Centers for Disease Control and Prevention released a health advisory on Sept. 10 containing advice to clinicians about leptospirosis in U.S. travelers returning from northern Israel.
Leptospirosis can cause a wide range of symptoms. Most patients have a mild flu-like illness with symptoms including fever, headache, muscle aches, conjunctival suffusion, vomiting, diarrhea, jaundice and sometimes a rash. Some patients may go on to develop severe illness, including liver and renal failure, hemorrhage (especially pulmonary), aseptic meningitis, cardiac arrhythmias and pulmonary insufficiency. Leptospirosis is fatal in approximately five to 15 percent of patients with severe illness.
The warning recommends that providers consider leptospirosis as a diagnosis in any patient who develops an acute febrile illness within four weeks of travel to one of the areas in northern Israel listed below since July 1, 2018.
Please evaluate patients for leptospirosis who have onset of an acute febrile illness within four weeks of travel to the Golan Heights region in northern Israel, especially with exposure to one of the seven natural water recreational sites listed above. If clinicians suspect leptospirosis in a patient, they should initiate treatment with antibiotics (e.g., doxycycline or penicillin) prior to receiving results of diagnostic tests, as earlier treatment is associated with a decrease in duration and severity of disease.
For more specifics about antibiotics and dosage, please see CDC’s leptospirosis fact sheet for clinicians.