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Rat Urine Is Spreading A Life-Threatening Bacterial Illness In Humans And Dogs

A half dozen people in New York City have recently become ill with an infection commonly transmitted via rat urine. The uptick in cases has led city officials to issue a health advisory cautioning residents to be careful around trash bags and food waste bins outside, which may be contaminated with infected urine.

[1]

So far this year, the New York City Department of Health and Mental Hygiene has recorded six human cases of this bacterial disease, which is called leptospirosis.

[2] Health authorities are calling the number an upward trend, noting that 24 cases were reported in the city in 2023 — the highest count seen in a single year.

"I don't expect a huge outbreak, but there will be scattered cases here and there," says William Schaffner, MD, an infectious disease specialist and professor of preventive medicine and health policy at the Vanderbilt University School of Medicine in Nashville, Tennessee. "Because symptoms can be flu-like and nonspecific, the disease may be difficult to identify, so it's important to raise awareness."

What Are the Symptoms of Leptospirosis?

While most people who get infected will not experience any symptoms, some will have fever, headache, chills, cough, vomiting, diarrhea, red eyes, and jaundice (yellow skin and eyes), according to the Centers for Disease Control and Prevention (CDC).

Dr. Schaffner says that possible distinguishing features of the illness can be muscle aches and pains — particularly in the calves and the lower back — and a sensitivity to light.

Usually, symptoms develop after 5 to 14 days following infection and last from a few days to three weeks or longer.

For some, the illness may seem to disappear, but then it can return more severely than before.

"After three to five days, the symptoms may resolve and you think you're all better," says Schaffner. "But then you get into the second phase — the fever recurs and often that's associated with severe headache and, again, a sensitivity to light."

The CDC estimates that about 10 percent of detected illnesses progress to potentially fatal conditions, such as kidney failure, liver failure, and meningitis.

[3] Leptospirosis during pregnancy can cause fetal complications including fetal death or abortion. For those with severe illness from the infection, the fatality rate ranges from 5 to 15 percent.

The New York City health department is urging doctors to consider leptospirosis in anyone presenting with likely symptoms, especially when there is evidence of acute kidney or liver failure, and possibly pulmonary hemorrhage, or bleeding into the lung.

Treatments Are Effective — Especially Early On

Administration of antibiotics early in the course of the disease has been shown to successfully reduce the severity and duration of leptospirosis.

While blood tests can confirm the infection, the CDC recommends starting a course of antibiotic treatment before getting test results if leptospirosis is highly suspected.

How to Prevent Leptospirosis

"People are infected not so much by direct contact with the animals but often by contact with urine or water that's been contaminated by urine," says Schaffner. The bacteria may enter the body through open wounds or mucous membranes (eyes, nose, mouth).

To lower or eliminate your chances of getting infected, the New York City health department offer these recommendations:

Avoid places where rats may have urinated.

If you cannot avoid areas where there are rats, or if you are cleaning areas where rats have been, use a solution of 1 part bleach and 10 parts water.

Protect yourself from contact with rat urine by wearing rubber gloves, especially if you have cuts or sores on your hands or arms.

Wash your hands with soap and warm water after any contact with areas where rats may live.

Always wear shoes whenever taking trash out.

Avoid wading, swimming, bathing, swallowing, or submerging your head in potentially contaminated freshwater (rivers, streams) especially after heavy flooding. When traveling to tropical regions, do not swim or wade in water that might contain animal urine.

The bacteria can thrive in warm, moist environments for weeks, which may explain why leptospirosis is more common in tropical and subtropical climates. The CDC estimates that every year more than one million cases occur worldwide.

A Warming Planet Could Increase the Number of Leptospirosis Cases Worldwide

Seeing cases further north and south of these tropical zones may become more common due to climate changes, according to Stephen Rich, PhD, a professor in the department of microbiology at the University of Massachusetts in Amherst.

"Climate change is a very real concern," says Dr. Rich. "I think that as the temperate zone gets more subtropical it will bring these diseases further north and south."

Human-to-human transmission is extremely rare but has been documented through sexual intercourse and breastfeeding. Transmission has also occurred in rare instances through animal bites

What Dog Owners Need to Know About Leptospirosis Rich adds an extra word of warning for dog owners. In New York City, there are usually about 15 dog cases a year.

[4] Dogs can become infected sniffing around trash bags tainted with infected urine or from drinking out of puddles and other still water that contain the bacteria.

A dog has the potential to pass the illness to its owner, but that would most likely be through contact with its urine, according to Rich.

There is a leptospirosis vaccine for dogs (not for humans) that the American Veterinary Medical Association highly recommends for all dogs that go outside.

[5]

Overall, Schaffner does not see reason to be alarmed nor signs that the illness may be spreading to other cities.

"I advise the public to be knowledgeable about leptospirosis and follow good hygienic practices with an emphasis on hand washing and wearing gloves if you engage in activities dealing with animal excretions," he says.

Rat Urine Is Causing Uptick In Rare Disease Among New York Sanitation Workers.

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