Overview
Symptoms start 1 to 8 weeks after exposure with fever and aches, then breathing can worsen quickly.
Spread by breathing dust from rodent droppings.
Symptoms
Common signs:
- Trouble breathing after flu-like symptoms
- Body aches
- Rat or mouse bite, or cleaning up droppings
Less common
- Fever
- Muscle aches
When to get medical care
Call 911Call 911 now for: trouble breathing after flu-like symptoms.
Get care todayMilder symptoms that could be early signs.
See a doctor soonQuestions about lowering your risk.
Causes
Rodents.
Does it spread or run in families?
- Yes, it can spread from person to person.
- How it spreads: rat urine, droppings, saliva, or rodents.
- Washing hands often and staying home when sick help protect others.
Who is more likely to get it
- Cleaning cabins and sheds
Diagnosis
This is diagnosed in the emergency room or hospital.
The exam
A physical exam.
Tests
Tests, if needed:
- Tests:
Treatment
Emergency care is needed. While waiting for help:
Self-care
- Call 911
- Rest
Prevention
To lower your risk or catch problems early:
- Wet droppings before cleaning
Which doctor treats this
- Emergency doctors treat it first, in the ER.
- They may send you to an infectious disease specialist, for hard-to-treat infections.
Back to school, work, or sports
- Stay home until you've had no fever for 24 hours without fever medicine and you're feeling better.
- For the next 5 days, wash hands often and wear a mask around others.
Children, pregnancy, and older adults
- Rural residents: Higher risk.
Pregnancy and breastfeeding
- If you're pregnant or planning to be, tell your prenatal provider about this condition.
- Some infections can pass to the baby during pregnancy or birth. Tell your provider if you've been exposed.
- Don't start or stop any medicine on your own. Some are safe in pregnancy and some need to be changed.
- Ask before taking any pain reliever. The FDA advises avoiding ibuprofen and naproxen after 20 weeks unless your doctor says to.
- Breastfeeding: Most medicines are fine, but ask. The NIH LactMed database lists what's known about each one.
For caregivers
- Go to visits when you can and take notes.
- Keep a list of medicines, allergies, and doctors in one place.
- Learn the warning signs that need fast care.
- Learn CPR. Many hospitals and the Red Cross offer classes.
- Take breaks and ask for help. Caregivers need care too.
Outlook
Fast ICU care improves survival.
Getting ready for your visit
Bring a list of your symptoms and medicines.
What to bring
- A list of your medicines and supplements
- Notes on when symptoms started and what makes them better or worse
Questions to ask
- What follow-up care do I need?
- How can I prevent this from happening again?
Research studies
Research studies test new ways to find and treat health problems. Some are looking for volunteers. Talk with your doctor before joining one.
Sources
Last updated 2026-11-12.