There's Something in the Water… Explaining the Link Between Leptospirosis and Tourism
Author: Erin Sarah Peak
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Many of you will not have heard of leptospirosis… and it is for this very reason why it is such a prominent health risk to tourists and travellers.
Leptospirosis is a zoonotic infection, in other words water and land can easily become contaminated with the bacteria by animals that have the disease. There will be no obvious signs that this has occurred, and many tourists do not realise that there is any health risk to them. The main way in which tourists contract this disease is through the participation of water sports, as this is a growing sector of niche tourism, leptospirosis has re-emerged in recent years. Leptospirosis has affected many countries with a subtropical climate, which just happen to be the main destinations for tourists to visit from the United Kingdom. Primary research conducted found that there have been recent cases in Northern Mindanao, Cuba, India, Fiji and Malaysia.
Air travel has increased rapidly as a means of transports for tourists, allowing people to travel further than ever before. This increased mobility of travellers is believed to be a primary reason for the re-emergence of leptospirosis, as travelling by air allows for the rapid dissemination of the disease. This is due to the fact that almost any location in the world can now be reached within 36 hours, less than the incubation period for most disease; this is the time between when an individual is exposed to the bacteria, and when signs and symptoms begin to show. This demonstrates how easily an individual could travel from one country to another, without realising that they were infected, which ultimately spreads the disease globally.
When tourists are faced with a health hazard which is uncommon to their country of origin they may not be aware of the precautions to take, and what symptoms are associated with various diseases, with the symptoms of leptospirosis very similar to influenza, it is often under or misdiagnosed. Therefore health promotional material needs to be available for tourists to access, however a look into this further found challenging findings. The Foreign and Commonwealth Office provide information for travellers and British nationals living abroad; concerning the different risk factors they may face in a given destination. When observing their website to see what information they had available on leptospirosis, it was virtually impossible to find. All of the information on leptospirosis referred to particular countries, and therefore if you were travelling to another destination, this could be easily missed. Demonstrating just why tourists are so under - informed about leptospirosis.
Primary research was conducted in order to investigate the opinions and behaviours of those who had contracted leptospirosis whilst on holiday. This was done by considering the content of online forums. Coding was used in order to identify the main themes, which were identified as; risk factors, symptoms, diagnosis and post illness behaviour. It was found that the biggest risk factor was participating in water sports, with more active sports posing a greater risk. Secondly it was found that cuts on the feet and body had resulted in many cases of leptospirosis and finally several people had contracted the disease from drinking contaminated water. Many people were unsure of the symptoms for leptospirosis, and had suffered from symptoms similar to influenza; this led to many people mistaking the disease for another illness. Symptoms did not appear for at least a week, which resulted in many people not seeking medical treatment until they were back in their home country. This delay in treatment resulted in more serious symptoms. Many of those who sought medical treatment were misdiagnosed by doctors, and to conclude it was found that misdiagnosis is more frequent in countries where leptospirosis is uncommon.
From the evidence identified it can be seen that leptospirosis is re-emerging in many countries, providing concern for health officials as well as destination managers. It is anticipated that by making small changes, such as informing tourists of the risks, in a clear and concise way, would reduce the chance of them contracting leptospirosis. It is anticipated that the tourist will have a better holiday experience being aware of leptospirosis, and taking precautions, than instead of contracting the disease. This will help to prevent some of the 500,000 reported cases of leptospirosis each year.
References
Hartskeerl, R.A., Collares-Pereira, M. and Ellis, W.A. (2011) Emergence, control and re-emerging leptospirosis: dynamics of infection in the changing world. Clinical Microbiology and Infection, 17 (4), pp.494-501.
Lau, C., Smythe, L. and Weinstein, P. (2010) Leptospirosis: an emerging disease in travellers. Travel Medicine and Infectious Disease, 8 (1), pp.33-39.
Pappas, G., Papadimitriou, P., Siozopoulou, V., Christou, L. and Akritidis, N. (2008) The globalisation of leptospirosis: worldwide incidence trends. International Journal of Infectious Diseases, 12 (4), pp.351-357.
