title: Clinical manifestations of dengue and leptospirosis in children in Mumbai: an observational study.
abstract: OBJECTIVE
  The aim of this study was to determine the causes of acute febrile illness in children presenting to our hospital following an extremely heavy rainfall event in the city of Mumbai in 2005. The clinical and laboratory manifestations of leptospirosis and dengue together with their outcomes are also described.
  
  
  METHODS
  This was an observational study conducted from 26 July to 30 November 2005. The diagnosis of leptospirosis was confirmed by a positive enzyme-linked immunosorbent assay (ELISA) test. The diagnosis of dengue was confirmed by a positive immunoglobulin (IgM) antibody capture ELISA test. Clinical features of patients with and without leptospirosis, respectively, and with and without dengue, respectively, were analysed.
  
  
  RESULTS
  A total of 602 patients (age range 1 month to 12 years) admitted to our hospital for acute febrile illness with no obvious focus of infection were enrolled in the study. Of these, 30 had malaria, 11 had enteric fever and seven had mixed infections. Twenty-seven patients had leptospirosis. Three clinical features were significantly associated with leptospirosis: flood water contact, myalgia and conjunctival suffusion. Eighty-one children had dengue. All patients responded well to the treatment and were released to go home. Four clinical features were significantly associated with dengue, namely, giddiness, abdominal pain, rash and bleeding manifestations.
  
  
  CONCLUSIONS
  Based on this review of the clinical and laboratory features of dengue fever and leptospirosis, we conclude that following the heavy rainfall event on 26 July 2005, there was a concurrent outbreak of leptospirosis and dengue among children presenting to our hospital.
authors.affiliation: Department of Pediatrics, Lokmanya Tilak Municipal Medical College and General Hospital, Mumbai, India. drzakisyed@gmail.com
authors.forename: S A
authors.initials: SA
authors.lastname: Zaki
authors.forename: P
authors.initials: P
authors.lastname: Shanbag
mesh_terms: D000208:Acute Disease; D000907:Antibodies, Bacterial / Q000032:analysis; D000914:Antibodies, Viral / Q000032:analysis; D016009:Chi-Square Distribution; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D003715:Dengue / Q000175:diagnosis* / Q000453:epidemiology; D004797:Enzyme-Linked Immunosorbent Assay; D005334:Fever / Q000382:microbiology* / Q000821:virology; D055868:Floods; D006801:Humans; D007194:India / Q000453:epidemiology; D007223:Infant; D007922:Leptospirosis / Q000175:diagnosis* / Q000453:epidemiology; D011237:Predictive Value of Tests; D011891:Rain; D012307:Risk Factors
chemical_list: D000907:Antibodies, Bacterial; D000914:Antibodies, Viral