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<p class=MsoPlainText><font size=2 face="Courier New"><span style='font-size:
10.0pt'>Dear Dick,</span></font></p>
<p class=MsoPlainText><font size=2 face="Courier New"><span style='font-size:
10.0pt'> </span></font></p>
<p class=MsoPlainText><font size=2 face="Courier New"><span style='font-size:
10.0pt'>First of all, Happy New Year!</span></font></p>
<p class=MsoPlainText><font size=2 face="Courier New"><span style='font-size:
10.0pt'> </span></font></p>
<p class=MsoPlainText><font size=2 face="Courier New"><span style='font-size:
10.0pt'>I think one difference is that of "splitters" and "clumpers".
We see it throughout systematics. </span></font></p>
<p class=MsoPlainText><font size=2 face="Courier New"><span style='font-size:
10.0pt'> </span></font></p>
<p class=MsoPlainText><font size=2 face="Courier New"><span style='font-size:
10.0pt'>True that <i><span style='font-style:italic'>Le. chagasi</span></i>
cannot be differentiated from <i><span style='font-style:italic'>Le. infantum</span></i>
with the tool we presently have.</span></font></p>
<p class=MsoPlainText><font size=2 face="Courier New"><span style='font-size:
10.0pt'> </span></font></p>
<p class=MsoPlainText><font size=2 face="Courier New"><span style='font-size:
10.0pt'>For those that work with the leishmanias, I believe that there is
little doubt that this organism was probably introduced from the </span></font>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.</p>
<p class=MsoPlainText><font size=2 face="Courier New"><span style='font-size:
10.0pt'> </span></font></p>
<p class=MsoPlainText><font size=2 face="Courier New"><span style='font-size:
10.0pt'>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 (<i><span style='font-style:italic'>Le. i. infantum</span></i>, <i><span
style='font-style:italic'>Le. i. chagasi</span></i> and maybe even include <i><span
style='font-style:italic'>Le. i. archibald</span></i>)?</span></font></p>
<p class=MsoPlainText><font size=2 face="Courier New"><span style='font-size:
10.0pt'> </span></font></p>
<p class=MsoPlainText><font size=2 face="Courier New"><span style='font-size:
10.0pt'> </span></font></p>
<p class=MsoPlainText><font size=2 face="Courier New"><span style='font-size:
10.0pt'>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.</span></font></p>
<p class=MsoPlainText><font size=2 face="Courier New"><span style='font-size:
10.0pt'> </span></font></p>
<p class=MsoPlainText><font size=2 face="Courier New"><span style='font-size:
10.0pt'>We must also consider that if, sometime, differentiating
characteristics are found, it will be easier to manage the "split"
literature than the "clumped" literature.</span></font></p>
<p class=MsoPlainText><font size=2 face="Courier New"><span style='font-size:
10.0pt'> </span></font></p>
<p class=MsoPlainText><font size=2 face="Courier New"><span style='font-size:
10.0pt'>Have a good year,</span></font></p>
<p class=MsoPlainText><font size=2 face="Courier New"><span style='font-size:
10.0pt'>Regards,</span></font></p>
<p class=MsoPlainText><font size=2 face="Courier New"><span style='font-size:
10.0pt'> </span></font></p>
<p class=MsoPlainText><font size=2 face="Courier New"><span lang=PT-BR
style='font-size:10.0pt'>Jorge</span></font></p>
<p class=MsoPlainText><font size=2 face="Courier New"><span lang=PT-BR
style='font-size:10.0pt'> </span></font></p>
<p class=MsoPlainText><font size=2 face="Courier New"><span lang=PT-BR
style='font-size:10.0pt'>Jorge R. Arias, Ph.D.</span></font></p>
<p class=MsoPlainText><font size=2 face="Courier New"><span style='font-size:
10.0pt'>Regional Advisor</span></font></p>
<p class=MsoPlainText><font size=2 face="Courier New"><span style='font-size:
