<html><body style="word-wrap: break-word; -webkit-nbsp-mode: space; -webkit-line-break: after-white-space; ">Date: Sun, 30 Nov 2008 17:35:36 -0500 (EST)<br>From: ProMED-mail <<a href="mailto:promed@promed.isid.harvard.edu">promed@promed.isid.harvard.edu</a>><br>Subject: PRO/AH/EDR> Leishmaniasis, visceral - Brazil (03): (DF), human, canine<br><br>LEISHMANIASIS, VISCERAL - BRAZIL (03): (FEDERAL DISTRICT), HUMAN, CANINE<br>************************************************************************<br>A ProMED-mail post<br><<a href="http://www.promedmail.org/">http://www.promedmail.org</a>><br>ProMED-mail is a program of the<br>International Society for Infectious Diseases<br><<a href="http://www.isid.org/">http://www.isid.org</a>><br><br>[1] Canine<br>[2] Human<br><br>*****<br>[1] Canine<br>Date: 27 Nov 2008<br>Source: Correio Braziliense [in Portuguese, trans. & summ. Mod.JW, edited]<br><<a href="http://www.correiobraziliense.com.br/html/sessao_13/2008/11/27/noticia_interna,id_sessao=13&id_noticia=52343/noticia_interna.shtml">http://www.correiobraziliense.com.br/html/sessao_13/2008/11/27/noticia_interna,id_sessao=13&id_noticia=52343/noticia_interna.shtml</a>><br><br><br>Lago Norte (North Lake), one of the most prestigious neighborhoods of <br>the federal capital [Brasilia], is threatened by leishmaniasis. Of <br>the 6132 dogs examined, 1093 were positive for the protozoan cause of <br>the disease, representing 18 percent of the animals. The serological <br>survey, conducted by the Department of Health, was completed this <br>week and put the health authorities on the alert. If the transmitter <br>sand fly sucks the blood of a sick dog and later bites a human, there <br>may be contamination.<br><br>Leishmaniasis affects the viscera and is fatal, especially in <br>children and the elderly. To prevent human cases, the official <br>recommendation is that sick animals should be sacrificed. Tonight [27 <br>Nov 2008], residents will meet with representatives of the government <br>and the public prosecutor to discuss a solution to this serious <br>public health problem.<br><br>The owners of sick animals are divided about the fate of the dogs. <br>Some prefer to sacrifice them to eliminate any chance of human cases; <br>others promise a legal fight with the Secretary of Health to try to <br>treat the dogs and keep them alive.<br><br>The sacrificing of sick dogs is a controversial measure. Specialists <br>say that the animals with positive results for leishmania may not be <br>infected. That's because dogs vaccinated against the disease are <br>positive on serological examination. "Not only because of the <br>vaccine: Animals who have tick fever, very common in dogs, can also <br>produce false positives for leishmaniasis," said the president of the <br>Animal Protection Society, Simone Lima.<br><br>She defends the right of the owners to carry out a check with a <br>different method implemented by the Department of Health "The <br>serological examination of zoonoses is not a definitive diagnosis but <br>an indication that the dog may be sick. There are other, more <br>accurate methods, such as bone marrow puncture. The owner should have <br>the right to make a rebuttal in case serology points to the presence <br>of leishmaniasis," said the organization's president.<br><br>The Manual of Surveillance and Control of Visceral Leishmaniasis, a <br>publication of the Ministry of Health launched in 2006 and used as a <br>national reference for combating the disease, does not validate <br>examinations such as bone marrow puncture. "In situations where the <br>owner of the animal requires rebuttal, it should be a serological <br>test performed by the laboratory network," says the manual of the <br>Ministry of Health.<br><br>[Byline: Helen Mader]<br><br>- --<br>Communicated by:<br>ProMED-mail <<a href="mailto:promed@promedmail.org">promed@promedmail.org</a>><br><br>[Another report from the same source dated 28 Nov 2008 says a total <br>of 1269 dogs tested positive in 3 cities of the Federal District. <br>Besides the 1017/5474 (19 percent) in Lago Norte (different from the <br>total given above), Fercal, in Sobradinho II, had 176/1224 (14 <br>percent) infected, and in Varjo, 76/658 (12 percent) had signs of the <br>disease, a total of 1269 positives. - Mod.JW]<br><br>******<br>[2]<br>Date: Sun 30 Nov 2008<br>Source: Correio Braziliense [Portuguese, trans. & sum. Mod.JW, edited]<br><<a href="http://www.correiobraziliense.com.br/html/sessao_13/2008/11/25/noticia_interna,id_sessao=13&id_noticia=51742/noticia_interna.shtml">http://www.correiobraziliense.com.br/html/sessao_13/2008/11/25/noticia_interna,id_sessao=13&id_noticia=51742/noticia_interna.shtml</a>><br><br><br>The Department of Health confirmed the 4th human case of <br>leishmaniasis in the Federal District in 2008, all in Sobradinho. <br>With the case [1st suspected] in October 2008, this year surpasses <br>the number of the infected last year [2007], when 3 people contracted <br>the disease. Since 2005, with the 1st appearance in humans, this is <br>the 15th occurrence in the Federal District, and on only 2 occasions <br>was the report from outside the region of Sobradinho.