Doctors urge caution during rainy-season travel amid risks from floodwater and rodent-contaminated surroundings.
Dubai: The family of an Indian expatriate in Dubai who died last week while on vacation in Kerala has confirmed that final laboratory tests showed he had contracted leptospirosis, commonly known as rat fever. The case has highlighted the risks associated with rainy-season travel, particularly exposure to floodwater and rodent-contaminated environments.
Teejo George, 48, a senior sales supervisor at a Dubai-based engineering consultancy, died at a hospital in Kannur on August 8, two days after being admitted with diarrhoea and body pain. Doctors had initially suspected rat fever.
His family later told Gulf News that additional laboratory tests confirmed he had leptospirosis, a bacterial infection that can spread through contact with water, soil or food contaminated by the urine of infected animals, particularly rodents.
The tragedy has resonated deeply within his UAE community, where he had lived and worked for nearly three decades. It has also highlighted the health risks expatriates may face when travelling to flood-prone areas during the rainy season, as well as when staying in homes or surroundings affected by rodent infestations.
What is rat fever?
Speaking to Gulf News, Dr Bashirat L. Giwa, an infectious disease consultant at Burjeel Medical City, Abu Dhabi, explained that the term “rat fever” is used loosely. “Rat fever” typically refers to rat-bite fever, a rare but serious bacterial infection transmitted by rodents.
It can also refer to leptospirosis, a separate bacterial infection transmitted through water or soil contaminated with the urine of infected rats and other animals,” she said. While both illnesses can cause fever and body aches, they differ in their causes and associated risks.
Incubation and symptoms
“The incubation period for leptospirosis is typically five to 14 days after exposure to the bacteria, although symptoms can develop anywhere between two and 30 days,” Dr Bashirat said.
Dr Deepak Damodaran, an internal medicine specialist at Aster Speciality Clinic, International City, Dubai, said the incubation period generally ranges from five days to two weeks. Early symptoms may include fever, headache — particularly pain behind the eyes — eye redness or congestion, muscle aches, especially in the legs, and nausea, vomiting or diarrhoea.
Dr Bashirat advised people who develop sudden fever, severe headache, red eyes or muscle pain, particularly in the calves or lower back, after exposure to floodwater, mud or animal urine to seek medical attention promptly. She noted that the infection “can progress rapidly from a mild flu-like illness to life-threatening severe disease.”
Red flags to watch
Both doctors stressed that leptospirosis can mimic common viral infections, influenza and dengue in its early stages, making it difficult to recognise and potentially dangerous if diagnosis is delayed.
Dr Bashirat said warning signs include jaundice accompanied by dark, tea-coloured urine, which may indicate liver damage; a significant reduction in urine output or swelling in the legs, which can signal kidney injury; unexplained bleeding or blood in vomit or stool; severe breathlessness or coughing up blood-stained sputum; and confusion, a stiff neck or seizures, which may indicate involvement of the nervous system.
Dr Deepak highlighted similar warning signs, including jaundice, reduced urine output, drowsiness, cough, breathlessness and chest pain.
Diarrhoea without fever
Although uncommon, diarrhoea can occur without fever, particularly in older adults or people with weakened immune systems, Dr Bashirat said. She explained that once Leptospira bacteria enter the bloodstream, they can irritate the lining of the digestive tract.
Patients should avoid self-treatment, Dr Deepak cautioned, noting that “vomiting and diarrhoea can cause dehydration and kidney failure if not properly monitored.”
Telling it apart
Distinguishing leptospirosis from dengue or a viral fever in the early stages can be difficult, as all three may begin with sudden fever, headache and generalised body aches, Dr Bashirat said.
One possible clue is eye redness without discharge, which may develop within the first three to four days of leptospirosis. By contrast, dengue is more commonly associated with pain behind the eyes. Muscle pain can also differ, with leptospirosis often causing severe, localised pain in the calves and lower back, while dengue tends to cause more widespread joint and bone pain.
Dr Deepak said key warning signs include “high fever with chills, muscle aches and a history of exposure to stagnant water.”
He added that a fever developing “within a week” of contact with rodents should raise suspicion of leptospirosis, particularly if similar cases have been reported in the same neighbourhood.
How fast it can turn serious
If left untreated, leptospirosis can progress from mild fever and other initial symptoms to organ failure within three to seven days. Once severe complications develop, a patient’s condition can deteriorate rapidly, sometimes within 24 to 48 hours, Dr Bashirat said.
Dr Deepak noted that progression to severe disease can also occur around a week after the onset of fever.
Jaundice not always present
Both doctors stressed that the absence of jaundice does not rule out leptospirosis. “Approximately 80% to 90% of symptomatic leptospirosis cases are anicteric, meaning they occur without jaundice,” Dr Bashirat said.
Dr Deepak similarly noted that the infection “can occur without jaundice”. Both doctors urged patients to tell their doctors about any recent exposure to floodwater, mud or rodents, as well as stays in homes that have remained locked and unoccupied for extended periods.
Dr Deepak described this as “a vital piece of history”, particularly for expatriates who develop symptoms after returning to the Gulf.
Risk in shut homes
Dr Deepak highlighted a particular risk for expatriates returning home during holidays. Homes left locked and unoccupied for months can attract rodents, which he identified as a major source of Leptospira bacteria.
Before entering or cleaning a home that has been closed for a long period, or dealing with a rodent infestation, Dr Deepak advised covering any cuts or scratches with waterproof dressings, wearing rubber gloves and enclosed waterproof footwear, and avoiding direct skin contact with dust or rodent droppings. He also recommended ventilating the premises before cleaning and never handling rodents or their droppings with bare hands.
Dead rodents and droppings should be removed using a shovel or while wearing gloves. The affected area should then be disinfected with a solution such as bleach, followed by thorough hand and skin washing with soap and water, the doctors advised.
Don’t drown rats in buckets
Experts also warned against a less obvious household practice: drowning trapped rats in buckets of water. Leptospira bacteria shed through rat urine can contaminate the water, potentially causing infection if it comes into contact with cuts, scrapes or even small wounds from recent nail clipping.
Because symptoms typically appear five to 14 days after exposure — and in some cases up to 30 days later — people may not immediately connect the infection to such an everyday household task.