10.0pt'>Pan American Health Organization</span></font></p>
<p class=MsoPlainText><font size=2 face="Courier New"><span style='font-size:
10.0pt'>525 Twenty-third Street</span></font> N.W</p>
<p class=MsoPlainText><font size=2 face="Courier New"><span style='font-size:
10.0pt'>Washington</span></font>, D.C. 20037</p>
<p class=MsoPlainText><font size=2 face="Courier New"><span lang=ES-TRAD
style='font-size:10.0pt'>Tel +1 (202) 974-3271</span></font></p>
<p class=MsoPlainText><font size=2 face="Courier New"><span lang=ES-TRAD
style='font-size:10.0pt'>FAX +1 (202) 974 3565</span></font></p>
<p class=MsoPlainText><font size=2 face="Courier New"><span lang=ES-TRAD
style='font-size:10.0pt'>ariasjor@paho.org</span></font></p>
<p class=MsoPlainText><font size=2 face="Courier New"><span lang=ES-TRAD
style='font-size:10.0pt'>www.paho.org/dengue</span></font></p>
<p class=MsoPlainText><font size=2 face="Courier New"><span style='font-size:
10.0pt'> </span></font></p>
<p class=MsoPlainText><font size=2 face="Courier New"><span style='font-size:
10.0pt'> </span></font></p>
<p class=MsoPlainText><font size=2 face="Courier New"><span style='font-size:
10.0pt'>-----Original Message-----<br>
From: Richard Ashford [mailto:ashford@liverpool.ac.uk] <br>
Sent: </span></font>Wednesday, January 15, 2003 6:24 AM<br>
To: Fred R. Opperdoes<br>
Cc: promed@promed.isid.harvard.edu; leish-l@bdt.org.br<br>
Subject: Re: [leish-l] Leishmaniasis in Brazil</p>
<p class=MsoPlainText><font size=2 face="Courier New"><span style='font-size:
10.0pt'> </span></font></p>
<p class=MsoPlainText><font size=2 face="Courier New"><span style='font-size:
10.0pt'>Dear Dr Opperdoes,</span></font></p>
<p class=MsoPlainText><font size=2 face="Courier New"><span style='font-size:
10.0pt'> </span></font></p>
<p class=MsoPlainText><font size=2 face="Courier New"><span style='font-size:
10.0pt'>In view of the repeated finding by several authors that the agent for
South </span></font></p>
<p class=MsoPlainText><font size=2 face="Courier New"><span style='font-size:
10.0pt'>American visceral leishmaniasis cannot reliably be distinguished from </span></font></p>
<p class=MsoPlainText><font size=2 face="Courier New"><span style='font-size:
10.0pt'>Mediterranean L. infantum, what is your justification for the continued
use </span></font></p>
<p class=MsoPlainText><font size=2 face="Courier New"><span style='font-size:
10.0pt'>of 'L. chagasi'?</span></font></p>
<p class=MsoPlainText><font size=2 face="Courier New"><span style='font-size:
10.0pt'> </span></font></p>
<p class=MsoPlainText><font size=2 face="Courier New"><span style='font-size:
10.0pt'>My own view is that geographical distribution is NOT a valid taxonomic </span></font></p>
<p class=MsoPlainText><font size=2 face="Courier New"><span style='font-size:
10.0pt'>character, and the continued use of this synonym hides the important </span></font></p>
<p class=MsoPlainText><font size=2 face="Courier New"><span style='font-size:
10.0pt'>implication that the infection was almost certainly introduced
relatively </span></font></p>
<p class=MsoPlainText><font size=2 face="Courier New"><span style='font-size:
10.0pt'>recently from the '</span></font>Old World'.</p>
<p class=MsoPlainText><font size=2 face="Courier New"><span style='font-size:
10.0pt'> </span></font></p>
<p class=MsoPlainText><font size=2 face="Courier New"><span style='font-size:
10.0pt'>Dick Ashford</span></font></p>
<p class=MsoPlainText><font size=2 face="Courier New"><span style='font-size:
10.0pt'> </span></font></p>
<p class=MsoPlainText><font size=2 face="Courier New"><span style='font-size:
10.0pt'>--On </span></font>14 January 2003 16:27 +0100 "Fred R.
