Routes of spread to humans:
(1) skin abrasion or cut
(2) conjunctiva
(3) inhalation of aerosols
(4) drinking or swallowing water
(5) animal bites
(6) human to human contact, including sexual intercourse
Sources:
(1) direct contact with animal urine
(2) indirect contact with urine through environmental water
Direct contact with animal urine:
(1) livestock farmer
(2) veterinarian
(3) abattoir (slaughterhouse) workers
(4) meat inspectors
(5) rodent handlers or control workers
(6) hunters
(7) rodent urine on utensils, food or beverage cans
(8) pet handling
Indirect contact:
(1) miners
(2) sewer workers
(3) soldiers
(4) septic tank cleaner
(5) gamekeeper
(6) canal workers
(7) rice field workers
(8) fish workers
(9) swimming in a creek or lake
(10) drinking water
(11) canoeing or boating
(12) white water rafting
(13) caving
(14) walking barefoot
(15) tropical farmers (taro, banana or sugar cane)
(16) camping
Animals infected:
(1) rats, voles and other rodents
(2) dogs, wolves and foxes
(3) pigs
(4) cattle
(5) sheep
Environmental risk factors for survival and spread:
(1) warm and humid weather
(2) flooding
(3) rainy season
(4) water of neutral pH
Protective measures associated with decreased survival and spread:
(1) detergent
(2) skin protection
(3) animal control measures
(4) drainage of wetlands
(5) salt water
