Report of case: leptospirosis after exposure to alligator carcass

Abstract

In the past decade, leptospirosis has emerged as a globally important infectious disease. Mortality remains significant; this may be related to delays in diagnosis because of lack of infrastructure and adequate clinical suspicion, and to other poorly understood reasons that may include inherent pathogenicity of some leptospiral strains or genetically determined host immunopathological responses. Leptospirosis is a spirochete parasitic bacterium most commonly reported from rodents and contracted through contact with rodent urine, but also reported from cows and other domestic animals and contracted through contact with contaminated water. Humans are infected by direct contact with animals or through exposure to fresh water or soil contaminated by infected animal urine. Leptospires enter the body through cuts and abrasions, mucous membranes or conjunctivae, or aerosol inhalation of microscopic droplets. From 1995-1998, approximately nine people working with alligators in south Florida have apparently contracted leptospirosis. All of the victims were working with wild alligators; most had contact with alligator nests and nearly half required hospitalization. Although it has been postulated that leptospires may be transmitted directly from infected, large reptiles to the hands of handlers, it has been felt that it was probably more likely that handlers were indirectly exposed by water contaminated with the urine of leptospiruric reptiles or that the swamps and waterways from which eggs are harvested are contaminated by the infected urine of rodents or other animals. This report describes a case in which a Florida State Trooper became symptomatic after removal of an alligator carcass from a south Florida roadway.