Opperdoes" </p>
<p class=MsoPlainText><font size=2 face="Courier New"><span style='font-size:
10.0pt'><opperdoes@trop.ucl.ac.be> wrote:</span></font></p>
<p class=MsoPlainText><font size=2 face="Courier New"><span style='font-size:
10.0pt'> </span></font></p>
<p class=MsoPlainText><font size=2 face="Courier New"><span style='font-size:
10.0pt'>> At </span></font>10:04 -0500 14/01/03, ProMED Digest wrote:</p>
<p class=MsoPlainText><font size=2 face="Courier New"><span style='font-size:
10.0pt'>>></span></font></p>
<p class=MsoPlainText><font size=2 face="Courier New"><span style='font-size:
10.0pt'>>> Date: </span></font>Tue, 14 Jan 2003 10:04:52 -0500 (EST)</p>
<p class=MsoPlainText><font size=2 face="Courier New"><span style='font-size:
10.0pt'>>> From: ProMED-mail <promed@promed.isid.harvard.edu></span></font></p>
<p class=MsoPlainText><font size=2 face="Courier New"><span style='font-size:
10.0pt'>>> Subject: PRO/AH/EDR> Leishmaniasis - </span></font>Brazil (Sao
Paulo)</p>
<p class=MsoPlainText><font size=2 face="Courier New"><span style='font-size:
10.0pt'>>></span></font></p>
<p class=MsoPlainText><font size=2 face="Courier New"><span style='font-size:
10.0pt'>>> LEISHMANIASIS ? </span></font>BRAZIL (SAO PAULO)</p>
<p class=MsoPlainText><font size=2 face="Courier New"><span style='font-size:
10.0pt'>>> ***********************</span></font></p>
<p class=MsoPlainText><font size=2 face="Courier New"><span style='font-size:
10.0pt'>>> A ProMED-mail post</span></font></p>
<p class=MsoPlainText><font size=2 face="Courier New"><span style='font-size:
10.0pt'>>> <http://www.promedmail.org></span></font></p>
<p class=MsoPlainText><font size=2 face="Courier New"><span style='font-size:
10.0pt'>>> ProMED-mail, a program of the</span></font></p>
<p class=MsoPlainText><font size=2 face="Courier New"><span style='font-size:
10.0pt'>>> International Society for Infectious Diseases</span></font></p>
<p class=MsoPlainText><font size=2 face="Courier New"><span style='font-size:
10.0pt'>>> <http://www.isid.org></span></font></p>
<p class=MsoPlainText><font size=2 face="Courier New"><span style='font-size:
10.0pt'>>></span></font></p>
<p class=MsoPlainText><font size=2 face="Courier New"><span style='font-size:
10.0pt'>>> </span></font>Date: 12 Jan 2003</p>
<p class=MsoPlainText><font size=2 face="Courier New"><span style='font-size:
10.0pt'>>> From: ProMED-mail <promed@promedmail.org</span></font></p>
<p class=MsoPlainText><font size=2 face="Courier New"><span style='font-size:
10.0pt'>>> Source: Informativo Cosmo </span></font>11 Jan 2003 [translated & edited by Mod.MPP]</p>
<p class=MsoPlainText><font size=2 face="Courier New"><span style='font-size:
10.0pt'>>>
<http://www.cosmo.com.br/cidades/sjriopreto/2003/01/10/materia_srp_48221</span></font></p>
<p class=MsoPlainText><font size=2 face="Courier New"><span style='font-size:
10.0pt'>>> .shtm></span></font></p>
<p class=MsoPlainText><font size=2 face="Courier New"><span style='font-size:
10.0pt'>>></span></font></p>
<p class=MsoPlainText><font size=2 face="Courier New"><span style='font-size:
10.0pt'>>></span></font></p>
<p class=MsoPlainText><font size=2 face="Courier New"><span style='font-size:
10.0pt'>>> The health authorities of </span></font>Aracatuba [Sao Paulo
state] are issuing an</p>
<p class=MsoPlainText><font size=2 face="Courier New"><span style='font-size:
10.0pt'>>> alert about an epidemic of human visceral leishmaniasis in 30</span></font></p>
<p class=MsoPlainText><font size=2 face="Courier New"><span style='font-size:
10.0pt'>>> municipalities of the region. In 2002, epidemiological
