Spirochete: Leptospira interrogans
Human exposure from animal urine, contaminated water/soil, or infected animal tissue.
Portal to entry - break in skin, mucosa, or conjunctiva
Average incubation of 10 days
Also described following hiking, trekking, and following triathlon competitions
Global estimate 1 million cases annually, 58,900 deaths
Uncommon in the US, although 50% of cases diagnosis in Hawaii
Leptospirosis
Normal causes of acute fever!
Typhoid fever
Malaria
Drug fever
Dengue
Murine typhus
Chikungunya