Latin America

the urine of rodents, livestock, or other infected mammals. Dogs MUST be vaccinated yearly against it in areas particularly at risk. But ingestion of contaminated water or exposure to urine from an infected animal puts humans at risk. Los Angeles has been having a major outbreak--yes, LA and some of those infected dogs (with wealthy owners) have had to undergo dialysis at UC-Davis Veterinary School, but many have died regardless. So, yeah, it is damned serious in terms of both kidney and liver damage. And, in recent years, there have been human outbreaks among triathletes swimming in infected lakes (Indiana outbreak comes to mind, but there were others--likely from infected livestock).

Physicians in endemic areas know to look for it in febrile patients with acute renal and liver involvement, but anti-vaxx dog owners may put their owners at risk--yeah, that is happening.