"Leptospirosis can be more serious in certain populations, including pregnant individuals, and may pose risks to both the pregnant person and the fetus," Department of Health spokesperson Adam LeFebvre told CG. "However, the risk can be managed with precautions and early medical care."
Heavy rainstorms in Hawai'i have created conditions that increase the risk of exposure to leptospirosis. The bacterial disease can infect both animals and humans while posing specific risks to pregnant people.
"Flooding events like the recent Kona Low storm can dramatically increase exposure risk by spreading contaminated soil and water across a broad area," the state's Department of Health and the Hawaiian Humane Society said together in a news release this week, per the Honolulu Star-Advertiser.
Two Kona Low storms — a type of seasonal cyclone — hit the state in March, dumping an estimated 2 trillion gallons of rain on the archipelago and causing significant flooding. While recent years have been drier, some experts believe climate change may be exacerbating the storms that do occur.
"Even if we're getting drier on average over time, which we seem to be doing, we can have these bigger extremes than we've had in the past," University of Hawai'i Climate Data Portal Mesonet Director Thomas Giambelluca told Hawai'i Public Radio. "And that is consistent with how we think the atmosphere is changing due to climate change."
While not wanting to alarm the public, the state's Humane Society has confirmed a single case of leptospirosis in a stray dog, which is particularly notable because the disease is zoonotic, meaning it can be spread from animals to people. The disease is caused by Leptospira, bacteria carried in the urine of infected animals, such as rodents, dogs, and pigs.
Symptoms include fever, headache, chills, sweating, muscle aches, jaundice, vomiting, diarrhea, a rash, and, in the absence of treatment, even death. Hawai'i has some of the highest infection risks in the U.S. due to its generally wetter, warmer climate, the Humane Society told local station KHON2.
According to the Centers for Disease Control and Prevention, around 1 million human cases occur each year around the world, with almost 60,000 fatalities attributed to the infection. It is among the flood-spread health concerns that the U.N. Population Fund warned pregnant people about in the aftermath of 2025's Hurricane Melissa.
"Leptospirosis can be more serious in certain populations, including pregnant individuals, and may pose risks to both the pregnant person and the fetus," DOH spokesperson Adam LeFebvre told CG via email. "However, the risk can be managed with precautions and early medical care. Pregnant individuals should be especially mindful to avoid exposure and contact their health care provider promptly if they develop symptoms."
According to a 2018 CDC factsheet, the disease "can cause fetal complications including fetal death or abortion." A systematic review published in 2021 in PLOS Neglected Tropical Diseases indicated that "fetal outcomes were found to be more common in pregnant patients who presented in the second trimester compared with patients who presented in the third trimester."
The review co-authors also noted that symptoms may mimic certain conditions associated with pregnancy, including preeclampsia, acute fatty liver of pregnancy, and HELLP syndrome (Hemolysis, Elevated Liver enzymes, and Low Platelets), "therefore further contributing to the issue of underdiagnosis" of the bacterial disease.
In addition to immediate medical care, the DOH advises avoiding exposure to floodwaters, mud, and contaminated materials, noting that the bacteria can survive for weeks or even months in soil and water.
"If exposure cannot be avoided, wear protective gear such as boots and gloves, cover any cuts or abrasions, and wash thoroughly with soap and clean water as soon as possible," LeFebvre told CG. "Prompt wound care and good hygiene go a long way in preventing infection. Avoid swallowing floodwater and take care when handling wet soil or debris."
The department is actively monitoring the situation, underscoring that while exposure risks can increase following storms, basic precautions and timely care can address these concerns.
"Our goal is to ensure residents have the information they need to stay safe and seek treatment quickly if needed," LeFebvre said.
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