[leish-l] Leishmaniasis in Brazil

Thu Jan 16 11:30:32 BRST 2003

Dear Dick,

First of all, Happy New Year!

I think one difference is that of "splitters" and "clumpers". We see it
throughout systematics. 

True that Le. chagasi cannot be differentiated from Le. infantum with the
tool we presently have.

For those that work with the leishmanias, I believe that there is little
doubt that this organism was probably introduced from the Old World fairly
recently, and perhaps at different times to different parts of the New
World. I assume this because of the spottiness of its distribution
throughout the Region.

However there is quite a bit of clinical and epidemiological data (such as
different genera of vectors) that seems to warrant the separation these two
species of Leishmania. Maybe the correct procedure would be to consider them
as subspecies (Le. i. infantum, Le. i. chagasi and maybe even include Le. i.
archibald)?

I am particular to the "splitting" into two species because it also allows
easier management of my technical cooperation since there is a great
difference in the population that it afflicts and because possible control
interventions that could be implemented are also different in the two areas.

We must also consider that if, sometime, differentiating characteristics are
found, it will be easier to manage the "split" literature than the "clumped"
literature.

Have a good year,

Regards,

Jorge

Jorge R. Arias, Ph.D.

Regional Advisor

Pan American Health Organization

525 Twenty-third Street N.W

Washington, D.C. 20037

Tel +1 (202) 974-3271

FAX +1 (202) 974 3565

ariasjor at paho.org

www.paho.org/dengue

-----Original Message-----
From: Richard Ashford [mailto:ashford at liverpool.ac.uk] 
Sent: Wednesday, January 15, 2003 6:24 AM
To: Fred R. Opperdoes
Cc: promed at promed.isid.harvard.edu; leish-l at bdt.org.br
Subject: Re: [leish-l] Leishmaniasis in Brazil

Dear Dr Opperdoes,

In view of the repeated finding by several authors that the agent for South 

American visceral leishmaniasis cannot reliably be distinguished from 

Mediterranean L. infantum, what is your justification for the continued use 

of 'L. chagasi'?

My own view is that geographical distribution is NOT a valid taxonomic 

character, and the continued use of this synonym hides the important 

implication that the infection was almost certainly introduced relatively 

recently from the 'Old World'.

Dick Ashford

--On 14 January 2003 16:27 +0100 "Fred R. Opperdoes" 

<opperdoes at trop.ucl.ac.be> wrote:

> At 10:04 -0500 14/01/03, ProMED Digest wrote:

>>

>> Date: Tue, 14 Jan 2003 10:04:52 -0500 (EST)

>> From: ProMED-mail <promed at promed.isid.harvard.edu>

>> Subject: PRO/AH/EDR> Leishmaniasis - Brazil (Sao Paulo)

>>

>> LEISHMANIASIS ? BRAZIL (SAO PAULO)

>> ***********************

>> A ProMED-mail post

>> <http://www.promedmail.org>

>> ProMED-mail, a program of the

>> International Society for Infectious Diseases

>> <http://www.isid.org>

>>

>> Date: 12 Jan 2003

>> From: ProMED-mail <promed at promedmail.org

>> Source: Informativo Cosmo 11 Jan 2003 [translated & edited by Mod.MPP]

>> <http://www.cosmo.com.br/cidades/sjriopreto/2003/01/10/materia_srp_48221

>> .shtm>

>>

>>

>> The health authorities of Aracatuba [Sao Paulo state] are issuing an

>> alert about an epidemic of human visceral leishmaniasis in 30

>> municipalities of the region. In 2002, epidemiological surveillance

>> reported 43 cases in humans resulting in 4 deaths; there were also 2

>> deaths in 2001. These deaths have led to the development of a strategic

>> plan for disease control by the Superintendence of Endemic Disease

>> Control (Sucen).

>>

>> As of Friday [10 Jan 2003], the Epidemiological Surveillance Unit

>> confirmed the first death this year [2003] attributable to visceral

>> leishmaniasis, signifying the 11th death due to this disease since its

>> reappearance in the region in the summer of 1998. The most recent death

>> [2003] is in an  adult male.

>>

>> The Epidemiological Surveillance Unit will investigate whether the death

>> was due to leishmaniasis or whether the disease was aggravated by an

>> underlying chronic cirrhosis (liver disease). Most cases have been in

>> children, especially those living in lower socioeconomic neighborhoods,

>> due to underlying malnutrition and an association with other diseases

>> such as pneumonia.

>>

>> Leishmaniasis is a disease caused by the protozoan _Leishmania_ spp. and

>> is transmitted by sand flies, which preferentially feed on dogs. For this

>> reason, disease control is primarily directed at the canine population.

>> Sucen is testing a type of collar with a mosquito repellant. About 10 000

>> dogs have been registered [by census] and are followed in Andradina, and

>> another 2000 in Aracatuba.

>>

>> [byline: Salete Duarte]

>>

>> - --

>> ProMED-mail

>> <promed at promedmail.org>

>>

>> [The species of leishmania implicated is _L.chagasi_ and the vectors are

>> _Lutzomyia_ spp. The animal reservoir includes dogs, foxes, and opossums.

>> In 1999, 3892 human cases were reported in Brazil, 3200 of which were in

>> the north eastern states (www.gideon.com), but the prevalence in Sao

>> Paulo state is not known. Leishmania is one of the infections that

>> increase following an increase in HIV prevalence. - Mod.EP]

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