Symptoms of leptospirosis:

The symptoms of leptospirosis usually develop seven to 14 days after the initial contact with infection, although they can develop in as little as three days, or as long as 30 days.

Phases of infection

The symptoms of leptospirosis can be characterised into two phases:

• Acute phase: this is the only phase that most people with leptospirosis will experience.

• Second phase: this phase will be experienced by five to 10% of people with leptospirosis.

The acute phase

Common symptoms of the acute phase of the infection include:

• fever, e.g. a temperature of, or above, 38°C (100.4F),

• severe joint pain, particularly in your calf muscles,

• headache, and

• chills.

Less common symptoms include:

• nausea,

• vomiting,

• diarrhoea,

• cough,

• sore throat, and

• a skin rash.

The symptoms of the acute phase should pass within four to nine days.

The second phase

About a week after the acute phase has passed, five to 10% of people with leptospirosis will enter a second, more serious, phase. It is not fully understood why this occurs.

The symptoms of the second phase are caused by the leptospires bacteria infecting organs, such as the brain, kidneys, liver, eyes and lungs.

The brain

Infection of the brain can cause symptoms of meningitis such as:

• a severe headache,

• sensitivity to light, and

• a stiff neck.

The kidneys

In the most serious cases of leptospirosis, the kidneys can lose all function (renal failure). This can cause symptoms such as:

• loss of appetite,

• tiredness,

• shortness of breath, and

• swollen ankles, feet or hands.

The liver

Infection of the liver can cause symptoms of hepatitis which include:

• weight loss,

• muscle aches,

• tiredness,

• nausea,

• alcohol intolerance,

• pain in the area over the liver, and

• yellowing of the skin and eyes (jaundice).

Without treatment, the function of the liver can deteriorate rapidly. If liver failure occurs, it can lead to death.

The eyes

In cases of leptospirosis, it is usually the iris or the tissues and muscles that support the iris and retina that become infected. This type of eye infection is known as uveitis. Symptoms of uveitis include:

• red, painful eyes,

• sensitivity to light (photophobia),

• floaters (dots that move across the field of vision), and

• blurred vision.

The lungs

Infections of the lungs can cause symptoms such as:

• coughing,

• shortness of breath, and

• coughing or splitting up blood.

If untreated, the lungs can become severely damaged causing a major loss of lung function and internal bleeding, both of which can be fatal.