FIRST documented in the Caribbean in 1838, leptospirosis remains a major public health concern throughout the region. According to the Pan American Health Organization (PAHO), the Caribbean has reported thousands of suspected and confirmed cases over the past two decades. Between 2000 and 2013, PAHO data shows that the regional incidence of the illness was two to five cases per 100,000, with outbreaks often associated with heavy rainfall and flooding, as well as conditions that allow contaminated water to spread widely throughout communities.

Floods and hurricanes fuel outbreaks

Flooding and hurricanes create ideal conditions for leptospirosis outbreaks. During and after these events, floodwaters often mix with soil and materials contaminated by rodent urine consequently, people who wade through or use this water for domestic purposes face a high risk of contracting infection. Concerningly also is the fact that, flooding damages municipal water systems, forcing communities to rely on rivers and streams that may be unsafe.

Hurricanes and flooding impacts rodents that are the main reservoirs of leptospirosis as due to these events rodents often lose their habitats in so doing they move into homes, food establishments, and other buildings, increasing human contact with contaminated surfaces and food. Clean-up activities after hurricanes pose additional risks; residents, farmers, garbage collectors, and clean-up crews are normally exposed to standing water and mud where the Leptospira bacteria thrive. Limited access to healthcare further complicates the situation, as delays in diagnosis and treatment frequently lead to more severe cases and even death. Altogether, these overlapping factors illustrate how disasters magnify public health risks, underscoring the urgent need for prevention, rapid response, and community awareness.

The disease

Leptospirosis is caused by Leptospira bacteria, which live in the urine of infected animals. Humans contract the disease through direct contact with water, soil, or food contaminated with rodent urine. In addition to ingestion, the bacteria can enter the body through cuts on the skin or exposure of the eyes and nose. Food-borne transmission is particularly common, as rodents often damage food and leave behind contamination invisible to the naked eye.

Recognising the symptoms of the disease is therefore key to reducing adverse effects. Initially, infected individuals often experience flu-like symptoms such as fever, chills, headaches, and muscle aches. These symptoms can quickly worsen to vomiting, jaundice, diarrhoea, and skin rash. In severe cases, leptospirosis can cause kidney failure, liver damage, meningitis, or death. To minimise the impact of the illness early diagnosis and treatment are critical, yet too often delayed.

Myths and misconceptions

Misinformation makes matters worse. Many believe only rats spread leptospirosis, when in fact dogs, pigs, goats, and mongooses are also reservoirs. Others think leptospirosis is confined to rural areas, but urban communities with poor sanitation or flooding concerns are equally vulnerable. Some assume the disease cannot be treated, yet antibiotics are effective when started early.

Even rainwater collected from roofs, often thought to be safe, can be contaminated by rodent urine. Food showing rodent bite marks should never be consumed, since rodents urinate where they feed. Another misconception is that leptospirosis can be spread by touching an infected person. The illness is not contagious in this way. Finally, water that looks clean may still harbour the bacteria, which are invisible to the naked eye.

Leptospirosis is preventable

Leptospirosis is preventable. Individuals can protect themselves by seeking medical attention immediately after possible exposure, vaccinating pets, and wearing protective clothing when working outdoors or during clean-up. Avoiding contact with stagnant water, covering water storage containers, disinfecting drinking water, and properly disposing of garbage and other waste that serve as rodent harbourage can all reduce the risk. Protecting outer openings in homes, food establishments, and other buildings also helps to keep rodents out. Most importantly, discarding any food damaged by rodents is essential to reduce the risk of transmitting the illness.

Leptospirosis may be centuries old, but climate change is intensifying the conditions that fuel its spread. More frequent floods, hurricanes, and sanitation challenges mean the threat is growing, not shrinking. Public health campaigns must continue to educate, dispel myths, and encourage early treatment. Communities must also take responsibility for prevention, while governments strengthen systems to respond quickly to these outbreaks.

Leptospirosis still looms large, but with vigilance, education, and action, its grip on the Caribbean can be broken.

Dr Karlene Atkinson is the vice-dean (acting) for the Joint Colleges of Medicine, Oral Health and Veterinary Sciences at the University of Technology, Jamaica.

Dr Karlene Atkinson.