[leish-l] Fatal cases of VL in Minas Gerais, Brazil

[Bruce Alexander]

I imagine these fatalities are largely due to ignorance and delays in seeking treatment rather than problems with availability of the drug or virulence of the parasite. There seems to be little awareness among urban populations at risk that the disease is transmitted by sand flies and this is reflected by the fact that they don't have a common name for the insects to distinguish them from mosquitoes and other biting flies. This may be due to the fact that Lu. longipalpis isn't highly anthropophilic and being silent isn't an obvious nuisance (unlike mosquitoes). 
This problem is I think compounded by health authorities who emphasize the role of domestic dogs while largely ignoring the insects. I recently saw one poster in Belo Horizonte showing a drawing of a hyperactive dog (it looked rabid rather than lethargic) to recommend  that people allow their animals to be tested for VL. Most meetings I attended during my five years in BH were dominated by dog owners or vets debating the wisdom of eliminating seropositive dogs as a control measure.  
I think there's a real need to make people aware that this is a disease that to all intents and purposes can only be acquired by the bite of infected sand flies. We need to determine the factors that favour urbanisation of the vector, with a view to getting populations at risk involved in preventative measures.  These don't seem to be considered priorities.  Improvements in diagnosis and treatments are all very well but why is so little attention paid to prevention and education?
Bruce Alexander 
    
 
  Jeffrey Jon Shaw <jeffreyj at usp.br> wrote: The Brazilian Press have drawn attention to the problem of visceral leishmaniasis (VL). In Minas Gerais State they record (Folha de São Paulo) 11 deaths in 220 cases in 2001 and in four more deaths due to visceral leishmaniasis in January 2002. One of these cases was a 2 year old girl who lived in the metropolitan area of the Sate capital, Belo Horizonte. The Minas Gerais health authorities are very concerned by the high number of fatal cases in just one month. _______________________________________________ leish-l mailing list leish-l at bdt.org.br http://panda.fat.org.br/mailman/listinfo/leish-l


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