Leptospirosis is a zoonotic infection, in other words water and land can easily become contaminated with the bacteria by animals that have the disease. There will be no obvious signs that this has occurred, and many tourists do not realise that there is any health risk to them. The main way in which tourists contract this disease is through the participation of water sports, as this is a growing sector of niche tourism, leptospirosis has re-emerged in recent years. Leptospirosis has affected many countries with a subtropical climate, which just happen to be the main destinations for tourists to visit from the United Kingdom. Primary research conducted found that there have been recent cases in Northern Mindanao, Cuba, India, Fiji and Malaysia.
Air travel has increased rapidly as a means of transports for tourists, allowing people to travel further than ever before. This increased mobility of travellers is believed to be a primary reason for the re-emergence of leptospirosis, as travelling by air allows for the rapid dissemination of the disease. This is due to the fact that almost any location in the world can now be reached within 36 hours, less than the incubation period for most disease; this is the time between when an individual is exposed to the bacteria, and when signs and symptoms begin to show. This demonstrates how easily an individual could travel from one country to another, without realising that they were infected, which ultimately spreads the disease globally.
When tourists are faced with a health hazard which is uncommon to their country of origin they may not be aware of the precautions to take, and what symptoms are associated with various diseases, with the symptoms of leptospirosis very similar to influenza, it is often under or misdiagnosed. Therefore health promotional material needs to be available for tourists to access, however a look into this further found challenging findings. The Foreign and Commonwealth Office provide information for travellers and British nationals living abroad; concerning the different risk factors they may face in a given destination. When observing their website to see what information they had available on leptospirosis, it was virtually impossible to find. All of the information on leptospirosis referred to particular countries, and therefore if you were travelling to another destination, this could be easily missed. Demonstrating just why tourists are so under - informed about leptospirosis.
Primary research was conducted in order to investigate the opinions and behaviours of those who had contracted leptospirosis whilst on holiday. This was done by considering the content of online forums. Coding was used in order to identify the main themes, which were identified as; risk factors, symptoms, diagnosis and post illness behaviour. It was found that the biggest risk factor was participating in water sports, with more active sports posing a greater risk. Secondly it was found that cuts on the feet and body had resulted in many cases of leptospirosis and finally several people had contracted the disease from drinking contaminated water. Many people were unsure of the symptoms for leptospirosis, and had suffered from symptoms similar to influenza; this led to many people mistaking the disease for another illness. Symptoms did not appear for at least a week, which resulted in many people not seeking medical treatment until they were back in their home country. This delay in treatment resulted in more serious symptoms. Many of those who sought medical treatment were misdiagnosed by doctors, and to conclude it was found that misdiagnosis is more frequent in countries where leptospirosis is uncommon.
From the evidence identified it can be seen that leptospirosis is re-emerging in many countries, providing concern for health officials as well as destination managers. It is anticipated that by making small changes, such as informing tourists of the risks, in a clear and concise way, would reduce the chance of them contracting leptospirosis. It is anticipated that the tourist will have a better holiday experience being aware of leptospirosis, and taking precautions, than instead of contracting the disease. This will help to prevent some of the 500,000 reported cases of leptospirosis each year.
References
Hartskeerl, R.A., Collares-Pereira, M. and Ellis, W.A. (2011) Emergence, control and re-emerging leptospirosis: dynamics of infection in the changing world. Clinical Microbiology and Infection, 17 (4), pp.494-501.
Lau, C., Smythe, L. and Weinstein, P. (2010) Leptospirosis: an emerging disease in travellers. Travel Medicine and Infectious Disease, 8 (1), pp.33-39.
Pappas, G., Papadimitriou, P., Siozopoulou, V., Christou, L. and Akritidis, N. (2008) The globalisation of leptospirosis: worldwide incidence trends. International Journal of Infectious Diseases, 12 (4), pp.351-357.