Recently I contracted Leptospirosis in Costa Rica and this blog aims to educate the masses of what this disease is as all whitewater kayakers need to learn these symptoms, it could save a life. This is very prevalent in flooded rivers almost everywhere and every kayaker is at risk from liver shutdown and worse, the quicker you can get diagnosed the better your recovery will be.
So I headed off to this amazing paddling destination with a group of young and excitable paddlers. Costa Rica is well known for it’s high adventure, spectacular rain forest and remarkable whitewater. Out trip had it all, warm water, a bunch of class 3/4 whitewater and it remains to be a place I will always return to. I believe that I contracted this by either stepping into a contaminated puddle with cuts on my leg, or via paddling a flooded swollen river. Potentially even a small cut on my leg could have been the problem, or getting water splash my eyes as I paddled a contaminated section of river.
Here is what wikipedia says about Leptospirosis
Up to 13 different genetic types of Leptospira may cause disease in humans. It is transmitted by both wild and domestic animals. The most common animals that spread the disease are rodents. It is often transmitted by animal urine or by water or soil containing animal urine coming into contact with breaks in the skin, eyes, mouth, or nose. In the developing world the disease most commonly occurs in farmers and poor people who live in cities. In the developed world it most commonly occurs in those involved in outdoor activities in warm and wet areas of the world.
Signs and Symptoms:
Leptospiral infection in humans causes a range of symptoms, and some infected persons may have no symptoms at all. Leptospirosis is a biphasic disease that begins suddenly with fever accompanied by chills, intense headache, severe myalgia (muscle ache), abdominal pain, conjunctival suffusion (red eye), and occasionally a skin rash. The symptoms appear after an incubation period of 7–12 days. The first phase (acute or septicemic phase) ends after 3–7 days of illness. The disappearance of symptoms coincides with the appearance of antibodies against Leptospira and the disappearance of the bacteria from the bloodstream. The patient is asymptomatic for 3–4 days until the second phase begins with another episode of fever. The hallmark of the second phase is meningitis (inflammation of the membranes covering the brain).
90 percent of cases of the disease are mild leptospirosis. The rest experience severe disease, which develops during the second stage or occurs as a single progressive illness. The classic form of severe leptospirosis is known as Weil’s disease, which is characterized by liver damage (causing jaundice), kidney failure, and bleeding. Additionally, the heart and brain can be affected, meningitis of the outer layer of the brain, encephalitis of brain tissue with same signs and symptoms; and lung affected as the most serious and life-threatening of all leptospirosis complications. The infection is often incorrectly diagnosed due to the nonspecific symptoms.
Other severe manifestations include extreme fatigue, hearing loss, respiratory distress, and azotemia.
For me I felt fine for a week after returning from my trip. Then 7 days later it hit me, I started randomly feeling tired, like a ton of bricks, I just couldn’t even walk without having a break. Next day came the high fever, every day spikes over 100 degrees. Sweats, shakes, unable to eat, hard to drink and keep fluids down, very tired and just feeling down right terrible. After 4 days of this I finally headed to the hospital and here they said it could be Leptospirosis. Thankfully they picked it up as if it is left too late you get all kinds of complications, plus the longer you leave it the longer your recovery will be. I have heard about some who have taken months to recover, some even longer still. Unfortunately this hit me right on the lead up to the world championships this year and I was wreaked for months. Everyone knows about Maleria, but how many people know about Leptospirosis?
As for treatment, Doxycycline is what my doctor placed me on. Here are two very important helpful tips when taking Doxycycline. Firstly don’t take it on an empty stomach as you will just hurl it back up. Eat some dairy at the same time to help this. Finally don’t take Doxycycline lying down, sit up, on a seat otherwise it is again coming back up. Trust me on these tips, Anna Bruno has quite a bit of knowledge when it comes to this drug and these tips were key for me. The first day I failed on each and every tip, needless to say that there was no way I was keeping this drug down.
So this is highly important information for every paddler. We all paddle on rivers that are swollen, flooded or risen and as a result we are very susceptible to Leptospirosis.
They say you learn something new everyday, help get the word out about this, the quicker you pick these symptoms up the better your chance of recovery.