The Travel Health and Vaccine Specialists

Health Alert



Leptospirosis in Israel

Updated September 18, 2018

Key Points
There is an outbreak of leptospirosis in northern Israel (Golan Heights).
Travelers at highest risk are those exposed to contaminated fresh water (like lakes and rivers in the affected area) through activities such as swimming, wading, kayaking, or rafting.
What is leptospirosis?
Leptospirosis is a disease spread by animal urine. People get infected when they come in contact with urine of infected animals or with urine-contaminated water, soil, or food.

Symptoms include fever, headache, chills, muscle aches, vomiting, jaundice (yellow eyes and skin), red eyes, stomach pain, diarrhea, and rarely, a rash. This disease can be deadly and in the more severe cases can cause kidney or liver failure, meningitis (swelling of the tissue covering the brain), or bleeding in the lungs.

What is the current situation?
Health officials in Israel have reported an outbreak of leptospirosis in the Golan Heights region of northern Israel. Cases have been linked to seven water sites, six of which are currently closed to the public: waterways of Gilabun (Jilbon), Majrase, Meshushim, Yarden (Jordan) Park, Yehudiya, Zakhi, and Zavitan.

In response to the outbreak, the Israeli Ministry of Health is working to manage the situation with the Israeli health care sector, the Nature and Parks Authority, the ministries of Agriculture and Rural Development and Environmental Protection, the Water Authority, and Mekorot (the national water company of Israel).

Who is at risk for leptospirosis?
Travelers at highest risk are those exposed to contaminated fresh water (like lakes and rivers in affected areas) through activities such as swimming, wading, kayaking, or rafting. Leptospirosis is also a potential hazard for travelers who spend time around animals, such as veterinarians and animal caretakers; humanitarian aid workers, and adventure travelers.

What can travelers do to prevent leptospirosis?
Travelers to areas with risk of leptospirosis can take the following steps to prevent the disease:

Avoid contact with water or soil that may be contaminated with animal urine, including the seven specific bodies of water listed above.
Don’t wade, swim in, or drink or swallow water from lakes or rivers that may be contaminated.
Cover any cuts or abrasions, and wear waterproof protective clothing, especially footwear, if you must have contact with water that might be contaminated.
Talk to your health care provider about taking medicine to help prevent leptospirosis if you cannot avoid contact with potentially contaminated water or soil. Be sure to tell your health care provider about all your planned activities.
There is no vaccine approved in the United States to prevent leptospirosis.

If you get sick during or after travel
If you feel sick during travel and think you may have leptospirosis:

Seek medical care immediately. Leptospirosis can be treated with antibiotics, which are most effective when given early during illness.
If you get sick after returning to the United States:

Seek medical care immediately. Tell them about your travel and that you think you have been exposed to contaminated water.
Learn more about leptospirosis, how to prevent it, and what to do if you think you have it at CDC’s leptospirosis page for travelers.

What can clinicians do?
Think Travel: Ask patients about recent international travel and keep leptospirosis in mind when treating patients with acute febrile illness within 4 weeks of travel to Golan Heights region in northern Israel, especially if they were exposed to one of the seven water sites listed above.
CDC has issued advice to clinicians for evaluation and treatment of ill travelers with potential exposure to leptospirosis, see “Advice to Clinicians about Leptospirosis in U.S. Travelers Returning from Northern Israel.”
Traveler Information
CDC Leptospirosis website
Leptospirosis Risk in Outdoor Activities
Leptospirosis Fact Sheet
Leptospirosis Prevention
Clinician Information
Advice to Clinicians about Leptospirosis in U.S. Travelers Returning from Northern Israel
Leptospirosis in CDC Health Information for International Travel (“Yellow Book”)
Leptospirosis Overview for Health Care Workers
Leptospirosis Fact Sheet for Clinicians
Think Travel posters to help start the conversation with patients about upcoming or recent international travel
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Page created: September 07, 2018
Page last updated: September 14, 2018
Page last reviewed: September 14, 2018
Content source: Centers for Disease Control and Prevention
National Center for Emerging and Zoonotic Infectious Diseases (NCEZID)
Division of Global Migration and Quarantine (DGMQ)
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