Leptospirosis

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Learn all about Leptospira bacteria which can be found in Hawaiian freshwater streams, rivers, and waterfalls.

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Leptospirosis, or just plain Lepto for short, is an infection you can get if you come into contact with Leptospira bacteria. The Leptospira bacteria is spread through the urine of infected animals. Because wild animals pee anywhere they want, their infected urine then gets into freshwater rivers and streams, where it can survive for weeks or even months. It's not an issue in the ocean because Lepto bacteria can only survive in saltwater for a few hours.

Now, I'm sure you aren't planning to come in direct contact with animal urine directly but once that urine is in a stream it can still infect you if that contaminated water comes in contact with your eyes, nose, mouth, or even through a cut or scratch on your body.

Why Is All Of This Important In Hawaii?


Because Lepto can be present in the various waterways, streams, rivers, and waterfalls you might encounter on your trip to Hawaii. Lepto tends to be a problem in tropical environments like Hawaii because there is a lot of rainfall that washes animal urine into the streams.

How Do You Avoid Leptospirosis?


Simple. Stay out of rivers, streams, waterfalls, and other sources of freshwater. Not every stream will be contaminated but unless you know for sure that the water is clean (and you won't know) then you can't be sure.

But I Want To Stand Under A Waterfall!


Well, people do all the time and don't get infected but is it really worth the risk? Waimea Valley on Oahu's north shore has a small waterfall and they'll let you (on most days) swim under it. When I asked the lifeguard there about Lepto he said that on days where the water is running slow they won't let people in but on days where the water is moving it's less of an issue. Reading up more on this topic seems to suggest that water flow isn't really the solution. See the side effects of Lepto below and weigh the risks yourself.

Of course, standing or swimming under a waterfall has its own risks beyond bacteria in the water. Falling rocks are likely to be a bigger health hazard and should be enough of a reason to keep you out of the waterfall.

What Are The Symptoms Leptospirosis?


Lepto can cause all sorts of symptoms such as headaches, fever, chills, muscle aches, vomiting, jaundice (yellow skin), red eyes, diarrhea, abdominal pain, and rash. In fact, many people think they just have the flu if they get Lepto. On the flip side, some people get infected and have no symptoms at all.

It usually takes around 2 days to 4 weeks after exposure until you get sick. After you have flu like symptoms you might even recover for a short time but then get sick again. The next time around it could lead to kidney or liver failure or meningitis and if left untreated recovery could take months, or it could kill you.

Yes, Lepto is the gift that keeps on giving up until it kills you.

What Do I Do If I Get Leptospirosis?


If you leave your Hawaii vacation with flu like symptoms and walked or swam in any type of freshwater pond, stream, river, or waterfall then go see a doctor and be sure they know what you did. Mention Lepto specifically because many mainland doctors might not think to check for that.

People have actually died because doctors didn't check for Lepto specifically because it's not common on the mainland. I've read several articles on Lepto that suggest around 50% of the 100-200 annual Lepto cases in the USA come from Hawaii.

Lepto is treated with certain antibiotics (according to the CDC these might be doxycycline or penicillin) but it's important that the doctors know this because other antibiotics might not help. It's very important that treatment happens early on, the common consensus is that the war on Lepto is won sooner rather than later.

What's The Bottom Line?


The bottom line is that you shouldn't worry about Lepto at all, it shouldn't impact your Hawaiian vacation nor should it be a cause for concern. Just stay out of freshwater streams and waterfalls and you won't have to worry about it. Will you listen to this advice? Some of you will, some of you won't.

Many people will still swim in these freshwater streams and waterfalls and be just fine, but is it worth risking? No, not at all. Besides, if the Lepto doesn't get you it's possible that a Flash Flood will. There are plenty of things in Hawaii that can hurt or kill you, so be sure to also read up on Hawaii Dangers - Read Before You Go.
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Matt Anderson
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Vickey W
Joined: Mar 2017
Reviews: 123
Likes Received: 46
Working in the medical field I know Leptospirosis is a risk and try my best to avoid it. If a sign is up or you are in doubt please do not swim in the water. The information you provided is very helpful. Also with me having Auto Immune Disease I am very watchful. Just take precaution and enjoy your trip.
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Graham R
Joined: Apr 2015
Reviews: 1
Likes Received: 1
Aloha Matt, Just wanted to thank you for your excellent article on lepto. We've recently moved to Maui from Australia, and have been concerned about the lepto risk to our dog. We don't allow him to swim or walk in stagnant pools of fresh water streams, but he swims in the ocean every day. Given the very low risk in sea water, I don't want to add to the toxins in his body by getting him vaccinated for lepto.
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