@article {Karande1070, author = {S Karande and M Bhatt and A Kelkar and M Kulkarni and A De and A Varaiya}, title = {An observational study to detect leptospirosis in Mumbai, India, 2000}, volume = {88}, number = {12}, pages = {1070--1075}, year = {2003}, doi = {10.1136/adc.88.12.1070}, publisher = {BMJ Publishing Group Ltd}, 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{\textdegree}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.}, issn = {0003-9888}, URL = {https://adc.bmj.com/content/88/12/1070}, eprint = {https://adc.bmj.com/content/88/12/1070.full.pdf}, journal = {Archives of Disease in Childhood} }