Kencing tikus (leptospirosis) is an infection spread through water or soil contaminated by the urine of infected animals, most often rats, and it is endemic in Malaysia. You can catch it when contaminated water gets into your mouth, eyes or a cut, for example during floods or while swimming in rivers and waterfalls. Many people have no symptoms or a mild flu-like illness, but some become seriously ill, with signs such as jaundice, being unable to pee or breathing difficulty. It is treated with antibiotics, so see a doctor if you develop a fever after contact with floodwater or rivers. There is no vaccine for people, so prevention means avoiding contaminated water and covering cuts.
What is kencing tikus (leptospirosis)?
Kencing tikus ("rat urine") is the Malay name for leptospirosis, also called Weil's disease. According to the NHS:
- it is an infection you can get from animals, soil or water;
- it is spread in the pee of infected animals, most commonly rats, and also mice, cows, pigs and dogs;
- most people who get it have no symptoms or mild flu-like symptoms, but some people get seriously ill.
Why is leptospirosis a concern in Malaysia?
Leptospirosis is much more common in warm, wet countries than in places such as the UK. In Malaysia:
- a 2025 Malaysian systematic review in Tropical Biomedicine describes leptospirosis as endemic in Malaysia, like dengue and malaria, and as one of the top causes of infectious disease-related deaths in the country;
- it has been a notifiable disease since 2010, which has improved reporting;
- the review concluded that it remains common and called for better public health action, especially in flood-prone areas;
- a 2025 review of Malaysian cases from 1976 to 2023 in Veterinary World found a notable link between outbreaks and occupational exposure, recreational water activities and monsoon-related flooding, with agricultural workers, town service workers and animal handlers at higher risk.
How do you get kencing tikus?
According to the NHS, you can get leptospirosis if:
- soil or fresh water (such as a river, lake or canal) containing infected pee gets into your mouth, eyes or a cut, often during activities like swimming, kayaking or fishing;
- you touch an infected animal's blood or flesh, usually through work with animals or animal parts.
In Malaysia, outbreaks have been linked to floods, recreational water activities such as swimming at rivers and waterfalls, and work in agriculture, town services or with animals. It is very rare to get leptospirosis from pets, other people or bites.
Simptom kencing tikus: what are the signs?
According to the NHS, symptoms of leptospirosis may include:
- a high temperature;
- headache;
- body aches and pain;
- tummy ache;
- feeling sick or being sick;
- diarrhoea;
- redness in the white part of the eyes;
- yellowing of the skin or the whites of the eyes (jaundice).
See a doctor if you might have been exposed to contaminated water, soil or animal pee and you have a fever, chills, headache, sickness, diarrhoea, body aches, red eyes or loss of appetite. Always tell the doctor about your recent contact with water or animals, as the early symptoms look like many other infections.
Kencing tikus or denggi: how are they different?
In Malaysia, a fever with headache and body aches is often first suspected to be dengue. The two infections are different:
| Kencing tikus (leptospirosis) | Demam denggi (dengue) | |
|---|---|---|
| Spread by | Water or soil contaminated by infected animal urine, mainly rats | Bites from infected Aedes mosquitoes |
| Common exposure | Floods, rivers, waterfalls, farms, drains | Mosquito breeding sites around homes |
| Shared symptoms | Fever, headache, body aches | Fever, headache, body aches |
| Treatment | Antibiotics | No specific medicine; supportive care |
A 2025 Malaysian review notes that leptospirosis is commonly misdiagnosed because it looks similar to other fevers such as dengue and malaria, so a doctor may need tests to tell them apart. See our guides to demam denggi and demam.
When is kencing tikus an emergency?
Get urgent medical help, according to the NHS, if you have possible leptospirosis and:
- yellow skin and whites of the eyes (jaundice);
- a rash;
- you have been unable to pee;
- swollen ankles, feet or hands (see our guide to kaki bengkak);
- chest pain;
- shortness of breath.
