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. 2003 Dec;88(12):1070–1075. doi: 10.1136/adc.88.12.1070

An observational study to detect leptospirosis in Mumbai, India, 2000

S Karande 1, M Bhatt 1, A Kelkar 1, M Kulkarni 1, A De 1, A Varaiya 1
PMCID: PMC1719391  PMID: 14670771

Abstract

Background: Leptospirosis is relatively uncommon in children. Following torrential rains and flooding an outbreak of leptospirosis was suspected in Mumbai.

Aims: To investigate the possibility of an outbreak of leptospirosis and describe the clinical illness.

Methods: From 24 July to 14 September 2000, children with a history of abrupt onset of high fever (>39°C), who presented to our hospital, were admitted and tested serologically for anti-Leptospira antibodies by a quantitative enzyme linked immunosorbent assay (ELISA) test. An IgM titre of more than 20U/ml confirmed the diagnosis of leptospirosis. Clinical features in the confirmed leptospirosis and leptospirosis negative groups were analysed.

Results: Of 53 children screened, 18 (34%) had leptospirosis. In all 18, the disease was anicteric and responded well to intravenous penicillin. Four clinical features present at the time of admission were significantly associated with leptospirosis: a history of contact with flood water (18/18 v 16/35), conjunctival suffusion (5/18 v 1/35), abdominal pain (9/18 v 5/35), and skin rash (5/18 v 1/35). As the number of these four features concomitantly present increased, the chances of the child having leptospirosis also increased significantly. A history of contact with flood water had a sensitivity of 100%, and the presence of conjunctival suffusion, abdominal pain, and skin rash had a specificity of 97%, 86%, and 97%, respectively, for identifying children with leptospirosis.

Conclusion: Leptospirosis should be suspected in febrile children with contact with flood water.

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Figure 1 .

Figure 1

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Temporal distribution of confirmed leptospirosis and leptospirosis negative cases in Mumbai (Bombay), India, 24 July to 14 September 2000.

Selected References

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