surveillance</span></font></p>
<p class=MsoPlainText><font size=2 face="Courier New"><span style='font-size:
10.0pt'>>> reported 43 cases in humans resulting in 4 deaths; there were
also 2</span></font></p>
<p class=MsoPlainText><font size=2 face="Courier New"><span style='font-size:
10.0pt'>>> deaths in 2001. These deaths have led to the development of a
strategic</span></font></p>
<p class=MsoPlainText><font size=2 face="Courier New"><span style='font-size:
10.0pt'>>> plan for disease control by the Superintendence of Endemic
Disease</span></font></p>
<p class=MsoPlainText><font size=2 face="Courier New"><span style='font-size:
10.0pt'>>> Control (Sucen).</span></font></p>
<p class=MsoPlainText><font size=2 face="Courier New"><span style='font-size:
10.0pt'>>></span></font></p>
<p class=MsoPlainText><font size=2 face="Courier New"><span style='font-size:
10.0pt'>>> As of Friday [</span></font>10 Jan 2003], the Epidemiological Surveillance Unit</p>
<p class=MsoPlainText><font size=2 face="Courier New"><span style='font-size:
10.0pt'>>> confirmed the first death this year [2003] attributable to
visceral</span></font></p>
<p class=MsoPlainText><font size=2 face="Courier New"><span style='font-size:
10.0pt'>>> leishmaniasis, signifying the 11th death due to this disease
since its</span></font></p>
<p class=MsoPlainText><font size=2 face="Courier New"><span style='font-size:
10.0pt'>>> reappearance in the region in the summer of 1998. The most
recent death</span></font></p>
<p class=MsoPlainText><font size=2 face="Courier New"><span style='font-size:
10.0pt'>>> [2003] is in an adult male.</span></font></p>
<p class=MsoPlainText><font size=2 face="Courier New"><span style='font-size:
10.0pt'>>></span></font></p>
<p class=MsoPlainText><font size=2 face="Courier New"><span style='font-size:
10.0pt'>>> The Epidemiological Surveillance Unit will investigate whether
the death</span></font></p>
<p class=MsoPlainText><font size=2 face="Courier New"><span style='font-size:
10.0pt'>>> was due to leishmaniasis or whether the disease was aggravated
by an</span></font></p>
<p class=MsoPlainText><font size=2 face="Courier New"><span style='font-size:
10.0pt'>>> underlying chronic cirrhosis (liver disease). Most cases have
been in</span></font></p>
<p class=MsoPlainText><font size=2 face="Courier New"><span style='font-size:
10.0pt'>>> children, especially those living in lower socioeconomic
neighborhoods,</span></font></p>
<p class=MsoPlainText><font size=2 face="Courier New"><span style='font-size:
10.0pt'>>> due to underlying malnutrition and an association with other
diseases</span></font></p>
<p class=MsoPlainText><font size=2 face="Courier New"><span style='font-size:
10.0pt'>>> such as pneumonia.</span></font></p>
<p class=MsoPlainText><font size=2 face="Courier New"><span style='font-size:
10.0pt'>>></span></font></p>
<p class=MsoPlainText><font size=2 face="Courier New"><span style='font-size:
10.0pt'>>> Leishmaniasis is a disease caused by the protozoan
_Leishmania_ spp. and</span></font></p>
<p class=MsoPlainText><font size=2 face="Courier New"><span style='font-size:
10.0pt'>>> is transmitted by sand flies, which preferentially feed on
dogs. For this</span></font></p>
<p class=MsoPlainText><font size=2 face="Courier New"><span style='font-size:
10.0pt'>>> reason, disease control is primarily directed at the canine
population.</span></font></p>
<p class=MsoPlainText><font size=2 face="Courier New"><span style='font-size:
10.0pt'>>> Sucen is testing a type of collar with a mosquito repellant.
