title: Serologic evidence of human leptospirosis in and around Kolkata, India: a clinico-epidemiological study.
abstract: OBJECTIVE
  To investigate the prevalence of leptospirosis among patients from within and outside Kolkata, India, attending the Calcutta School of Tropical Medicine, for treatment during August 2002 to August 2008.
  
  
  METHODS
  The leptospirosis cases were determined on the basis of clinical, epidemiological, and biochemical factors, and were tested for leptospiral antibodies using IgM ELISA. Serum samples with absorbance ratio ≥ 1.21 were interpreted as reactive.
  
  
  RESULTS
  The commonest presentation involved fever, headache and jaundice. The male-female ratio was 61:46. A total of 65(64.20%) cases had abnormal liver and renal functions respectively, and 57.1% had both the abnormalities. The highest incidence (75, 35.04%) was recorded in September-October followed by July-August (53, 24.77%). The reactive cases had absorbance ratios between 1.21 and 8.21, and 53 showed equivocal result, while IgM non reactivity were seen in 90 patients (absorbance ratios 0.10-0.90). The patients responded to treatment with parenteral antibiotics, penicillin, ceftriaxone and cefotaxime; follow up did not reveal case fatality.
  
  
  CONCLUSIONS
  The cardinal signs of leptospirosis help in making clinical diagnosis, but in any hyper-endemic situation any patient reporting with acute fever and signs of pulmonary, hepatic or renal involvement should be suspected to have leptospirosis and investigated accordingly. Increased awareness, and early diagnosis and treatment, can reduce mortality due to leptospirosis.
authors: Department of Bacteriology and Serology, Calcutta School of Tropical Medicine, Kolkata, India.
authors: Manisha
authors: M
authors: DebMandal
authors: Shyamapada
authors: S
authors: Mandal
authors: Nishith Kumar
authors: NK
authors: Pal
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000008:administration & dosage*; D000907:Antibodies, Bacterial / Q000097:blood / Q000302:isolation & purification*; D002439:Cefotaxime / Q000008:administration & dosage; D002443:Ceftriaxone / Q000008:administration & dosage; D002648:Child; D002980:Climate; D004359:Drug Therapy, Combination; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D005334:Fever / Q000382:microbiology; D006261:Headache / Q000382:microbiology; D006801:Humans; D007075:Immunoglobulin M / Q000097:blood; D015994:Incidence; D007194:India / Q000453:epidemiology; D007262:Infusions, Intravenous; D007565:Jaundice / Q000382:microbiology; D007919:Leptospira / Q000276:immunology / Q000302:isolation & purification*; D007922:Leptospirosis / Q000097:blood / Q000175:diagnosis* / Q000453:epidemiology*; D008297:Male; D008875:Middle Aged; D010406:Penicillins / Q000008:administration & dosage; D012189:Retrospective Studies; D012307:Risk Factors; D055815:Young Adult
chemical_list: D000900:Anti-Bacterial Agents; D000907:Antibodies, Bacterial; D007075:Immunoglobulin M; D010406:Penicillins; D002443:Ceftriaxone; D002439:Cefotaxime