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NYC Issues Warning Of Infectious Disease Spread By Rat Urine After Record Year Of Reported Cases

New York City health officials issued a warning about the increase in transmitted bacterial illness spread by rat urine after 24 cases were reported in 2023, the most for any year. 

Only six cases of leptospirosis have been reported in the city so far this year, but numbers were trending upward, the New York City Department of Health said. 

Cases in New York are largely associated with exposure to materials contaminated with rat urine from the Norway rat. 

The disease can cause fever, headache, chills, muscle aches, vomiting, diarrhea, cough, conjunctival suffusion, jaundice, and rash, Celia Quinn, the deputy commissioner for the Division of Disease Control, who issued an April 12 memo warning of the disease.  

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A rat crosses a Times Square subway platform. New York City health officials have issued a warning about the increase in transmitted bacterial illness spread by rat urine. (AP Photo/Richard Drew, File)

If not treated, kidney failure, meningitis, liver damage, and respiratory distress can occur, she said. 

"Transmission occurs through direct contact with infectious urine or urine contaminated water, soil, or food, entering the body through open wounds or mucous membranes," the memo states. 

From 2001 to 2023, the Bronx had the most cases with 37, while Manhattan had 28, the memo said. Six deaths were reported in the same time period.

Person-to-person transmission is rare, officials said.

The Leptospira bacteria can die within minutes in the dry heat and freezing cold, Quinn said. 

"The cold winters of NYC likely limit the extent to which leptospires can survive in the environment," she said. "However, excessive rain and unseasonably warm temperatures, factors associated with climate change, may support the persistence of leptospires in more temperate areas like NYC."

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Rats swarm around a bag of garbage near a dumpster in New York. (AP)

More than half of the 24 cases reported last year were reported between June and October, a period when there was a warmer and wetter climate with excessive rain and "unseasonably" warm days.

The number of cases raised alarms because only three per year were reported from 2001 to 2020. From 2021 to 2023, the city received 15 reports of leptospirosis.

Some 3 million rats call New York City home, according to a study by a pest company. 

In December, Mayor Eric Adams said rat infestation was partly responsible for many New Yorkers leaving the city. 

"Some people who have children and families decide they want to go to a place where their children can play outdoors, larger green spaces, you want to see animals — you don't see animals except for rats in New York," Adams said when asked about the plunging population data.

A rat scavenges for food on the subway platform at Herald Square September 3, 2017, in New York City. (Gary Hershorn/Getty Images)

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"So there's a combination of things," he added. "And we are getting rid of those rats, by the way."

Human Infections From Rat Urine On The Rise In New York City

The New York Department of Health and Mental Hygiene has released a health advisory after multiple cases of human leptospirosis -- an infection that is associated to exposure to rat urine -- have been reported so far this year in New York City.

There were 24 cases of leptospirosis in the city in 2023, higher than in any prior year, according to the NYC Department of Health and Mental Hygiene.

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However, in the first quarter of this year alone, there have already been six to date.

"For comparison, the average number of locally acquired cases during 2021 to 2023 was 15 per year, and 3 cases per year during 2001 to 2020," health officials said. "This year, 6 cases have been reported as of April 10, 2024."

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"Among the 98 locally acquired cases reported from 2001 to 2023, the median case age was 50 years (range 20 to 80 years), usually male (94%) and, reported most often from the Bronx (37), followed by Brooklyn (19), Manhattan (28), Queens (10), and Staten Island (4)," said the NYC Department of Health and Mental Hygiene.

Those suffering from severe leptospirosis have acute renal and hepatic failure and, occasionally, severe pulmonary issues, health officials in New York City said. However, symptoms may include fever, headache, chills, muscle aches, vomiting, diarrhea, cough, conjunctival suffusion, jaundice, and rash, the city said.

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The incubation period is usually 5 to 14 days but it is possible for it to last between 2 to 30 days. If leptospirosis is not treated, kidney failure, meningitis, liver damage, and respiratory distress can occur.

FILE - Rats swarm around a bag of garbage near a dumpster in New York, July 7, 2000. New York lawmakers are proposing rules to humanely drive down the population of rats and other rodents, eyeing contraception and a ban on glue traps as alternatives to poison or a slow, brutal death. (AP Photo/Robert Mecea, File)

Robert Mecea/AP

There were a total of six deaths caused by leptospirosis from 2001 to 2023 in New York City, according to the NYC Department of Health and Mental Hygiene.

