VL Sao Paulo

[Jeffrey Shaw]

The following is a copy of a correspondance sent to Promed and a related
article published in one of Brazil principal newspapers.

The concern of these reports is that canine visceral leishmaniasis is
moveing south into the heavily populated State of São Paulo.

LEISHMANIASIS, VISCERAL, FATAL - BRAZIL (SAO PAULO)
********************************************
A ProMED-mail post
<http://www.healthnet.org/programs/promed/html>

[see also:
Leishmaniasis, visceral, dogs - Brazil (Sao Paulo)   981110130328
Leishmaniasis - Brazil: Background                            981114223903]

Date: Wed, 16 Jun 1999 15:09:17 -0300
From: "CARLOS BRISOLA MARCONDES" <cbrisola at mbox1.ufsc.br>
Source: newspaper Folha de Sao Paulo 16 Jun 1999 [translated]


A 14 year old girl died of visceral leishmaniasis (VL) in the Municipality
of Aracatuba, in the State of Sao Paulo. This is the first death of this
disease in the state. She was being treated as leukemic for one year, and VL
was  found one week ago.

739 dogs in about 10 000 in the city are positive, there are no vehicles to
transport dogs to be killed, and there are positive dogs in 13 nearby
cities, within a radius of 50 km.

--
Prof. Dr. Carlos Brisola Marcondes
Depto Microbiol. Parasitol./CCB
UFSC - Campus Trindade
88040-900 Florianopolis (SC)
Brazil

[Dogs are the reservoir of VL, caused by protozoan parasites of the genus
_Leishmania_ transmitted by sandflies (phlebotomines). Some of the symptoms
are lymphadenopathy (swelling of the lymph nodes),  leukopenia, a lowering
of the white cell count in the blood, & anemia, lowering of the red cell
count, a combination which in some cases might mimic leukemia, which is a
cancerous proliferation of the white cells.  It is not clear whether the
child was misdiagnosed for one year, or whether the leukemia treatment
contributed to the VL infection spreading throughout her body.  In any
event, this case should alert physicians to look for alternative diagnoses
to chronic blood count abnormalities - Mod.JW]
...................................................jw

A further report on this outbreak appeared in the Correio Braziliensis.
Brasília, Distrito Federal, 16 June 1999.
[http://www.correioweb.com.br/7dias/sexta.htm/brasil/pagina5.htm]
This relates the difficulties of the local health authorities are having in
elliminating infected dogs. Some owners, especially those of pedigree dogs,
hide them to avoid them being sacrificed. 

	  "Segundo a diretora da Vigilância Epidemiológica do
          estado, Lucelena Araújo, os agentes sanitários enfrentam
          forte resistência da população, que tenta evitar de todas
          as formas a execução de cães, principalmente os de raça.
          Dos 132 animais que apresentaram exame sorológico
          positivo no mês de maio, 25 não foram sacrificados porque
          seus donos não admitiram a ação das autoridades
          sanitárias. A doença é transmitida do cachorro — principal
          hospedeiro do protozoário — para o homem por meio da
          picada de um mosquito.

            Diretores das unidades de saúde que participam do
          combate à doença se reuniram ontem para discutir formas
          de se acelerar o sacrifício dos cães contaminados. O
          secretário estadual de Saúde, José da Silva Guedes,
          criticou os sanitaristas de Araçatuba afirmando que é
          preciso ter mais agilidade no controle de cães doentes.
          Ele lembrou que países como a China erradicaram a
          doença matando inclusive cães sadios."