Leptospirosis: the possible risk to those participating in water-based sports and activities

INTRODUCTION

Outdoor sports and recreational activities based around water are increasingly popular. Such activities include outdoor swimming, ‘Tough Mudder’ races, canoeing, and triathlons. For example, the number participating in triathlons is now over 150 000, an increase of 7% since 2015.¹ Between October 2015 and October 2016 over 71 000 people took part in rowing, 107 000 in angling, and 41 000 in canoeing.² However, such activities expose participants to infection with leptospirosis. GPs need to be aware that the condition may be seen in people not typically considered to be at such risk. Leptospirosis is easily misdiagnosed,³ thus awareness that it may be seen in these new risk groups could aid prompt identification of infection.

Leptospirosis is a zoonotic bacterial infection, caused by spirochaetes of genus Leptospira (Figure 1).³ Many mammals are carriers of infection, rats being the most well known.⁴ Infection resides in the renal tubules of affected animals, leptospires being emitted via urine into the environment.⁴ Humans become infected through activity in contaminated areas. Leptospires gain entry through abrasions, mucous membranes, and the conjunctiva.³ Leptospirosis was traditionally …