The symptoms of leptospirosis usually develop abruptly 7 to 14 days after exposure to the leptospira bacteria.
However, it is possible for symptoms to develop from 3 days to 30 days after exposure.
Mild leptospirosis
Symptoms of mild leptospirosis include:
- high temperature (fever) that is usually between 38 and 40°C (100.4-104°F)
- chills
- sudden headaches
- nausea (feeling sick)
- vomiting
- loss of appetite
- diarrhoea
- cough
- sore throat
- a non-itchy skin pain
- muscle pain, particularly affecting the muscles in the calves and lower back
- conjunctivitis (irritation and redness of the eyes)
The symptoms of mild leptospirosis usually resolve within five to seven days. However, a small number of people will go on to experience a further phase of more serious symptoms, known as severe leptospirosis.
Severe leptospirosis
The symptoms of severe leptospirosis develop one to three days after the symptoms of mild leptospirosis have passed.
The pattern of symptoms usually falls into one of three groups, depending on which organs have become infected:
- the liver, kidneys and heart (this pattern of infection is known as Weil’s disease)
- the brain
- the lungs
In rare cases, it is possible to experience all three groups of symptoms at the same time.
Liver, kidney and heart
If these organs become infected, you will probably experience the following symptoms:
- jaundice (yellowing of the skin and the whites of the eyes)
- loss of appetite
- tiredness
- shortness of breath
- swollen ankles, feet or hands
- weight loss
- muscle aches
- nausea (feeling sick)
- nosebleeds
- a noticeable, painful swelling in your liver
- a decrease in the amount of urine that you pass
- chest pain
- rapid and irregular heartbeat
Left untreated, your kidneys may lose their ability to function. This is known as kidney failure and it can be fatal.
The brain
There are two ways that the brain can become infected:
Both types of brain infection cause similar symptoms, including:
- high temperature (fever) of 38°C (100.4°F) or above
- nausea (feeling sick)
- vomiting
- changes in mental state, such as confusion,
drowsiness or disorientation
- seizures (fits)
- aversion to bright lights (photophobia)
- inability to speak
- inability to control physical movements
- stiff neck
- a blotchy red rash that does not fade or change colour when you place a glass against it
- uncharacteristic behaviour, such as being unusually aggressive
Left untreated, the infection can cause brain damage, coma and death.
The lungs
A leptospirosis infection that spreads to the lungs presents the most serious health threat because it carries a significant risk of death. This is because the bacteria damage the lung tissues, which can result in massive internal bleeding and loss of lung function, both of which can be fatal.
Symptoms include:
- a high temperature, which can be as high as 40.5°C (105°F)
- shortness of breath
- coughing up blood (sometimes the amount of blood coughed up is so great that a person can choke on it)
