[Leish-l] Leishmaniasis, visceral - Brazil (03): (DF), human, canine

Mon Dec 1 04:14:01 BRST 2008

Date: Sun, 30 Nov 2008 17:35:36 -0500 (EST)
From: ProMED-mail <promed at promed.isid.harvard.edu>
Subject: PRO/AH/EDR> Leishmaniasis, visceral - Brazil (03): (DF),  
human, canine

LEISHMANIASIS, VISCERAL - BRAZIL (03): (FEDERAL DISTRICT), HUMAN, CANINE
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[1] Canine
[2] Human

*****
[1] Canine
Date: 27 Nov 2008
Source: Correio Braziliense [in Portuguese, trans. & summ. Mod.JW,  
edited]
<http://www.correiobraziliense.com.br/html/sessao_13/2008/11/27/noticia_interna,id_sessao=13&id_noticia=52343/noticia_interna.shtml 
 >

Lago Norte (North Lake), one of the most prestigious neighborhoods of
the federal capital [Brasilia], is threatened by leishmaniasis. Of
the 6132 dogs examined, 1093 were positive for the protozoan cause of
the disease, representing 18 percent of the animals. The serological
survey, conducted by the Department of Health, was completed this
week and put the health authorities on the alert. If the transmitter
sand fly sucks the blood of a sick dog and later bites a human, there
may be contamination.

Leishmaniasis affects the viscera and is fatal, especially in
children and the elderly. To prevent human cases, the official
recommendation is that sick animals should be sacrificed. Tonight [27
Nov 2008], residents will meet with representatives of the government
and the public prosecutor to discuss a solution to this serious
public health problem.

The owners of sick animals are divided about the fate of the dogs.
Some prefer to sacrifice them to eliminate any chance of human cases;
others promise a legal fight with the Secretary of Health to try to
treat the dogs and keep them alive.

The sacrificing of sick dogs is a controversial measure. Specialists
say that the animals with positive results for leishmania may not be
infected. That's because dogs vaccinated against the disease are
positive on serological examination. "Not only because of the
vaccine: Animals who have tick fever, very common in dogs, can also
produce false positives for leishmaniasis," said the president of the
Animal Protection Society, Simone Lima.

She defends the right of the owners to carry out a check with a
different method implemented by the Department of Health "The
serological examination of zoonoses is not a definitive diagnosis but
an indication that the dog may be sick. There are other, more
accurate methods, such as bone marrow puncture. The owner should have
the right to make a rebuttal in case serology points to the presence
of leishmaniasis," said the organization's president.

The Manual of Surveillance and Control of Visceral Leishmaniasis, a
publication of the Ministry of Health launched in 2006 and used as a
national reference for combating the disease, does not validate
examinations such as bone marrow puncture. "In situations where the
owner of the animal requires rebuttal, it should be a serological
test performed by the laboratory network," says the manual of the
Ministry of Health.

[Byline: Helen Mader]

- --
Communicated by:
ProMED-mail <promed at promedmail.org>

[Another report from the same source dated 28 Nov 2008 says a total
of 1269 dogs tested positive in 3 cities of the Federal District.
Besides the 1017/5474 (19 percent) in Lago Norte (different from the
total given above), Fercal, in Sobradinho II, had 176/1224 (14
percent) infected, and in Varjo, 76/658 (12 percent) had signs of the
disease, a total of 1269 positives. - Mod.JW]

******
[2]
Date: Sun 30 Nov 2008
Source: Correio Braziliense [Portuguese, trans. & sum. Mod.JW, edited]
<http://www.correiobraziliense.com.br/html/sessao_13/2008/11/25/noticia_interna,id_sessao=13&id_noticia=51742/noticia_interna.shtml 
 >

The Department of Health confirmed the 4th human case of
leishmaniasis in the Federal District in 2008, all in Sobradinho.
With the case [1st suspected] in October 2008, this year surpasses
the number of the infected last year [2007], when 3 people contracted
the disease. Since 2005, with the 1st appearance in humans, this is
the 15th occurrence in the Federal District, and on only 2 occasions
was the report from outside the region of Sobradinho.

To the head of the Center for Endemics of the Department of Health,
Ailton da Silva, the fact that the area is still basically rural
contributes to the higher incidence of occurrences. "In spite of the
penetration of humans into the region, the environment is still
preserved. The [vector] insect has its characteristic habitat there."

But the Secretary does not rule out the risk of contamination in
other cities, such as Lago Norte (North Lake), where preliminary data
indicate the existence of 1000 infected dogs in the region. According
to the Secretary of Health for Surveillance, the presence of infected
animals and transmitting sand flies implies a risk of the emergence
of human cases.

In 2006, a resident of Brazlandia and another in Ceilandia were
infected. However, Silva says that the location of the contamination
was not proven. "The likelihood is that people did not contract the
disease in those areas, because we have not found any sick dogs in
those cities," he pointed out.

According to the Secretary, the fight against the vector is
difficult. "Unlike dengue, [the] leishmaniasis [vector] does not need
water for its life cycle," said Silva. The insect usually stays in
shaded and humid places and reproduces in the presence of organic
matter.

One of the preventive measures is to keep the yard clean. "Prune
trees that block the sun and remove leaves and feces of animals to
help prevent the spread of the disease," said the head of the Center
for Endemics.

The removal of sick or infected dogs, one of the species most
vulnerable to the insect, also lessens the likelihood of
contamination. If the transmitting sand fly bites an infected dog and
later a human, transmission of leishmaniasis can occur.

The 1st signs of the disease are pale skin, lack of appetite,
weakness, anemia, abdominal pain, vomiting, diarrhea and fever for
more than 15 days. "If a person lives in the area of risk and falls
ill, they should think about the likelihood of leishmaniasis and seek
the Health unit to identify the disease," he said. The exam can be
done by the public health network. The person must be hospitalized at
least 20 days for medical care. According to Silva, it is important
to detect the disease as early as possible to aid recovery. In 2006,
2 people died because of leishmaniasis.

- --
Communicated by:
ProMED-mail <promed at promedmail.org>

[Although the WHO lists almost all of Brazil as endemic for visceral
leishmaniasis (VL)
<http://www.who.int/leishmaniasis/leishmaniasis_maps/en/index.html>,
the focus is in the northeast and in the Amazonas.

It seems that VL is spreading towards the south and east and has
recently been reported for the 1st time from Minas Gerais, which
borders the Federal District: (Paula et al. 1st finding of _Lutzomyia
longipalpis_ (Lutz & Neiva, 1912) in the urban area of Uberlandia,
MG, concomitant with the 1st reported autochthonous case of human
visceral leishmaniasis. Rev Soc Bras Med Trop. 2008;41:304-5).

In northeast Brazil, dogs are the main reservoir, which probably also
is the case in the new areas where VL is now found. See: (Queiroz et
al. Canine visceral leishmaniasis in urban and rural areas of
Northeast Brazil. Res Vet Sci. 2008 Sep 18. (E-pub ahead of print)
<http://www.ncbi.nlm.nih.gov/pubmed/18804826?ordinalpos=14&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_DefaultReportPanel.Pubmed_RVDocSum 
 >.

Maps:
Federal District: <http://en.wikipedia.org/wiki/Brazilian_Federal_District 
 >
  Minas Gerais:
<http://en.wikipedia.org/wiki/Minas_Gerais>
  - Mod.EP]
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