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Nine hundred and forty two serum samples from clinically suspected cases of leptospirosis admitted in Lokmanya Tilak Municipal General Hospital, Mumbai during July-September 2005 were tested by LeptoTek Dri-dot/Leptocheck. One hundred and sixty five positive sera by these tests were sent to I.R.R., Mumbai, for detection of leptospira IgM antibodies by ELISA (PanBio). Eighty seven positive sera were also sent to B.J. Medical College, Pune, for microscopic agglutination test (MAT) for serovar identification. Seropositivity with LeptoTek Dri-dot/Leptocheck was 34.3%. Adults and males predominated. All patients were febrile. The commonest presentation in adults was jaundice (81.4%), followed by oliguria (37.6%). In children, myalgia was commonest (75.6%), followed by conjunctival suffusion (54.7%). IgM ELISA positivity was 69.1% and MAT positivity was 29.9%. Commonest serovar detected in this geographical area was Leptospira icterohaemorrhagiae (42.9%), followed by L. bataviae, L. tarassovi, and L. pomona . Considering at least two of the above three serological tests positive, 127 cases could be diagnosed and only 89.8% of them could be diagnosed by ELISA and rapid test. Therefore, along with rapid serological tests, IgM ELISA should be routinely done for laboratory diagnosis of leptospirosis.

Following prolonged water logging due to heavy rainfall in Mumbai during July 2000, a total of 102 patients clinically suspected of leptospirosis were admitted in our hospital. Blood samples were examined for the presence of leptospires by dark ground microscopy (DGM) and IgM antibodies were detected by ELISA. Out of 102 blood samples, 37 were positive by ELISA giving a positivity rate of 36.27%. Of these, only 24 were positive by DGM. Out of the positive cases, 37.83% had respiratory symptoms, 32.43% each had jaundice and conjunctival suffusion and 16.21% had renal involvement. Mortality amongst the positive cases was 10.81%. Apart from hepatic and renal involvement, respiratory symptoms due to leptospirosis are on the rise.