[Leish-l] Leishmaniasis - Argentina: epidemic potential

Gordon Hamilton j.g.c.hamilton at biol.keele.ac.uk
Tue Mar 24 15:03:04 BRT 2009


Dear All,

the article contains the following interesting statement,

"The analysis of the experience from Brazil and Paraguay indicates 
that there is a probability of having one person infected for every 
60 infected dogs"

does anyone know the source of this information and is it true? 


many thanks


Gordon Hamilton



  ----- Original Message ----- 
  From: Chang, Kwang-Poo 
  To: Laila Nimri ; fred opperdoes ; Leish-l at lineu.icb.usp.br 
  Sent: Saturday, March 21, 2009 3:25 PM
  Subject: Re: [Leish-l] Leishmaniasis - Argentina: epidemic potential


  To: Prof. Laila Nimri and all

   

  The issue appears to be a language translation problem. I was told that all blood sucking flies are referred to as "mosquito" in Spanish.

   

  KP

   


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  From: leish-l-bounces at lineu.icb.usp.br [mailto:leish-l-bounces at lineu.icb.usp.br] On Behalf Of Laila Nimri
  Sent: Thursday, February 26, 2009 1:53 AM
  To: fred opperdoes; Leish-l at lineu.icb.usp.br
  Subject: Re: [Leish-l] Leishmaniasis - Argentina: epidemic potential

   

  Just to correct a very important information about the vector of Visceral leishmaniasis, it is definitely not a mosquito, it is a sand fly of the genus Lutzomyia as mentioned correctly below or a Phlebotomus. The environmental or climatic changes that affect mosquitoes might have affected the sand flies and lead to the emergence of the disease.

   

  Prof. Laila Nimri


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  From: leish-l-bounces at lineu.icb.usp.br [leish-l-bounces at lineu.icb.usp.br] On Behalf Of fred opperdoes [fred.opperdoes at uclouvain.be]
  Sent: Thursday, February 26, 2009 8:21 AM
  To: Leish-l at lineu.icb.usp.br
  Subject: [Leish-l] Leishmaniasis - Argentina: epidemic potential

    Date: Wed, 25 Feb 2009 21:23:15 -0500 (EST)
    From: ProMED-mail <promed at promed.isid.harvard.edu>
    Subject: PRO/AH/EDR> Leishmaniasis - Argentina: epidemic potential

    LEISHMANIASIS - ARGENTINA: EPIDEMIC POTENTIAL
    ***********************************************
    A ProMED-mail post
    <http://www.promedmail.org>
    ProMED-mail is a program of the
    International Society for Infectious Diseases
    <http://www.isid.org>

    Date: Tue 24 Feb 2009
    Source: Datachaco.com [trans. Mod JGM, edited]
    <http://datachaco.com/noticia.php?numero=17399>


    The occurrence of cases of yellow fever made people pay attention to 
    mosquito-borne diseases, and dengue fever, which is currently 
    attacking with unusual strength in Paraguay, set another alarm in 
    Chaco, Corrientes, and Misiones provinces, which share borders with 
    Paraguay and Bolivia.

    However, a new emerging disease has become the main epidemic threat 
    in Argentina: Visceral leishmaniasis. This little known disease is 
    being analyzed now as a cause for a sanitary red alert in Argentina.

    Visceral leishmaniasis is also caused by a mosquito-borne parasite. 
    There is no vaccine for this disease, and therapy is instituted only 
    once a case is clearly defined. Its mortality rate is around 8 per 
    cent, and it has a particular feature: Dogs may act as reservoirs for 
    the parasite.

    A summary of the life cycle of the parasite indicates that 
    _Lutzomyia_ insects infect dogs. These animals develop the disease 
    and transmit the parasite to another insect vector, which now is 
    capable of transmitting visceral leishmaniasis to humans. There is no 
    human-to-human transmission.

    Since the very 1st case was reported in 2006, 36 persons have been 
    affected, and there are 4 deceased patients. The possibility of a 
    rapid increase in the number of cases is a reason for concern.

    Last week 2 cases of visceral leishmaniasis were reported in Posadas. 
    One is an 18-year-old woman, and the other is a 21-year-old man, who 
    separately developed the symptoms of the disease. Some personnel from 
    the army are currently collaborating with municipal authorities in 
    Posadas for cleaning wastelands, which are considered breeding places 
    for insect vectors.

