Extremely rare disease has parents worried for daughter

Dear Doctor: Our youngest daughter is starting college in New York City this fall, and on top of all the empty nest emotions my husband and I are dealing with, a friend has warned us about something she saw on the news called “rat urine disease.” What is it? Should we be worried?

Dear Reader: There’s nothing like a rare and off-putting health threat to get the 24-hour news cycle into a lather. We’ll spare you additional worry and jump right to the point: No, you do not need to add rat urine disease to the list of challenges we all face when a child first leaves home.

That said, the reason that leptospirosis — that’s what it’s called — has created headlines is that three individuals in the Bronx contracted the disease last winter. One of them later died. But according to health officials in New York, leptospirosis is extremely rare. In a city of 8.5 million residents, between one and three cases of the disease are seen each year. Add in the fact that the disease is treatable with antibiotics, and the threat level plummets.

Now that you’re (hopefully) breathing easier, let’s talk specifics.

Leptospirosis is the name of the disease caused when leptospira, a corkscrew-shaped bacterium, enters the body. It produces a wide range of symptoms, many of which can be mistaken for other diseases. These include high fever, chills, nausea, diarrhea, rash, headache, jaundice and muscle aches. In some cases, infected individuals may not have any symptoms at all. Untreated, leptospirosis may lead to liver or kidney failure, or meningitis. Treatment is with antibiotics, with early diagnosis yielding the best outcomes.

Although the news reports your friend saw focused on rats, which are the most common carriers of leptospira in urban environments, the bacterium can be found in a range of animals. These include cattle, pigs, dogs and horses, other rodents, and some wild animals.

Infected animals, which don’t show any disease symptoms, will continue to excrete the bacteria for several months or even several years. Humans become infected when they come into contact with either the urine of an infected animal, or its bodily fluids, other than saliva. You can also pick up the infection from a substance that carries the infected urine or fluids, such as soil, water or trash.

The bacterium typically enters the body through the skin, particularly if it is broken due to a scratch or a cut. It can also enter through the mucous membranes of the mouth, eyes or nose. According to the Centers for Disease Control and Prevention, wide outbreaks of leptospirosis are usually caused by exposure to contaminated water, such as floodwaters. Person to person transmission is rare.

If you’re still worried, recommend the following precautions to your daughter:

— Steer clear of rats and their habitats.

— If you do make contact, wash the affected body part thoroughly with soap and water.

— To clean areas where rats may have been, use one part household bleach and 10 parts water, which kills the leptospirosis bacteria. Wear gloves and goggles.

— If you develop symptoms after making contact with suspected rat urine, whether directly or in a rat-infested environment, seek medical care.

Eve Glazier, M.D., MBA, is an internist and assistant professor of medicine at UCLA Health. Elizabeth Ko, M.D., is an internist and primary care physician at UCLA Health.

Send your questions to askthedoctors@mednet.ucla.edu, or write: Ask the Doctors, c/o Media Relations, UCLA Health, 924 Westwood Blvd., Suite 350, Los Angeles, CA, 90095. Owing to the volume of mail, personal replies cannot be provided.