Puerto Rico: Leptospirosis outbreak reported islandwide through October

Event

Puerto Rican health authorities have reported an ongoing islandwide outbreak of leptospirosis since January. At least 226 cases have occurred (22 confirmed, 38 probable, 166 suspected) Jan. 1-Oct. 8. The increase in leptospirosis cases can be attributed to the passage of Hurricane Fiona. The most affected region is Caguas, followed by Mayaguez, Metropolitana, and Ponce. No cases were reported in 2021. This report represents the most recent data available as of Oct. 19.

Context

Weekly confirmed cases had been reported across Puerto Rico, which have significantly increased due the impact of Hurricane Fiona across various regions. The last leptospirosis outbreak in Puerto Rico was in 2017, when 76 cases were reported following the aftermath of Hurricane Maria. Widespread flooding following a hurricane creates the ideal conditions for leptospirosis outbreaks. This is especially true of individuals who work outdoors near animals or in agricultural settings, where the risk of exposure is highest. Household exposure may occur from drinking water contaminated with animal urine; exposure to surfaces contaminated by rodents also presents a risk of infection, highlighting the importance of strict hand hygiene measures.

Leptospirosis is caused by a bacterium that spreads to humans through water and soil contaminated by infected animal urine. Symptoms typically appear 5-14 days after exposure, but can develop up to 30 days after exposure. Symptoms generally include headache, fever, muscle aches, chills, diarrhea, vomiting, and abdominal pain. However, some individuals can develop a more severe illness called Weil's disease, which can be life-threatening. Symptoms of Weil's disease may include meningitis (inflammation of the brain and spinal cord), kidney failure, and/or liver failure.

Advice

Avoid contact with contaminated soil and water. Seek medical attention if symptoms develop within one month of being in affected areas.