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孟买贫民窟儿童中的钩端螺旋体病

Leptospirosis in children in Mumbai slums.

作者信息

Karande Sunil, Kulkarni Hemant, Kulkarni Madhuri, De Anuradha, Varaiya Ami

机构信息

Department of Pediatrics, Lokmanya Tilak Municipal Medical College and Lokmanya Tilak Municipal General Hospital, Sion, Mumbai, India.

出版信息

Indian J Pediatr. 2002 Oct;69(10):855-8. doi: 10.1007/BF02723705.

Abstract

OBJECTIVE

There is limited data available on symptomatic leptospirosis in Indian children. We report an outbreak of leptospirosis that occurred in children living in slums following heavy rainfall and flooding. This hospital-based prospective study was conducted from July to August 2001.

METHODS

Diagnosis of acute leptospirosis was suspected by following the Indian Leptospirosis Society working definition for leptospirosis. Diagnosis was confirmed by detecting anti-Leptospira antibodies, using either a Leptospira genus-specific latex agglutination assay or a dipstick assay or by a macroscopic slide agglutination test.

RESULT

Thirty (32%) out of 93 children admitted had acute leptospirosis. Fever, bodyache, chills, abdominal pain, headache, vomiting, cough, hepatosplenomegaly, edema and crepitations were the common presenting signs and symptoms. Twenty - two children had anicteric leptospirosis and 8 had Weil disease. Response to penicillin treatment was good in all except in one child with Weil disease who died of renal failure within 3 hours of admission.

CONCLUSION

Leptospirosis has emerged as an infectious disease in Mumbai. During monsoon, parents should ensure that their child does not have contact with the contaminated flood water.

摘要

目的

关于印度儿童症状性钩端螺旋体病的数据有限。我们报告了一场在暴雨和洪水过后发生在贫民窟儿童中的钩端螺旋体病疫情。这项基于医院的前瞻性研究于2001年7月至8月进行。

方法

按照印度钩端螺旋体病协会对钩端螺旋体病的工作定义来怀疑急性钩端螺旋体病的诊断。通过检测抗钩端螺旋体抗体来确诊,使用钩端螺旋体属特异性乳胶凝集试验、试纸条检测法或宏观玻片凝集试验。

结果

93名入院儿童中有30名(32%)患有急性钩端螺旋体病。发热、身体疼痛、寒战、腹痛、头痛、呕吐、咳嗽、肝脾肿大、水肿和捻发音是常见的症状和体征。22名儿童患无黄疸型钩端螺旋体病,8名患韦尔病。除一名患韦尔病的儿童在入院3小时内死于肾衰竭外,所有儿童对青霉素治疗反应良好。

结论

钩端螺旋体病已在孟买成为一种传染病。在季风季节,家长应确保孩子不接触受污染的洪水。

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