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Arch Dis Child. 2003 Dec;88(12):1070-5.

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

Author information

1
Department of Paediatrics, Lokmanya Tilak Municipal Medical College and General Hospital, Sion, Mumbai, Bombay, 400 022, India.

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 degrees 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.

Comment in

PMID:
14670771
PMCID:
PMC1719391
[Indexed for MEDLINE]
Free PMC Article

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