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Deadly Leptospirosis Infections Surge Drastically in New York


Between 2001 and 2020, there was an average of 3 cases per year. However, last year’s tally surged to 24.

A record number of people in New York City fell ill with a life-threatening bacterial infection last year, typically spread through rat urine, according to the NYC Department of Health and Mental Hygiene. This year, the city appears to be on track for another record high.

The infection is leptospirosis, which can manifest with various symptoms, including non-specific ones like fever, headache, chills, muscle aches, vomiting, diarrhea, and cough. However, if left untreated, it can progress to severe stages, leading to kidney failure, liver damage, jaundice, hemorrhage, bloody eyes (conjunctival suffusion), respiratory distress, and potentially death.

The spirochete bacteria of the genus Leptospira, responsible for leptospirosis, infect rats, which then excrete the bacteria in their urine. Humans can contract the infection through direct contact with open wounds or mucous membranes.

New York City has long grappled with its rat population, estimated last year to be as high as 3 million. Mayor Eric Adams has prioritized combating the rat population, and recently, the city council proposed a new strategy: administering birth control in the form of salty pellets to reduce the rodent population.

However, leptospirosis has only recently become a significant concern due to rat activity. Between 2001 and 2020, the city averaged just three cases of leptospirosis annually, some of which were travel-related. But during the pandemic, the rat population seemingly surged, leading to a sharp increase in leptospirosis cases. From 2021 to 2022, the average jumped to 15 cases, reaching 24 cases in 2023—the highest number recorded for a single year. As of April 10 this year, there have been six cases reported.

The current number of cases for this year is alarming, considering that Leptospira bacteria are vulnerable to environmental conditions. They perish rapidly in freezing winter temperatures and dry summer heat, thriving mainly in warm, moist environments. Last year, the months with the highest number of cases were June and October. The health department attributed the surge in cases partly to climate change, which has led to increased rainfall and unseasonably warm temperatures.

In a recent health advisory, the city’s health department urged clinicians to remain vigilant for cases of leptospirosis, which are typically treated with common oral antibiotics for mild cases and intravenous doses for severe cases. Symptoms usually manifest within 5 to 14 days after exposure but can appear anywhere from 2 to 30 days.

Out of the 98 locally acquired cases documented by the city between 2001 and 2023, nearly all occurred in men (94 percent), with a median age of 50 and a range of 20 to 80 years. The majority of cases were reported in the Bronx (37), followed by Manhattan (28), Brooklyn (19), Queens (10), and Staten Island (4). Patients often presented to clinicians with acute kidney and liver failure, and in some cases, severe respiratory complications. Among the 98 cases, six resulted in fatalities.

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