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"In NYC, locally acquired cases typically have a history of a residential or occupational exposure to rat urine or environments (including soil and water) and materials contaminated with rat urine (e.G., handling trash bags or bins containing food waste), health officials said in their press release regarding the uptick in cases of leptospirosis. "Person-to-person transmission is rare. The NYC Health Department conducts inspections and works with property owners to remediate rat conditions, if indicated."

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According to the NYC Department of Health and Mental Hygiene, leptospira bacteria are fragile and can die within minutes in dry heat or freezing temperatures.

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"The cold winters of NYC likely limit the extent to which leptospires can survive in the environment," health officials said. "However excessive rain and unseasonably warm temperatures, factors associated with climate change, may support the persistence of leptospires in more temperate areas like NYC."

In 2023, half of the locally acquired cases were reported in the months of June (5) and October (5), months that were warmer and wetter with excessive rain and unseasonably warm days compared to prior years, according to the NYC Department of Health and Mental Hygiene.

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Cases of leptospirosis must be reported to the NYC Health Department within 24 hours and more information about the illness can be found on the New York City Health Department and CDC websites.

"As always, we appreciate your collaboration in improving the health of New Yorkers and helping us direct remediation efforts in New York City," said Celia Quinn, Deputy Commissioner of the Division of Disease Control in New York City.

Deadly In Dogs And Humans, Cases Of Bacterial Infection Linked To Rats Trend Up In NYC

What to Know

Human leptospirosis infections in NYC are largely associated with exposure to environments and materials contaminated with rat urine.

Six cases have been reported so far in 2024, compared with 24 for all of last year; the 2023 total was the highest ever recorded in a year by city health officials

In NYC, locally acquired cases typically have a history of a residential or occupational exposure to rat urine or environments or contaminated materials

The New York City Department of Health is urging providers to be aware of a continued uptick in a potentially deadly rat-transmitted bacterial illness that can infect both humans and pets.

Cases of human leptospirosis remain limited -- there have been six cases reported to date in the city this year -- but are trending upward. Twenty-four cases were reported to New York City in 2023, the highest annual total yet, officials say.

Infections in the city are largely associated with exposure to environments and materials contaminated with rat urine, including soil, water and trash bags or bags containing food waste.

Symptoms range from fever to headache, chills, muscle aches, vomiting, diarrhea, cough, jaundice and rash. The incubation period is usually 5 to 14 days, with a range of 2 to 30 days. If not treated, kidney failure, meningitis, liver damage and respiratory distress can occur. Leptospirosis is treated with antibiotics, like penicillin and doxycycline.

Over the last 22 years, just 98 locally acquired cases have been reported. Clinically, cases presented with acute renal and hepatic failure, and occasionally severe pulmonary involvement. Six of those 98 patients died. Across the board, the median case age was 50, usually male (94%) and reported most often from the Bronx (37), followed by Manhattan (28), Brooklyn (19), Queens (10) and Staten Island (4). Person-to-person transmission is rare.

Leptospira bacteria can die within minutes in dry heat or freezing temperatures, limiting their survival in the city's cold winters. Excessive rain (we just had a fourth-wettest March on record) and unseasonable warmth, factors associated with climate change, may support the persistence of the bacteria.

Last year, half of the locally acquired cases were reported in the months of June and October, months that were warmer and wetter with heavy rain and unseasonably warm days compared with prior years, health officials said.

Leptospirosis can also be a life-threatening disease in canines. Dog to human transmission is rare. In early 2022, the suspected leptospirosis-related deaths of four dogs prompted an investigation and closure of a popular Brooklyn dog park.

Diagnostic testing is available and includes PCR on blood, urine and serologic testing. A blood test would detect the disease the fastest. Cases are required to be reported to the city health department within 24 hours.

New York lawmakers are proposing rules to humanely drive down the population of rats and other rodents. They are eyeing rat birth control and a ban on glue traps as alternatives to poison or a slow, brutal death. A new rule recently went into effect requiring all businesses to use lidded trash bins or face fines.

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