<!doctype html public "-//w3c//dtd html 4.0 transitional//en">
<html>
Dear Dick,
<p>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.
<p>KP
<p>Richard Ashford wrote:
<blockquote TYPE=CITE>Dear Philippe
<p>I was away, in Israel, so missed the nonsense about Iraq till now.
<br>Congratulations on the moderateness of your response. It's probably
just
<br>as well I missed it, as my response would have been 'a l'ashfordienne',
and
<br>people would have been upset by straight talk.
<p>By the way, I have been thoroughly through all the reports I can find,
and
<br>can find absolutely NO reliable evidence of L. tropica causing VL.
Every
<br>report is flawed one way or another and, before postulating such an
<br>unlikely event, the evidence would have to be very convincing a) that
the
<br>parasite really is tropica and b) that the infection really is
<br>leishmaniasis!
<p>Best wishes,
<p>Dick
<p>--On 02 June 2003 09:53 +0200 desjeuxp@who.int wrote:
<p>> This report on leishmaniasis in Iraq is full of mistakes and confusing.
<br>> There is no real outbreak of visceral leishmaniasis but accumulated
non
<br>> treated cases. The transmission season is from May to October with
a major
<br>> risk of transmission in September/October and, due to the incubation
time,
<br>> cases are mainly detected from November to April. Due to the pre-war
<br>> situation and the lack of drugs during this period, accumulated cases
of
<br>> last year transmission are seen now. UNICEF and WHO have recently
sent a
<br>> large quantity of drugs.
<br>>
<br>> L major and L.tropica are at the origin of zoonotic and anthroponotic
<br>> cutaneous leishmaniasis specially in central and Northern but CERTAINLY
<br>> not at the origin of leishmaniasis visceral in Iraq.
<br>>
<br>> Regards
<br>>
<br>> P. Desjeux
<br>>
<br>> _______________________________
<br>>
Dr Philippe Desjeux
<br>>
Medical Officer
<br>> Department of Communicable Disease
<br>>
Surveillance and Response
<br>>
(CDS/CSR)
<br>> World Health Organization
Direct Tel. (+41 22) 791 38 70
<br>> 20, Avenue Appia
Operator (+41 22) 791 21 11
<br>> CH-1211 Geneva 27
Fax: (+41 22) 791
48 78
<br>> Switzerland
Email. <desjeuxp@who.int>
<br>>
<br>>
<br>> -----Original Message-----
<br>> From: Fred R. Opperdoes [<a href="mailto:opperdoes@trop.ucl.ac.be">mailto:opperdoes@trop.ucl.ac.be</a>]
<br>> Sent: Sunday, 1 June 2003 08:13
<br>> To: leish-l@fat.org.br
<br>> Subject: [leish-l] Leishmaniasis - Iraq
<br>>
<br>>
<br>> At 22:46 -0400 5/31/03, ProMED Digest wrote:
<br>>> Date: Sat, 31 May 2003 20:08:31 -0400 (EDT)
<br>>> From: ProMED-mail <promed@promed.isid.harvard.edu>
<br>>> Subject: PRO/EDR> Leishmaniasis - Iraq: RFI
<br>>>
<br>>> LEISHMANIASIS - IRAQ: REQUEST FOR INFORMATION
<br>>> **********************
<br>>> A ProMED-mail post
<br>>> <<a href="http://www.promedmail.org">http://www.promedmail.org</a>
<br>>> ProMED-mail, a program of the
<br>>> International Society for Infectious Diseases
<br>>> <<a href="http://www.isid.org">http://www.isid.org</a>>
<br>>>
<br>>>
<br>>> Date: Fri, 31 May 2003
<br>>> From: Pablo Nart <p.nart@vet.gla.ac.uk>
<br>>> Source: NDTV Thu 29 May 2003
<br>>> <<a href="http://www.ndtv.com/template/template.asp?template=Usiraqconfrontation&">http://www.ndtv.com/template/template.asp?template=Usiraqconfrontation&</a>
<br>>> slu
<br>> g=%3CI%3EKalaAzar%3C%2FI%3E+outbreak+in+Iraq%3A+UNICEF&id=38619&callid=1>
<br>>>
<br>>>
<br>>> Outbreak of Kala-Azar (visceral leishmaniasis) in Iraq
<br>>> - --------------------------------------------------
<br>>> UNICEF has announced an outbreak of Kala-Azar (Visceral Leishmaniasis)
in
<br>>> Iraq. Though there have been outbreaks of the disease in Iraq in
the past
<br>>> around this time of year, it is particularly severe this time.
<br>>>
<br>>> There are now more than 200 cases of Kala-Azar reported in Iraq.
The
<br>>> country does see regular outbreaks of the disease.
<br>>> UNICEF has warned that this time the outbreak could be severe.
<br>>>
<br>>> Kala-Azar is spread mainly by sand flies and causes malnutrition
and
<br>>> anaemia. When left untreated, the disease is fatal within 4 to 6
weeks.
<br>>>
<br>>> [Byline: Kamini Sawhney (Baghdad)]
<br>>>
<br>>> - --
<br>>> ProMED-mail
<br>>> <promed@promedmail.org>
<br>>>
<br>>> [Leishmaniasis is endemic in Iraq and is caused by _L. major_ and
_L.
<br>>> tropica_, which can cause both visceral leishmaniasis (VL) and cutaneous
<br>>> leishmaniasis (CL). Leishmaniasis from these 2 species are predominantly
<br>>> CL, and an increase in CL will most probably be found if looked
for. It
<br>>> is possible that malnutrition and other infections may have caused
more
<br>>> cases to manifest as VL. Leishmania is transmitted from animal
<br>>> reservoirs and human hosts by sandflies. There are no annual statistics
<br>>> on VL in Iraq, but Gideon (<www.gideononline.com>) reports 8500
cases
<br>>> from 1971 to 1980, with the highest prevalence in the central areas
and
<br>>> greater Baghdad. Cases have not been reported since then, but there
is
<br>>> no reason to believe that there have been fewer cases. More information
<br>>> on this outbreak would be appreciated. - Mods.EP/MPP]
<br>>>
<br>>> [see also:
<br>>> 2001
<br>>> - ----
<br>>> Leishmaniasis, suspected - Iraq 20010917.2245]
<br>>> ...................mpp/ep/pg/mpp
<br>>>
<br>>> ------------------------------
<br>>
<br>> _______________________________________________
<br>> leish-l mailing list
<br>> leish-l@fat.org.br
<br>> <a href="http://panda.fat.org.br/mailman/listinfo/leish-l">http://panda.fat.org.br/mailman/listinfo/leish-l</a>
<br>> _______________________________________________
<br>> leish-l mailing list
<br>> leish-l@fat.org.br
<br>> <a href="http://panda.fat.org.br/mailman/listinfo/leish-l">http://panda.fat.org.br/mailman/listinfo/leish-l</a>
<p>Please note new status and phone number:
<br>R.W. Ashford
<br>Professor (Retired) of Parasite and Vector Biology
<br>Liverpool School of Tropical Medicine
<br>Liverpool L3 5QA
<br>Tel: +44 151 632 2714
<br>Fax: +44 151 705 3371
<br>e-mail: ashford@liv.ac.uk
<br>_______________________________________________
<br>leish-l mailing list
<br>leish-l@fat.org.br
<br><a href="http://panda.fat.org.br/mailman/listinfo/leish-l">http://panda.fat.org.br/mailman/listinfo/leish-l</a></blockquote>
</html>