<br><br>To the head of the Center for Endemics of the Department of Health, <br>Ailton da Silva, the fact that the area is still basically rural <br>contributes to the higher incidence of occurrences. "In spite of the <br>penetration of humans into the region, the environment is still <br>preserved. The [vector] insect has its characteristic habitat there."<br><br>But the Secretary does not rule out the risk of contamination in <br>other cities, such as Lago Norte (North Lake), where preliminary data <br>indicate the existence of 1000 infected dogs in the region. According <br>to the Secretary of Health for Surveillance, the presence of infected <br>animals and transmitting sand flies implies a risk of the emergence <br>of human cases.<br><br>In 2006, a resident of Brazlandia and another in Ceilandia were <br>infected. However, Silva says that the location of the contamination <br>was not proven. "The likelihood is that people did not contract the <br>disease in those areas, because we have not found any sick dogs in <br>those cities," he pointed out.<br><br>According to the Secretary, the fight against the vector is <br>difficult. "Unlike dengue, [the] leishmaniasis [vector] does not need <br>water for its life cycle," said Silva. The insect usually stays in <br>shaded and humid places and reproduces in the presence of organic <br>matter.<br><br>One of the preventive measures is to keep the yard clean. "Prune <br>trees that block the sun and remove leaves and feces of animals to <br>help prevent the spread of the disease," said the head of the Center <br>for Endemics.<br><br>The removal of sick or infected dogs, one of the species most <br>vulnerable to the insect, also lessens the likelihood of <br>contamination. If the transmitting sand fly bites an infected dog and <br>later a human, transmission of leishmaniasis can occur.<br><br>The 1st signs of the disease are pale skin, lack of appetite, <br>weakness, anemia, abdominal pain, vomiting, diarrhea and fever for <br>more than 15 days. "If a person lives in the area of risk and falls <br>ill, they should think about the likelihood of leishmaniasis and seek <br>the Health unit to identify the disease," he said. The exam can be <br>done by the public health network. The person must be hospitalized at <br>least 20 days for medical care. According to Silva, it is important <br>to detect the disease as early as possible to aid recovery. In 2006, <br>2 people died because of leishmaniasis.<br><br>- --<br>Communicated by:<br>ProMED-mail <<a href="mailto:promed@promedmail.org">promed@promedmail.org</a>><br><br>[Although the WHO lists almost all of Brazil as endemic for visceral <br>leishmaniasis (VL)<br><<a href="http://www.who.int/leishmaniasis/leishmaniasis_maps/en/index.html">http://www.who.int/leishmaniasis/leishmaniasis_maps/en/index.html</a>>,<br>the focus is in the northeast and in the Amazonas.<br><br>It seems that VL is spreading towards the south and east and has <br>recently been reported for the 1st time from Minas Gerais, which <br>borders the Federal District: (Paula et al. 1st finding of _Lutzomyia <br>longipalpis_ (Lutz & Neiva, 1912) in the urban area of Uberlandia, <br>MG, concomitant with the 1st reported autochthonous case of human <br>visceral leishmaniasis. Rev Soc Bras Med Trop. 2008;41:304-5).<br><br>In northeast Brazil, dogs are the main reservoir, which probably also <br>is the case in the new areas where VL is now found. See: (Queiroz et <br>al. Canine visceral leishmaniasis in urban and rural areas of <br>Northeast Brazil. Res Vet Sci. 2008 Sep 18. (E-pub ahead of print)<br><<a href="http://www.ncbi.nlm.nih.gov/pubmed/18804826?ordinalpos=14&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_DefaultReportPanel.Pubmed_RVDocSum">http://www.ncbi.nlm.nih.gov/pubmed/18804826?ordinalpos=14&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_DefaultReportPanel.Pubmed_RVDocSum</a>>.<br><br>Maps:<br>Federal District: <<a href="http://en.wikipedia.org/wiki/Brazilian_Federal_District">http://en.wikipedia.org/wiki/Brazilian_Federal_District</a>><br> Minas Gerais:<br><<a href="http://en.wikipedia.org/wiki/Minas_Gerais">http://en.wikipedia.org/wiki/Minas_Gerais</a>><br> - Mod.EP]<br></body></html>