[leish-l] VL tropica ? 6-11-03

K.P. Chang changk at mail.finchcms.edu
Wed Jun 11 17:57:02 BRT 2003


Dear Dick,

Some isolates from bone marrow aspirates of American GIs in Desert Storm/Desert
Shield contain nagt gene sequences identical to that of L tropica. However, they
don't really have the typical kala-azar symptoms. So, it is possible that the
parasites might have been picked up from the skin during the bone marrow
puncture.

KP

Richard Ashford wrote:

> Dear Philippe
>
> I was away, in Israel, so missed the nonsense about Iraq till now.
> Congratulations on the moderateness of your response.  It's probably just
> as well I missed it, as my response would have been 'a l'ashfordienne', and
> people would have been upset by straight talk.
>
> By the way, I have been thoroughly through all the reports I can find, and
> can find absolutely NO reliable evidence of L. tropica causing VL.  Every
> report is flawed one way or another and, before postulating such an
> unlikely event, the evidence would have to be very convincing a) that the
> parasite really is tropica and b) that the infection really is
> leishmaniasis!
>
> Best wishes,
>
> Dick
>
> --On 02 June 2003 09:53 +0200 desjeuxp at who.int wrote:
>
> > This report on leishmaniasis in Iraq is full of mistakes and confusing.
> > There is no real outbreak of visceral leishmaniasis but accumulated non
> > treated cases. The transmission season is from May to October with a major
> > risk of transmission in September/October and, due to the incubation time,
> > cases are mainly detected from November to April. Due to the pre-war
> > situation and the lack of drugs during this period, accumulated cases of
> > last year transmission are seen now. UNICEF and WHO have recently sent a
> > large quantity of drugs.
> >
> > L major and L.tropica are at the origin of zoonotic and anthroponotic
> > cutaneous leishmaniasis specially in central and Northern but CERTAINLY
> > not at the origin of leishmaniasis visceral in Iraq.
> >
> > Regards
> >
> > P. Desjeux
> >
> >       _______________________________
> >                Dr Philippe Desjeux
> >                    Medical Officer
> >       Department of Communicable Disease
> >               Surveillance and Response
> >                     (CDS/CSR)
> > World Health Organization             Direct Tel. (+41 22) 791 38 70
> > 20, Avenue Appia                      Operator    (+41 22) 791 21 11
> > CH-1211 Geneva 27             Fax:          (+41 22) 791 48 78
> > Switzerland                   Email.        <desjeuxp at who.int>
> >
> >
> > -----Original Message-----
> > From: Fred R. Opperdoes [mailto:opperdoes at trop.ucl.ac.be]
> > Sent: Sunday, 1 June 2003 08:13
> > To: leish-l at fat.org.br
> > Subject: [leish-l] Leishmaniasis - Iraq
> >
> >
> > At 22:46 -0400 5/31/03, ProMED Digest wrote:
> >> Date: Sat, 31 May 2003 20:08:31 -0400 (EDT)
> >> From: ProMED-mail <promed at promed.isid.harvard.edu>
> >> Subject: PRO/EDR> Leishmaniasis - Iraq: RFI
> >>
> >> LEISHMANIASIS - IRAQ: REQUEST FOR INFORMATION
> >> **********************
> >> A ProMED-mail post
> >> <http://www.promedmail.org
> >> ProMED-mail, a program of the
> >> International Society for Infectious Diseases
> >> <http://www.isid.org>
> >>
> >>
> >> Date: Fri, 31 May 2003
> >> From: Pablo Nart <p.nart at vet.gla.ac.uk>
> >> Source: NDTV Thu 29 May 2003
> >> <http://www.ndtv.com/template/template.asp?template=Usiraqconfrontation&
> >> slu
> > g=%3CI%3EKalaAzar%3C%2FI%3E+outbreak+in+Iraq%3A+UNICEF&id=38619&callid=1>
> >>
> >>
> >> Outbreak of Kala-Azar (visceral leishmaniasis) in Iraq
> >> - --------------------------------------------------
> >> UNICEF has announced an outbreak of Kala-Azar (Visceral Leishmaniasis) in
> >> Iraq. Though there have been outbreaks of the disease in Iraq in the past
> >> around this time of year, it is particularly severe this time.
> >>
> >> There are now more than 200 cases of Kala-Azar reported in Iraq. The
> >> country does see regular outbreaks of the disease.
> >> UNICEF has warned that this time the outbreak could be severe.
> >>
> >> Kala-Azar is spread mainly by sand flies and causes malnutrition and
> >> anaemia. When left untreated, the disease is fatal within 4 to 6 weeks.
> >>
> >> [Byline: Kamini Sawhney (Baghdad)]
> >>
> >> - --
> >> ProMED-mail
> >> <promed at promedmail.org>
> >>
> >> [Leishmaniasis is endemic in Iraq and is caused by _L. major_ and _L.
> >> tropica_, which can cause both visceral leishmaniasis (VL) and cutaneous
> >> leishmaniasis (CL). Leishmaniasis from these 2 species are predominantly
> >> CL, and an increase in CL will most probably be found if looked for. It
> >> is possible that malnutrition and other infections may have caused more
> >> cases to manifest as VL. Leishmania is transmitted from animal
> >> reservoirs and human hosts by sandflies. There are no annual statistics
> >> on VL in Iraq, but Gideon (<www.gideononline.com>) reports 8500 cases
> >> from 1971 to 1980, with the highest prevalence in the central areas and
> >> greater Baghdad. Cases have not been reported since then, but there is
> >> no reason to believe that there have been fewer cases. More information
> >> on this outbreak would be appreciated. - Mods.EP/MPP]
> >>
> >> [see also:
> >> 2001
> >> - ----
> >> Leishmaniasis, suspected - Iraq      20010917.2245]
> >> ...................mpp/ep/pg/mpp
> >>
> >> ------------------------------
> >
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> Please note new status and phone number:
> R.W. Ashford
> Professor (Retired) of Parasite and Vector Biology
> Liverpool School of Tropical Medicine
> Liverpool L3 5QA
> Tel: +44 151 632 2714
> Fax: +44 151 705 3371
> e-mail: ashford at liv.ac.uk
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