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HEALTH
New York, NY
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RAT URINE IS CAUSING UPTICK IN RARE DISEASE AMONG NEW YORK SANITATION WORKERS.

Eduardo Cuevas
USA TODAY


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NEW YORK – A year after New York City anointed a czar for its war on rats,
health officials are seeing a jump in cases of a rare disease linked to rat
urine.

Sanitation employees, who collect the city’s trash and are frequently exposed to
rats, say workers are disparately represented in cases of leptospirosis, the
illness caused by exposure to rats' urine.

A union shop steward experienced such severe symptoms from the disease he was
read his last rites before he made a recovery, said Harry Nespoli, president of
the Uniformed Sanitationmen's Association, which represents Department of
Sanitation workers. And when the New York City Department of Health and Mental
Hygiene released a warning about the upward trend in cases last week, another
worker was hospitalized with symptoms, he said.



“The streets are looking cleaner, but the rats are still around,” Nespoli told
USA TODAY. “Look, they were here before us.”

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In 2023, New York City had 24 cases of the disease, the highest number of any
reported year, Dr. Celia Quinn, New York City's deputy health commissioner for
disease control, wrote in the health department’s April 12 advisory. This year
there have already been six cases as of April 10. 



Between 2001 and 2023, New York had 98 cases – and about a quarter of them
occurred just in 2023, according to health department figures. Some people
experienced acute kidney and liver failure and some had severe respiratory
problems. Six people died in just over two decades.

Nearly all cases involved men and the median age for infection was 50. The Bronx
had the most cases, at 37, followed by 28 in Manhattan, 19 in Brooklyn, 10 in
Queens and four on Staten Island.



In April 2023, Mayor Eric Adams appointed the city’s first “rat czar,” whose job
is to reduce the pest population and promote cleaner streets and new approaches
to trash collection. The City Council also considered ordinances that could
decrease the rat population using a birth control program.

In 2024, six sanitation workers got the disease, according to Nespoli, of the
sanitation workers union. Five of the 24 cases the year prior occurred among
sanitation workers, he added.



Nespoli said exposure to the illness is a job risk for trash collection workers.
It can happen when workers’ gloves get wet, making them softer and easier for
rat urine to penetrate, he said. He has advised workers to change their gloves
frequently.

No sanitation workers have died of the disease, Nespoli added. But the prospect
of such a scenario prompted a state bill backed by the union that would provide
benefits to employees and their families if they become disabled or die from the
disease.





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In an email, Vincent Gragnani, a spokesperson for the city sanitation
department, said the department frequently communicates with workers about how
to prevent leptospirosis. Workers are encouraged to wear gloves to prevent
contact with rat urine, among other dangers. He said the department also reminds
workers to avoid touching their faces with work gloves.

As the city moves more trash into containers, he said, sanitation workers won’t
have as much direct contact with trash and trash bags. In the last year, placing
trash into containers has also reduced rat sightings reported to 311, including
6.3% citywide and 14.3% in rat mitigation zones, he added. By the fall, about
70% of all city trash is set to be placed in containers, which city officials
expect will further drive down rat numbers.



The health department said in an email it had worked with the sanitation
department’s medical division of occupational health to educate city workers
about occupational risks and safety protocols, including through personal
protective equipment. The department held a virtual event Wednesday to inform
workers about leptospirosis and other health risks.

“We will continue to take steps to ensure city workers are aware of best
practices,” the email said.

In its advisory last week, the health department said leptospirosis is spread
via bacteria in infected animals’ urine. It’s transmitted through direct contact
with contaminated water, soil or food which enters the body through open wounds
or mucous membranes. The specific bacteria in New York City is associated with
the Norwegian rat, the large brown breed historically found scampering through
the city's trash, streets, subways, basements and sewage. Transmission of the
disease between people is rare. Health officials said people are most likely to
become ill from contact with areas where infected rats have urinated, especially
when handling trash bags or bins.




LEPTOSPIROSIS SYMPTOMS

The incubation period for the disease is typically five to 14 days, but it can
become active after two days or it can take as long as a month to appear.
Symptoms for people vary widely but include fever, headache, diarrhea, jaundice
and rash, according to the U.S. Centers for Disease Control and Prevention. But
without treatment, the disease can lead to kidney failure, meningitis, liver
damage and respiratory distress.



In their advisory, city health officials noted the leptospira bacteria typically
die in freezing temperatures or dry heat. However, excessive rain and
unseasonably hot temperatures associated with climate change extend its
possibilities for survival, which may help explain how bacteria have come to
thrive in New York City. Officials cited hotter and wetter climates in June and
October of 2023, compared with prior years when 10 of the year’s 24 cases
occurred.

Health officials urged local providers to report cases as swiftly as possible.  

The push to control rat populations gained renewed attention earlier this year
following the death of the famous owl "Flaco," who escaped from the Central Park
Zoo and lived in New York City. In February, Flaco died after crashing into a
Manhattan building. Bronx Zoo veterinary pathologists found elevated levels of
rat poison in his system that would have impaired his ability to fly.







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