H06 - Leptospirosis

Leptospirosis is a bacterial infection resulting from exposure to the Leptospira interrogans bacterium. There is an acute form of human infection known as Weil’s Disease, where the patient suffers from jaundice. Weil’s Disease is comparatively rare, though ‘mild’ cases of leptospirosis are surprisingly common across the globe.

Leptospirosis is a zoonotic disease which means it is passed from animals to humans; it is extremely rare to catch it from another human being. Anyone who is exposed to rats, rat or cattle urine or fetal fluid from cattle is at risk. Farmers are now the main group at risk for both Weil’s Disease and cattle leptospirosis. The cattle form is a special risk for dairy farmers. Other people who have contracted leptospirosis in recent years include: vets, meat inspectors, butchers, abattoir and sewer workers. Workers in contact with canal and river water are also at risk.

Protective clothing or footwear should be worn by anyone exposed to contaminated water or soil because of their job. However, employers should have safe work practices to prevent leptospirosis and these are detailed in the Leptospirosis Procedure.

In 2005/06, two million people were suffering from an illness they believed was caused or made worse by their current or past work. In 2005 approximately 1,578 cases of work-related infections (including leptospirosis) were reported. Employers should be aware of the main piece of legislation that applies to infections at work which is the Control of Substances Hazardous to Health Regulations 2002 (COSHH).

Micro-organisms are covered in COSHH by the term biological agents. These are defined as any micro-organism, cell culture, prion or human endoparasite whether or not genetically modified which may cause infection, allergy, toxicity or otherwise create a hazard to human health. The general requirements of COSHH, ie risk assessment and prevention or control of exposure will apply to most workplaces. But there are also additional requirements for work with micro-organisms, in laboratories, animal rooms, and industrial processes, contained in Schedule 3 of the main regulations.

The second piece of relevant legislation is the Reporting of Injuries, Diseases and Dangerous Occurrences Regulations 1995 (RIDDOR 95). RIDDOR lists reportable diseases which include infections such as leptospirosis, hepatitis, tuberculosis, anthrax, legionellosis and tetanus.

What is this?

This is a written procedure which gives details about the identification, treatment and control of leptospirosis (Weil’s disease) in the workplace. A PDF of the procedure is available to download (see attached), please use it in conjunction with the attached Toolbox Talk.

What is leptospirosis?

Leptospirosis is a bacterial disease associated with wild and domestic animals. It is most commonly found in rats but is also present in other rodents, cattle, pigs, sheep and horses.

Who is affected by leptospirosis?

Leptospirosis is primarily an occupational disease for outdoor workers. Those mainly affected work as farmers, veterinarians, sewer workers or others whose occupation involves contact with animals, especially rats. People who work close to water are also at risk.

How is it spread?

Leptospirosis is spread mainly by the urine of infected animals and is generally not transmitted from person to person. Outbreaks of leptospirosis are usually caused by exposure to water contaminated with the urine of infected animals. Humans can become infected through swallowing contaminated food, or handling soil containing infected animal urine. The disease can enter the body via the skin, especially through mucosal surfaces such as the eyes or nose, or through broken skin.

What are the symptoms of leptospirosis?

You should be aware that sometimes there are no symptoms at all associated with the disease. However, the common symptoms of leptospirosis are fever, headache, chills, muscle aches, vomiting, jaundice, anaemia and sometimes rashes. People with leptospirosis are usually quite ill and are often hospitalised. People often recover but if the disease is not treated, the patient could develop kidney damage, meningitis, liver failure, and respiratory distress. This second phase is called Weil’s disease. In rare cases death occurs.

How soon after exposure/infection do symptoms appear?

The incubation period is usually 10 days with a range of 4 to 19 days.

How is leptospirosis diagnosed?

The disease is diagnosed using specific blood and urine tests available through a local GP or hospital.

What do responsible managers need to do?

The responsible manager must:

• Ensure clean welfare facilities are maintained on site;
• Provide rodent control;
• Provide personal protective equipment such as gloves, goggles and boots;
• Provide information, instruction and training, and access to the HSE guide on Leptospirosis. (The affected person should take the guide with him to a GP if symptoms occur.)

What do employees need to do?

The disease can be prevented if employees practise good sanitation habits, especially before eating. Cuts and grazes should be covered when at work, and the use and maintenance of boots and gloves in hazardous places is extremely important.

Antibiotics are the main course of treatment. Personnel must ensure they visit their GP immediately they believe they have symptoms suggestive of leptospirosis.

Associated documentation

• HSE guide to Leptospirosis

This workplace procedure forms part of a Health & Safety Risk Management System for employers in the quarrying industry. The procedures, which cover a wide range of workplace risks and hazards, can be viewed here