Co-infection of Dengue and Leptospirosis in Patients Presenting to a Tertiary Care Hospital with Acute Febrile Illness: A Cross-sectional Study DC05-DC09
Dr. Priyadarshini Shanmugam,
No 9/5, 7th Cross Street, Karpagam Gardens, Adyar, Chennai-600020, Tamilnadu, India.
E-mail: priyadarshini0018@ gmail.com
Introduction: Dengue and Leptospirosis are emerging important public health problems in India. While Dengue is a vector borne viral infection transmitted by Aedes mosquitoes, Leptospirosis is a zoonosis caused by pathogenic Leptospira. The incidence of both these infections increases during the rainy season. Due to simultaneous transmission of both these infections during rainy season, co-infections can occur. These mixed infections can change the clinical spectrum of disease to more fulminant course and presents a diagnostic and therapeutic challenge to the treating physicians.
Aim: To determine the prevalence of Dengue and Leptospira co-infection by Dengue NS1 antigen, IgM and IgG ELISA, Leptospira PCR and Leptospira IgM ELISA.
Materials and Methods: This was a cross-sectional study done over a period of one year at Chettinad Hospital and Research Institute. Symptomatic patients belonging to all age groups with fever of 7 days duration were included in the study. Blood (10ml) was collected from 100 febrile patients by using aseptic techniques, serum separated by centrifugation and then screened for both infections.
Results: Dengue infection was found to be positive in 29 patients (29%) and Leptospirosis was found to be positive in 18 patients (18%). Four (4%) patients had a co-infection of dengue and leptospirosis. Among the 29 dengue positive patients, NS1 antigen was positive in 22 (75.86%), anti-dengue IgM was positive in 15 (51.72%) and anti-dengue IgG was positive in 8 (27.58%) patients. Dengue RT-PCR was found to be positive in 20 patients (68.96%). Among the 18 Leptospira positive patients, Leptospira IgM and Leptospira PCR were positive in 8 (44.44%) & 10 (55.55%) patients respectively. Of the co-infected patients, 75% were found to be positive for Dengue NS1, RT-PCR and Leptospira PCR and 25% was found to be positive for anti-dengue IgM and Leptospira IgM antibodies.
Conclusion: Co-infections may result in illness with overlapping signs and symptoms and enhanced ability to diagnose it early in illness with robust diagnostic methods which will help guide the physicians.