By NewsDesk  @infectiousdiseasenews

The New York City Health Department have reported fourteen people ( 13 local, one travel associated) leptospirosis cases to date in 2021, more than the total number reported to health officials in any prior year.

Rattus norvegicus/National Park Service

Cases have been identified in all boroughs except Staten Island, with no obvious clustering.

Thirteen of the fourteen people were hospitalized with acute renal and hepatic failure, two of whom also had severe pulmonary involvement. One person died as a result of infection. All other hospitalized patients were treated and discharged.

Most cases had a clear history or risk factor which exposed them to an environment with a severe rat infestation. Three cases reported homelessness.

Between 2006 and 2020 in New York City, 57 cases (44 local, 13 international travel associated) of leptospirosis were identified by the Health Department.

Leptospirosis is a worldwide zoonotic disease caused by the spirochete bacteria of the genus and species
Leptospira interrogans. Warm, moist environments are associated with higher rates of disease, with cases occurring in both rural and urban settings.

Clinically, there is a wide spectrum of illness. Symptoms may include fever, headache, chills, muscle aches, vomiting, diarrhea, cough, conjunctival suffusion, jaundice, and sometimes a rash. The incubation period is usually 5–14 days, with a range of 2–30 days. If not treated, kidney failure, meningitis, liver damage, and respiratory distress can occur.

In NYC, most human cases are associated with exposure to rats, or environments where rats live. Infected animals may excrete the bacteria into the environment. Humans can become infected through contact with urine from infected animals, or from water, soil, or food that has been contaminated with the urine of infected animals. The bacteria can enter the body through open wounds or mucous membranes. Drinking contaminated water can also cause infection. Person-to-person transmission is rare.

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