Weil's disease, believed to have caused the death this week of Olympic gold medal-winning rower Andy Holmes, is the acute human form of a bacterial infection with a raft of different names: mud fever, swamp fever, haemorrhagic jaundice, swineherd's disease, sewerman's flu. All are known as Leptospirosis, mild cases of which affect millions of people every year worldwide.
The infection is caught through contact with infected animal urine (mainly from rodents, cattle or pigs), generally in contaminated water, and typically enters the body through cuts or scrapes, or the lining of the nose, mouth, throat or eyes. Only a very few patients experience the severe, life-threatening illness known as Weil's disease, thought to kill two or three people a year in Britain.
After an incubation period that can vary from three days to three weeks, most patients suffer severe headaches, red eyes, muscle pains, fatigue, nausea and a temperature of 39C or above. In roughly a third of cases there is a skin rash; sometimes hallucinations.
In very severe cases, symptoms include haemorrhaging from the mouth, eyes and internally. There is significant and rapid organ damage: liver and kidney failure can occur within 10 days, leading to jaundice (these are the only cases that can properly be called Weil's disease). Hospitalisation, followed by antibiotics and often dialysis, will be required if the patient is to survive. Recovery can take months.
According to British Rowing, the risk of contracting Weil's disease from recreational water in the UK is "very small". Infection is logically more likely in slow-moving or stagnant water and areas where agriculture and rodents mix; lakes, ponds and canals are more likely to be contaminated than fast-running streams, although some activities – angling, for example, where minor cuts and nicks are common, and swimming, where some water will almost inevitably enter the mouth – could heighten exposure.
Rowers and canoeists should cover all cuts and abrasions; avoid splashing themselves, or swallowing potentially contaminated water; wash their hands carefully and if possible shower afterwards; and wash all equipment and clothing regularly. Anyone experiencing flu-like symptoms after contact with fresh water should see their doctor immediately.
