wrong direction. Secondly, wear protective clothing and footwear when walking in areas that may have rat urine contaminated water or soil. Third of all, stay away from rats, which is a good idea in general. And if someone suggests bathing in or drinking rat urine, just say no.
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