Terrifying bacteria I picked jungle up in the
But the scariest thing? You can get it here, too
IT’S the souvenir you don’t want — a holiday illness no one can diagnose or treat. That’s where the Hospital for Tropical Diseases can help, as this series by DIANA PILKINGTON reveals.
THE day after his work summer party last year, Adam Millward woke up drained of energy and with a pounding headache. ‘I knew it wasn’t just a hangover,’ says the 29-year-old from London.
‘But I put it down to too much sun — we’d spent several hours on a roof terrace on a boiling June day.’
Adam, an editor at Guinness World Records, dragged himself to work — but, the following day, after he was caught slumped on his desk, his boss sent him home at 10.30am.
By now, he was beginning to worry he had picked up something in Colombia. He had returned from a solo trip three days earlier.
The highlight of his two-and-a-half week holiday was a visit to the Ciudad Perdida, the ruins of an ancient city.
Adam says: ‘To get there, we had to do a fourday trek through the jungle, walking through streams and rivers up to our waist — plenty of opportunities to pick up something nasty.’
As he would later discover, Adam had leptospirosis — a bacterial infection that’s spread through the urine of infected animals, such as cattle and rodents, and which you can pick up in contaminated water practically anywhere in the world, including the UK.
In most cases, it causes mild, flu-like symptoms, but it can potentially have severe consequences, including organ failure, internal bleeding and even death.
However, his new GP wasn’t convinced there was anything to worry about. Suspecting that Adam had just picked up a virus in Britain, the doctor sent him home with instructions to rest, drink water and take paracetamol.
Yet his symptoms got worse. Adam’s knees, hips and back started to ache and, at night, he became very feverish — burning up one minute and freezing the next. His eyes had become very red and irritated, and his skin looked red.
This was, he says, when he became ‘really scared’. ‘I made the mistake of Googling my symptoms, and a lot of terrifying sounding conditions came up. One was dengue fever, a mosquito-borne virus that can make you blind and can even be fatal. My mind went into overdrive with worry.’
A second trip to the GP three days later was equally fruitless — but on a third visit, a week after the symptoms began, the doctor agreed to refer Adam for a blood test. ‘The results showed that my liver was functioning at a quarter of what it should be. And they still didn’t know what was wrong with me.’
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THIS point, Adam was sent to the Hospital for Tropical Diseases in London for specialist help. There, doctors agreed the signs pointed to dengue, and arranged a further blood test for it. ‘They reassured me that my symptoms were relatively mild and the disease should run its course. Within a week or two, my aches and fever began to ease,’ says Adam.
However, when the results came a month later (there’s only one lab that tests for dengue), they were negative. This is when the possibility of leptospirosis was mentioned.
There are around a million cases a year and, while it’s mainly associated with warmer countries, there have been cases in France and even in the UK. Junior British tennis player Gabriella Taylor was diagnosed with it earlier this year. ‘People can catch it either through direct contact with the infected animal or with contaminated water or soil,’ explains Robert Heyderman, a professor of infectious diseases and international health who works at the Hospital for Tropical Diseases.
‘The bacteria tend to gain access through cuts in the skin, via the mucous membranes such as the nose, or by swallowing.
‘The risk is spending time in slowmoving fresh water such as lakes, rivers and canals — the bacteria can’t survive in salt water, while very fast-moving water will dilute it.
‘People can catch it playing water sports, such as canoeing or white water rafting, particularly in the slower-moving shallows. They can also catch it doing triathlons.’ In the UK, those most at risk are vets, farm workers and sewage workers.
Learning of his possible new diagnosis, Adam began to ‘ kick myself’, as it dawned on him he could well have picked up the bacteria wading through streams in the Colombian jungle. ‘I’m normally a well-prepared traveller. But this time, I’d only taken a pair of canvas shoes, instead of waterproof hiking boots. And my feet were soon covered in sores, so the infection could easily have got into my body.’
It takes from a week to 30 days for symptoms of leptospirosis to develop. In most cases, it is a mild illness, with aches, pains and fever and, sometimes, a rash. Patients can also get sore and bloodshot eyes, because the bacteria affects the blood vessels and blood clotting.
In some cases, even once the bacteria leaves the system, the body will mount a response to it, which can make the symptoms worse and lead to blurred vision.
And some patients will go on to develop the more severe form of the disease, known as Weil’s disease, which affects the liver and kidneys. There may also be bleeding in the lungs, and inflammation of the heart, which can lead to potentially fatal abnormal heart rhythms.
Or the brain can swell — a form of meningitis.
Although the death rate from leptospirosis is low (less than 1 per cent), between 12 and 20 per cent of patients with Weil’s disease will die from it. And cases of Weil’s disease in the UK have risen in recent years: in 2013, the number of cases was double that of 2012.
Older people or those with a compromised immune system (for example, people taking steroids) are more at risk of Weil’s, and the bug may be more severe in the Northern Hemisphere.
Leptospirosis is usually treated with antibiotics, though the effectiveness of this hasn’t been conclusively proven — in some cases, it eventually clears up by itself.
Patients with Weil’s are admitted to hospital and given intravenous antibiotics. In terms of prevention, Professor Heyderman says that it’s important to be aware of the risk, especially if you’re doing watersports or going in potentially contaminated water — even here in the UK.
‘Avoid swallowing the water and avoid the water altogether if you have breaks in the skin. And if you’re going on a jungle trek, keep your feet well protected.’
Luckily, by the time Adam was given a blood test to confirm leptospirosis, all that was left of his symptoms was tiredness.
But then, he had another shock: while waiting for the results, his vision started getting blurry, so he returned to the hospital in a panic and, as a precaution, he was given antibiotics.
‘Thankfully, my eyesight got better within a week,’ he says. ‘But it took about two months in total until my exhaustion went away.
‘The illness knocked me for six, but I’m not going to let my experience stop me travelling. At least now I’ve invested in proper hiking boots.’