Comparison of clinical profile of leptospirosis patients during post flood and non-post flood periods

Background: Leptospirosis is a zoonotic infection with high mortality rates. The incidence of leptospirosis is more during floods. The aim of the study was to find the difference in clinical profile of leptospirosis during post flood and non-post flood periods.Methods: This was a cross sectional observational study comparing the clinical profile of leptospirosis patients admitted in Government Medical College Ernakulam, Kerala during the post flood period of 2018 with that of non-post flood period. The data with respect to clinical features and investigations were retrieved from the hospital records.Results: Out of the 42 patients studied 15 were from the post flood period and the rest 27 patients were from the non-post flood period. The mean age in the post flood group was 40 years and that in the non-post flood group 43 years. Myalgia, icterus and calf tenderness was significantly higher in the post flood group. The mean platelet count was significantly lower in the non-post flood period (p value=0.011). Mean serum urea and total bilirubin were significantly higher in the post flood group compared to non-post flood group (p value=0.001). Cardiac complications were seen only among the post flood group.Conclusions: The clinical profile and complications were different in leptospirosis patients during post flood and non-post flood periods. These findings help the treating physicians to formulate different approaches in treating patients during the post flood and non-post flood period.

Clinical profile of post flood fever in a tertiary care hospital in Kerala

Background: Floods are an important source of infection epidemic worldwide. Analysis of different infections presenting during floods can lead us to have a unified approach during such periods.Methods: This study describes the clinical features of fever patients presented to a tertiary care hospital in Kerala after the 2018 flood. Clinical findings of the confirmed leptospirosis cases were also compared with non-leptospirosis cases.Results: A total of 48 patients with fever and myalgia were studied and majority of them were males (77%). 40 patients had contact with contaminated water. But only 10 of them had taken prophylactic doxycycline. Complications were seen less among those who took prophylactic doxycycline. The mean time from the first symptom to first medical care was 4.4 days. Leptospirosis was seen among 15 patients and 2 patients had dengue fever. Hepatic involvement and renal involvement were seen significantly higher among leptospirosis patients.Conclusions: This study emphasized the importance of prophylactic doxycycline and early initiation of antibiotics during flood outbreaks. Awareness among treating doctors and patients is required for the control of outbreaks and prevention of mortality during floods.