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Medical Author:

John P. Cunha, DO, FACOEP

John P. Cunha, DO, FACOEP

John P. Cunha, DO, is a U.S. board-certified Emergency Medicine Physician. Dr. Cunha's educational background includes a BS in Biology from Rutgers, the State University of New Jersey, and a DO from the Kansas City University of Medicine and Biosciences in Kansas City, MO. He completed residency training in Emergency Medicine at Newark Beth Israel Medical Center in Newark, New Jersey.

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Medical Editor:

William C. Shiel Jr., MD, FACP, FACR

William C. Shiel Jr., MD, FACP, FACR

Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.

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In this Article

• What is leptospirosis?
• What are leptospirosis symptoms and signs?
• How is leptospirosis diagnosed?
• What is the treatment for leptospirosis? What is the prognosis for leptospirosis?
• Can leptospirosis be prevented with a vaccine?
• Can my pets get leptospirosis?
• Leptospirosis At A Glance
• Leptospirosis Index

The diagnosis of leptospirosis is made by culture of the bacterial organism Leptospira from infected blood, spinal fluid, or urine. However, many doctors must rely upon rising Leptospira antibody levels in the blood in order to make the diagnosis, as the technique required to perform the culturing is delicate and difficult.

The treatment of leptospirosis involves high doses of antibiotics. Antibiotic treatment (doxycycline [Vibramycin, Oracea, Adoxa, Atridox], penicillin) is most effective when initiated early in the course of the illness. Severely ill patients may need hospitalization for IV fluid and antibiotic treatment. Severe liver and kidney manifestations of the infection may require intensive medical care and sometimes dialysis treatment. However, even in severe cases, liver and kidney function often does return after recovery from the illness.

Mortality rates for severe illness with leptospirosis can range from 5%-40%, depending on the severity of organ dysfunction and the patient's general health prior to infection. Most previously healthy patients have a good prognosis and will make a full recovery.

A vaccine for leptospirosis is available and used in some countries in Europe and Asia. It must be given every year like a flu shot. A longer-acting vaccine is being investigated in Cuba. It is not currently available in the United States.

Travelers who are going to an area where leptospirosis is common and who will be engaged in activities that increase likelihood of exposure can take 200 mg of doxycycline per week by mouth starting before and during the time period of potential exposure. According to the Leptospirosis Information Center, there are no drug-resistant strains of the bacteria at this time.

Leptospirosis was a reportable disease in the United States, but it was removed from the national CDC list of reportable diseases. It is, however, still reportable in some states, most notably Hawaii.