Education and advice for teachers and schools

The risks of exposure to infection from wild animals, especially rodents, is rarely taught in schools. This is a situation that causes some concern as often those most at risk are the 5-16 age group, as they are:

  • More likely to play in or near contaminated water, especially in urban areas
  • Less likely to associate risk with their actions
  • Less likely to associate the presence of rats with any danger of infection
  • More likely to have symptoms ignored or mis-diagnosed by parents or doctors

There are two separate aspects to an education awareness scheme, but a balance must be drawn between realistic explanation of risks and over-emphasis or causing panic. The depth of any scheme needs to reflect the local environmental conditions and be aimed at two end groups:-

  1. Parents and guardians should be aware of the risks, but also the symptoms of infection.
  2. Children should be aware of the risks and how to associate what they see with what dangers are presented.

Education for parents

Parents and guardians should be made aware of the fact that leptospirosis exists in the first instance. In recent surveys, less than 20% of adults knew of the infection at all – many people in the developed world associate rats with historical infections such as Plague, but only consider the current threat to be that of general uncleanliness leading to risks of food poisoning, or infection from bites. It is certainly true that in many urban areas the statistical risks of contracting leptospirosis are small, but with areas having a large feral rodent or mammal population, or where school trips are planned, the exposure risks can be significant. The infection may not be caught while at school, but could be prevented by what happens there.

Education presented via children to parents must be by nature of logistics a target-oriented system – children at increased risk can be targeted, however it is impractical to promote education to the entire population and could be counter-productive. Those groups at higher risk include families:-

  • based in farming areas
  • based in areas of inland waterways
  • engaged in high-risk pastimes or sports such as watersports (canoeing, sailing, fishing, etc)
  • based in urban areas with known histories of rodent infestation

Education of target groups should include awareness of the following points:-

  • Rats carry a bacterial infection that they leave behind in their urine. This can contaminate water, food or other wet areas they travel through.
  • Contact with urine or items that have urine on them, if eaten or applied to broken skin, can cause an infection but the urine has to remain wet. Dry surfaces are not a risk.
  • The general initial symptoms of the infection should be discussed.
  • The risks are specifically from water or damp materials contaminated with urine and this must enter the body via some means. There are minimal risks from the general acts of living in areas with rat populations provided sensible hygiene is observed. The infection rarely passes from person to person. It can occasionally be caught from pets and livestock.
  • Pet rats and other domesticated rodents, if isolated from feral carriers, are of no risk.

Education for children

There are two main points to emphasise to children in target groups, the methods of achieving this are both age- and group-dependent. Education of children in a sporting group, such as a canoe club, can be specific and more advanced than for a general population. Those with a specific connection to risk can be educated as part of their sporting training and as such will take more interest in the subject. As is the case in general for education, a non-specific target group will show very poor uptake and retention of information which they think is not important to them. Unlike with ‘famous’ infections such as rabies and the plague, there are no great historical accounts of leptospirosis to use in education – but the infection has been seen in recent natural disasters such as flooding from hurricanes and tsunamis, and so can be integrated into current affairs subjects.

Although this website makes the point several times that rats are not the only carrier of infection, for educating children it can help to stereotype – however if in your location the carrier species is different, the children should be aware of it. So, what to tell them?

Point one: Rats

To most school-age children, rats are a source of fear and excitement. Many of them will never see a rat ‘up close’, however are exposed to them on TV, in books and films, often as an object of fear. When presented with one in reality, they tend to contrast fear and wariness with fascination. Very few children would consider handling a rat, but correspondingly many would spend time watching one, throwing stones it it, prodding it with a stick, chasing it, etc. The risks arise from the fact that during this time the child may be exposed to area contamination (such as from water), about which they know nothing.
Children should be told that rats carry infections, though most inately know this from media exposure. The emphasis should be placed on the fact that areas where rats live are also sources of infection even when the rats are not at home. They should be told the urine from rats can infect water, soil, food or anything else damp the rats walk over, and that drinking, eating or handling these items can cause a serious illness. The initial effects come on about a week later and seem like a very bad cold, but can get a lot worse, ending with hospital treatment and sometimes death. The golden rule is to avoid any places where rats may live or visit, and never to drink or eat anything that a rat may have been near to.

Point two: Water

Children are exposed to contaminated water usually via local lakes, rivers etc. during play. There is a separate issue of exposure caused by specific recreational use of water, such as for canoeing. For the general exposure risks, emphasis must be placed on the idea that both urban and rural lakes, rivers, canals, even small ponds, can present a risk of infection through swimming, drinking the water or contact with broken skin. Children should be taught to treat such locations, however clean they may look initially, as dangerous until proven otherwise. This can be connected to general water safety and anti-drowning messages. It is not simply leptospira that present a risk from bodies of water, there are also numerous bacterial and microcellular pathogens commonly present that can cause skin irritation, digestive disorders, vomiting, fever and worse. If they accidentally fall into water then they should tell their parent or guardian about it. Finally it’s important to point out that water doesn’t have to be dirty or smelly to be dangerous – often rats will prefer their homes to be clean.