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ORIGINAL ARTICLE |
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| Year : 2003 | Volume
: 57
| Issue : 3 | Page : 101-104 |
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Clinical and epidemiological correlation of Leptospirosis among patients attending KMCH, Manipal.
K Jagadishchandra, AG Prathb, SP Rao
Dept. of Microbiology, Kasturba Medical College and Hospital, Manipal 576 119,
| Date of Acceptance | 19-Nov-2002 |
Correspondence Address:
K Jagadishchandra
Dept. of Microbiology, Kasturba Medical College and Hospital, Manipal 576 119
PMID: 14514258
Leptospirosis is one of the most widespread zoonotic diseases in the world. Infection may range from sub clinical infection to death of the patient. It may also occur endemically in tropical countries, showing seasonal incidences following heavy rainfall. As the diagnosis is difficult due to vague clinical symptoms, laboratory investigations are essential for the confirmation of the disease. This study was undertaken to correlate the clinical findings, occupation and behavioural pattern in seropositive cases of Leptospirosis. A total of 733 patients suspected of Leptospirosis were tested for specific IgM ELISA and clinical findings, occupation and behavioural pattern were noted.
Keywords: Antibodies, Bacterial, blood,Enzyme-Linked Immunosorbent Assay, Female, Human, Immunoglobulin M, blood,India, epidemiology,Leptospirosis, blood,epidemiology,Male,
How to cite this article:
Jagadishchandra K, Prathb A G, Rao S P. Clinical and epidemiological correlation of Leptospirosis among patients attending KMCH, Manipal. Indian J Med Sci 2003;57:101-4 |
How to cite this URL:
Jagadishchandra K, Prathb A G, Rao S P. Clinical and epidemiological correlation of Leptospirosis among patients attending KMCH, Manipal. Indian J Med Sci [serial online] 2003 [cited 2013 May 21];57:101-4. Available from: http://www.indianjmedsci.org/text.asp?2003/57/3/101/11902 |
| ¤ Introduction | |  |
Leptospirosis is one of the most widespread zoonotic diseases in the world. Infection may range from sub clinical infection to death of the patient. It may also occur endemically in tropical countries, showing seasonal incidences following heavy rainfall.[1] In India cases have been reported as early as 1915 and after 1980's increasingly reported from South India and Andammans. As the diagnosis is difficult due to vague clinical symptoms, laboratory investigations are essential for the confirmation of the disease. Darkground microscopy is a simple and cost effective method for early diagnosis of Leptospirosis.[2] By testing for specific IgM Antibodies by means of ELISA,[3] Dipstick assays[4],[5] and microagglutination test we can confirm the diagnosis for Leptospirosis. This work was undertaken to study the clinical and epidemiological features of serologically positive cases of Leptospirosis.
| ¤ Materials and methods | | |
A total of 733 patients with history of acute onset of fever associated with headache and bodyache with any of the following clinical features were included in the study.[6] 1) Jaundice, 2) Oliguria, 3) Cough, haemoptysis and breathlessness, 4) Bleeding tendencies including haemetemsis, haematuria and subconjunctival haemorrage. From these patients 2 serum samples were collected and tested for Specific IgM antibodies for Leptospira by ELISA (PanBio IgM ELISA). Serum samples showing a titer above 15 PanBio units were considered positive for Leptospira. Clinical features, detailed history about the house surroundings, occupation and visit to endemic areas were recorded.
| ¤ Observations | | |
Out of 733 patients suspected of Leptospirosis, 84 were positive by IgM ELISA. [Table - 1] and [Table - 2] shows the sex, rural and urban distribution, occupation and behavioural pattern of patients included in the study group. [Table - 3] shows the common clinical features of the study group.
| ¤ Discussion | | |
In the present study serum samples of 733 suspected cases of Leptospirosis were screened for specific IgM antibodies by ELISA. Out of these 84 (11.45%) were positive which is comparable to studies conducted in Port Blair[7] and Madras.[8] About 54.76% of patients were agriculturists. These findings are similar to studies conducted in Port Blair[7] and Madras.[8] In present study 90% of patient with Leptospirosis gave history of rat infestation in their house and 55.95% gave history of rearing or contact with animals. Similar findings were found in Madras study[8] and Port Blair study.[9] Cardinal signs of Leptospirosis like myalgia, conjuctival suffusion and subconjuctival haemorrage were considerably lower in this study when compared to Port Blair[9] and Madras.[8] Hepatic involvement and renal involvement were 65 and 63% respectively with some patients having both. Pulmonary complications were lower as comparable to studies -conducted in Madras,[8] Vietnam and Korea.[10] Gastrointestinal syndrome with diarrhoea as a predominant feature in 24% and comparable with study conducted in Madras.[8]
| ¤ Conclusion | | |
The present study shows that in a case of fever of acute onset with history of headache and bodyache, Leptospirosis should be suspected in this coastal Karnataka. Since majority of patients had renal and hepatic involvement patients should be watched for development of complications. Serological test like ELISA for IgM antibodies should be done to rule out Leptospirosis, as timely administration of specific antibodies like penicillins will save the life of patient.
| ¤ References | | |
| 1. | Chandrasekeran S. Review of human Leptospirosis. Indian J Med Sci 1999;53:293-5.  |
| 2. | Rao PS, Sashibushan, Shivananda PG. Comparison of Darkground Microscopy with serological tests in diagnosis of Leptospirosis with Hepatorenal involvement. A preliminary study. Indian Patho Microbio 1998;41:427-9. |
| 3. | Winslow WE, Merry DJ, Moira L, Devine PL. Evaluation of a commercial enzyme-linked immunosorbent assay for detection of immunoglobulin M antibody in diagnosis of human Leptospiral infection. Clinical Microbil 1997;35:1938-42. |
| 4. | Terpstra. Leptodipstick, a diagnostic assays for detection of Leptospira specific Immunoglobulin M antibodies in human sera. Clinical Microbiol 1997;35:1:92-7. |
| 5. | Sehgal SC, Vijayacharl P, Sharma S, Sugunan AR. Leptodipstick. A rapid and simple method for serodiagnosis of acute Leptos - pirosis. Trans Royal Soc Trop Medi Hygi 1999;93:161-4. |
| 6. | Leptospirosis Disease burden assessment ICMR project Guidelines 2001. |
| 7. | Singh SS. Vijayachari P, Sinha A, et al. Clinico epedimiological study of hospitalized cases of severe Leptospirosis. Indian J Med 1999;109:94-9. |
| 8. | Murhekar MV, Sugunan AP, Vijayachari P, Sharma S, Sehgal SC. Risk factors in transmission of Leptospiral Infection. Lnd J Med Res 1998;107:218-23. [PUBMED] |
| 9. | Bovet YP, Merien F. Human Leptospirosis in the Seychelles. A population based study. Am J Trop Med Hyg 1998;345-341. |
| 10. | Zochowski WJ, Palmer MF, Coleman TJ. Evaluations of three commercial kits for use as screening methods for detection of Leptospiral antibodies in UK. Clinical Pathol 2001;54;1:25-30. |
Tables
[Table - 1], [Table - 2], [Table - 3]
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