    This health problem has become quite dangerous and important in the 
    main cities in Misiones province, and specialists warn that the 
    disease may reach other provinces in the short term.

    "We are observing that the vector is spreading fast, and 2 corridors 
    have been established, one directing towards Resistencia and the 
    other one towards Corrientes. Also, the northern area of Entre Rios, 
    as well as Santa Fe, and Cordoba are vulnerable places. The mosquito 
    vector for visceral leishmaniasis has become an urban-living insect, 
    so there is a substantial risk for its presence in big urban 
    centers," explained Dr. Daniel Salomon, from the National Center for 
    Epidemics in Argentina's Ministry of Health.

    "It is quite difficult to implement preventive measures, because 
    people are so in love with their pets," commented Dr. Salomon. There 
    are very few options for controlling the spread of the disease apart 
    from sacrificing sick animals.

    In 2004, the 1st dog infected with the causative agent of visceral 
    leishmaniasis was detected. When 40 cases were reported in Misiones 
    province, the Ministry of Health issued a red alert. Nonetheless, the 
    current situation is much worse. In Posadas, it was determined that 
    7000 dogs actually have the parasite. Additionally, there are 300 
    infected dogs in Corrientes, and it is worth mentioning that in its 
    capital city, there are thousands of homeless dogs considered to be 
    infected with the parasite.

    The analysis of the experience from Brazil and Paraguay indicates 
    that there is a probability of having one person infected for every 
    60 infected dogs. There is a high risk for an epidemic.

    Sanitary authorities recommend that pets must not be carried to the 
    areas considered to be at risk. It is also advisable not to transport 
    dogs from the affected regions to other areas in the country. The 
    idea is to cut the transmission cycle of the parasite. Those persons 
    who may visit the northern part of Argentina must be immunized 
    against yellow fever as an ordinary preventive measure, and they must 
    leave their pets at home as an additional preventive measure.

    "Visceral leishmaniasis was present in the northern part of South 
    America until migrating workers started moving it towards the south. 
    In early 2000, there were some important outbreaks in Campo Grande do 
    Sul and in Asuncion, where the average number of persons infected is 
    around 70 per year. In Brazil there are around 4000 cases and 200 
    deaths per year," pointed out Dr. Salomon, who had been doing some 
    field work during the past few weeks in the Litoral provinces.

    He also added: "There is a trend for an increase in visceral 
    leishmaniasis, so the disease may spread, and it is expected to have 
    more cases."

    Climate changes and deforesting seem to be the main explanations for 
    the migration of mosquito-borne diseases. However, trying to justify 
    the occurrence of emergent diseases only because of reasons inherent 
    to nature itself may exonerate provincial and municipal authorities 
    for not complying with their obligations with respect to the 
    implementation of disease control programs and cleaning empty lots.

    Consequently, now there are many public accusations between Misiones, 
    Corrientes, and Chaco health officers. These persons, now that there 
    are cases of visceral leishmaniasis, immediately try to explain that 
    transmission may have taken place outside their respective 
    jurisdictions. The clear point is that the mosquito vector appears 
    because of lack of public hygiene.

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

    [Leishmaniasis has been slowly spreading in northern Argentina over 
    the past decades (Salomon O et al. First visceral leishmaniasis focus 
    in Argentina. Mem Inst Oswaldo Cruz. 2008;103:109-11
    <http://www.ncbi.nlm.nih.gov/pubmed/18368242?ordinalpos=9&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_DefaultReportPanel.Pubmed_RVDocSum>).

    The ecology of the vector has been changing, and increasing 
    urbanization has been suggested as one of the explanations (Salomon 
    OD et al. Phlebotominae (Diptera: Psycodidae) fauna in the Chaco 
    region and Cutaneous Leishmaniasis transmission patterns in 
    Argentina. Mem Inst Oswaldo Cruz. 2008;103:578-84
    <http://www.ncbi.nlm.nih.gov/pubmed/18949328?ordinalpos=3&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_DefaultReportPanel.Pubmed_RVDocSum>).
     - Mod.EP]



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