About 10 000</span></font></p>
<p class=MsoPlainText><font size=2 face="Courier New"><span style='font-size:
10.0pt'>>> dogs have been registered [by census] and are followed in
Andradina, and</span></font></p>
<p class=MsoPlainText><font size=2 face="Courier New"><span style='font-size:
10.0pt'>>> another 2000 in </span></font>Aracatuba.</p>
<p class=MsoPlainText><font size=2 face="Courier New"><span style='font-size:
10.0pt'>>></span></font></p>
<p class=MsoPlainText><font size=2 face="Courier New"><span style='font-size:
10.0pt'>>> [byline: Salete Duarte]</span></font></p>
<p class=MsoPlainText><font size=2 face="Courier New"><span style='font-size:
10.0pt'>>></span></font></p>
<p class=MsoPlainText><font size=2 face="Courier New"><span style='font-size:
10.0pt'>>> - --</span></font></p>
<p class=MsoPlainText><font size=2 face="Courier New"><span style='font-size:
10.0pt'>>> ProMED-mail</span></font></p>
<p class=MsoPlainText><font size=2 face="Courier New"><span style='font-size:
10.0pt'>>> <promed@promedmail.org></span></font></p>
<p class=MsoPlainText><font size=2 face="Courier New"><span style='font-size:
10.0pt'>>></span></font></p>
<p class=MsoPlainText><font size=2 face="Courier New"><span style='font-size:
10.0pt'>>> [The species of leishmania implicated is _L.chagasi_ and the
vectors are</span></font></p>
<p class=MsoPlainText><font size=2 face="Courier New"><span style='font-size:
10.0pt'>>> _Lutzomyia_ spp. The animal reservoir includes dogs, foxes,
and opossums.</span></font></p>
<p class=MsoPlainText><font size=2 face="Courier New"><span style='font-size:
10.0pt'>>> In 1999, 3892 human cases were reported in </span></font>Brazil,
3200 of which were in</p>
<p class=MsoPlainText><font size=2 face="Courier New"><span style='font-size:
10.0pt'>>> the north eastern states (www.gideon.com), but the prevalence
in Sao</span></font></p>
<p class=MsoPlainText><font size=2 face="Courier New"><span style='font-size:
10.0pt'>>> Paulo state is not known. Leishmania is one of the infections
that</span></font></p>
<p class=MsoPlainText><font size=2 face="Courier New"><span style='font-size:
10.0pt'>>> increase following an increase in HIV prevalence. - Mod.EP]</span></font></p>
<p class=MsoPlainText><font size=2 face="Courier New"><span style='font-size:
10.0pt'>> _______________________________________________</span></font></p>
<p class=MsoPlainText><font size=2 face="Courier New"><span style='font-size:
10.0pt'>> leish-l mailing list</span></font></p>
<p class=MsoPlainText><font size=2 face="Courier New"><span style='font-size:
10.0pt'>> leish-l@bdt.org.br</span></font></p>
<p class=MsoPlainText><font size=2 face="Courier New"><span style='font-size:
10.0pt'>> http://panda.fat.org.br/mailman/listinfo/leish-l</span></font></p>
<p class=MsoPlainText><font size=2 face="Courier New"><span style='font-size:
10.0pt'> </span></font></p>
<p class=MsoPlainText><font size=2 face="Courier New"><span style='font-size:
10.0pt'> </span></font></p>
<p class=MsoPlainText><font size=2 face="Courier New"><span style='font-size:
10.0pt'>_______________________________________________</span></font></p>
<p class=MsoPlainText><font size=2 face="Courier New"><span style='font-size:
10.0pt'>leish-l mailing list</span></font></p>
<p class=MsoPlainText><font size=2 face="Courier New"><span style='font-size:
10.0pt'>leish-l@bdt.org.br</span></font></p>
<p class=MsoPlainText><font size=2 face="Courier New"><span style='font-size:
10.0pt'>http://panda.fat.org.br/mailman/listinfo/leish-l</span></font></p>
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