Early diagnosis of leptospirosis using conventional techniques: A study in a tertiary care hospital, Mysore, South Karnataka, India

Leptospirosis is an emerging worldwide zoonotic disease and it has become a serious threat to the people of developing countries. Here we have evaluated a commercially available IgM ELISA kit with an Immuno Chromatographic Test (ICT) and also analyzed the clinical and laboratory findings of the seropositive cases. ICT and IgM ELISA were performed on 265 serum samples obtained from patients with signs and symptoms of leptospirosis from August 2013 to October 2014. Out of the 265 samples 140 were positive with ELISA, 10 were positive with ICT. The sensitivity of ELISA was 92.1% (140/152), and sensitivity of ICT was 11.8% (18/152). ICT gives less subjective results than IgM ELISA. Our study showed that adults were more infected and the majority of seropositive cases occurred from August- October. Fever, head ache and hepatomegaly were the predominating clinical symptoms and thrombocytopenia the commonest laboratory finding among the seropositive cases. This data also suggests that there is strong association between the occupation of the people and the incidence of leptospirosis since majority of the Leptospira antibody positive cases were farmers. Lack of proper diagnostic tests and unawareness of the disease has contributed to the under-reporting of leptospirosis. All persons with fever for >7 days should be screened for leptospirosis with IgM ELISA. IgM ELISA can serve as a very good alternative to the unaffordable tests like MAT and PCR.