People with severe symptoms may need to be treated in hospital.
How is leptospirosis treated?
According to the NHS:
- leptospirosis is usually treated with antibiotic tablets prescribed by a doctor;
- it is important to finish the whole course, even if you start to feel better;
- paracetamol or ibuprofen can relieve aches, pains and fever (but if dengue has not been ruled out, avoid ibuprofen and ask a doctor first);
- most people recover in a few days or weeks;
- people with severe symptoms may need to be treated in hospital.
Pencegahan: how can you protect yourself?
There is no vaccine for people. According to the NHS, you can lower your risk if you:
- avoid touching water or soil that may contain animal pee, including floodwater;
- cover cuts and grazes with waterproof plasters, and clean wounds as soon as possible;
- wear protective clothing, such as boots and gloves, if you are at risk through your work;
- shower as soon as possible after being in potentially infected water;
- wash your hands with soap and water after handling animals;
- do not touch dead animals with your bare hands;
- do not drink water from rivers or lakes without boiling or treating it first;
- make sure your dog is vaccinated against leptospirosis.
Frequently asked questions (FAQ)
What is kencing tikus (leptospirosis)?
Kencing tikus is the Malay name for leptospirosis, also called Weil's disease. It is an infection spread in the urine (pee) of infected animals, most commonly rats, and also mice, cows, pigs and dogs. People catch it when contaminated water or soil gets into the mouth, eyes or a cut. It is endemic in Malaysia.
What are the symptoms of kencing tikus (simptom kencing tikus)?
Many people have no symptoms or mild flu-like symptoms, but some become seriously ill. Symptoms can include a high temperature, headache, body aches, tummy ache, feeling or being sick, diarrhoea, red eyes, and yellowing of the skin or eyes (jaundice).
How do you get kencing tikus?
You can get it if water or soil containing infected animal pee gets into your mouth, eyes or a cut, for example during floods, swimming in rivers, lakes or waterfalls, fishing, or through work in agriculture or with animals. It can also spread through contact with infected animals' blood or flesh. It is very rare to catch it from other people.
Is kencing tikus dangerous?
It can be. Most people recover in a few days or weeks with antibiotics, but some people get seriously ill. Get urgent medical help for yellow skin or eyes, a rash, being unable to pee, swollen ankles, feet or hands, chest pain or shortness of breath. In Malaysia, leptospirosis is one of the top causes of infectious disease-related deaths.
How is leptospirosis treated?
It is treated with antibiotics prescribed by a doctor, and it is important to finish the whole course even if you feel better. Paracetamol can help with fever and aches. People with severe symptoms may need hospital treatment. Tell your doctor if you have been in floodwater, rivers, waterfalls or other places where rats may live.
Is kencing tikus the same as dengue?
No. Dengue is spread by Aedes mosquitoes, while leptospirosis is spread through water or soil contaminated by infected animal urine. Both are common in Malaysia and can cause fever, headache and body aches, so a doctor may need tests to tell them apart. Mention any recent contact with floodwater, rivers or animals.
How can I prevent kencing tikus?
Avoid touching water or soil that may contain animal pee, cover cuts with waterproof plasters, wear protective clothing such as boots and gloves if you are at risk through your work, shower soon after being in potentially infected water, do not touch dead animals with bare hands, and do not drink untreated water from rivers or lakes. There is no vaccine for people.
Disclaimer
This article is for general information only and is not a substitute for advice, diagnosis or treatment from a doctor. Health supplements are not intended to diagnose, treat, cure or prevent any disease.
References
- Leptospirosis (Weil's disease) — NHS
- Mohd Yusof MS, Ahmed N, Bakhir SNI, et al. The prevalence of leptospirosis infections among humans in Malaysia: a systematic review and meta-analysis. Tropical Biomedicine 2025;42(2):201–212
- Leptospirosis in humans and animals in Malaysia: a review from 1976 to 2023. Veterinary World 2025;18(3):673–685
