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<br><br><div class="ecxgmail_quote">---------- Forwarded message ----------<br>From: <b class="ecxgmail_sendername">ProMED-mail</b> <span dir="ltr"><<a href="mailto:promed@promed.isid.harvard.edu">promed@promed.isid.harvard.edu</a>></span><br>
Date: 2011/3/23<br>Subject: PRO/AH/EDR> Leishmaniasis, canine - Argentina: (CN)<br>To: <a href="mailto:promed-ahead-edr@promedmail.org">promed-ahead-edr@promedmail.org</a><br><br><br>LEISHMANIASIS, CANINE - ARGENTINA: (CORRIENTES)<br>
***********************************************<br>
A ProMED-mail post<br>
<<a href="http://www.promedmail.org" target="_blank">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" target="_blank">http://www.isid.org</a>><br>
<br>
Date: Sun 20 Mar 2011<br>
Source: El Litoral [in Spanish, trans. Mod.JG, edited]<br>
<<a href="http://www.ellitoral.com.ar/leer_noticia.asp?IdNoticia=158479" target="_blank">http://www.ellitoral.com.ar/leer_noticia.asp?IdNoticia=158479</a>><br>
<br>
<br>
The arrival of autumn and the consequent temperature reduction may<br>
not have direct consequences on the leishmaniasis outbreak that is<br>
currently affecting the city of Corrientes since the beginning of this<br>
year [2011]. According to specialists, the risk for transmission and<br>
spread of the disease will still be high.<br>
<br>
"Even though temperatures have now come down, this does not mean a<br>
risk reduction; it is also necessary that people maintain good hygiene<br>
in their households in order to prevent proliferation of both the<br>
sandfly responsible of transmitting leishmaniasis, and the dengue<br>
fever mosquito", declared this week Mr Carlos Frette, secretary of<br>
health and environment for the municipality of Corrientes.<br>
<br>
It is worth mentioning that to date this year [2011], 31 positive<br>
cases of canine visceral leishmaniasis have been confirmed in the<br>
city. New cases may be confirmed in the next days, after samples were<br>
taken in the Juan de Vera, Centro, Fray Jose de la Quintana, and San<br>
Cayetano communities.<br>
<br>
--<br>
Communicated by:<br>
ProMED-mail<br>
<<a href="mailto:promed@promedmail.org">promed@promedmail.org</a>><br>
<br>
[The city of Corrientes can be located on the HealthMap/ProMED-mail<br>
interactive map of Argentina at <<a href="http://healthmap.org/r/0C3B" target="_blank">http://healthmap.org/r/0C3B</a>>. -<br>
Sr.Tech.Ed.MJ]<br>
<br>
[The phlebotomine sandflies, _Phlebotomus_ spp (Old World sandflies)<br>
and _Lutzomyia_ spp (New World sandflies), are members of the family<br>
Psychodidae. These flies are confined primarily to the tropical and<br>
subtropical regions of the world. Members of these genera are tiny,<br>
moth-like flies, about 1.5-4 mm long. The legs are as long as the<br>
antennae, comprising 16 segments that often have a beaded, hairy<br>
appearance. They are commonly known as sandflies, moth flies, or owl<br>
midges. The key morphologic feature for identification is that the<br>
body of the sandfly is covered with fine hairs. The females have<br>
piercing mouthparts and feed on blood of a variety of warm-blooded<br>
animals, including humans. Many species feed on reptiles. Male<br>
sandflies suck moisture from any available source and are even said to<br>
suck perspiration from people. Sandflies tend to be active only at<br>
night and, in contrast to black flies, are weak fliers; their flying<br>
is deterred by air currents, even slight ones. During the day,<br>
sandflies seek protection in crevices and caves, among vegetation, and<br>
within dark buildings. They often seek protection within rodent and<br>
armadillo burrows; these mammals can serve as reservoir hosts.<br>
<br>
Visceral leishmaniasis is a chronic, severe, protozoal disease of<br>
humans, dogs, and certain rodents, characterized by cutaneous or<br>
mucocutaneous lesions, lymphadenopathy, weight loss, anemia, lameness,<br>
renal failure, and occasionally epistaxis or ocular lesions.<br>
<br>
Canine leishmaniasis is a zoonotic disease, and dogs act as a<br>
reservoir of the parasite for humans where there is a competent<br>
vector.<br>
<br>
The incubation period is quite variable, ranging from 3 months to<br>
several years. The clinical features vary widely; main clinical<br>
presentations are skin lesions, loss of weight or poor appetite, local<br>
or generalized lymphadenopathy, ocular lesions, renal failure,<br>
epistaxis, lameness, and anemia. Occasionally, some dogs have chronic<br>
diarrhea or liver failure. The most common cutaneous lesions are<br>
alopecia with severe dry desquamation, usually beginning on the head<br>
and extending to the rest of the body. Other animals develop chronic<br>
ulceration, located particularly on the head and limbs. The signs<br>
invariably show a slow, progressive evolution.<br>
<br>
The results of blood and urine tests also vary greatly. Most animals<br>
have a polyclonal hyperproteinemia. Non regenerative anemia is present<br>
in 50 percent of dogs. Some animals show leukopenia, whereas others<br>
have leukocytosis. In animals with renal lesions, it is also usual to<br>
find increased plasma urea and creatinine, proteinuria, and hematuria.<br>
<br>
<br>
The most reliable diagnostic test for canine leishmaniasis is direct<br>
observation of the parasite in bone marrow or lymph node smears. The<br>
amastigotes appear as oval basophilic bodies (4 micrometer) in the<br>
cytoplasm of macrophages. However, it is sometimes impossible to<br>
detect the parasite in infected animals, especially in lymph node<br>
smears. Serologic methods are useful in diagnosis; indirect<br>
immunofluorescence and ELISA are widely used. The results of a<br>
serologic test should be interpreted in conjunction with the clinical<br>
picture. Although these tests are reliable, a few infected dogs remain<br>
seronegative, and there are also seropositive dogs that never develop<br>
the disease.<br>
<br>
For treatment, the drugs of choice are the pentavalent antimony<br>
derivatives, particularly N-methylglucamine antimoniate (80-100<br>
mg/kg/day, IM (intramuscular) or SC (subcutaneous) [not approved for<br>
use in dogs in the USA]) and sodium stibogluconate (75 mg/kg, SC, bid<br>
[available only from the CDC in the USA]). During the 1st month, the<br>
dog is treated with either drug and allopurinol (20 mg/kg, PO<br>
(orally), sid (once a day); during the next 5 months, the dog is<br>
treated with only allopurinol, which is less expensive and less<br>
toxic.<br>
<br>
Amphotericin B given IV (intravenously, 0.5-0.8 mg/kg, diluted in<br>
10-60 mL of 5 percent dextrose given over 45 seconds every 48 hours to<br>
reach a total cumulative dose of 8-15 mg/kg) or SC 2-3 times/week<br>
(0.5-0.8 mg/kg added to 500 mL of 0.45 percent saline and 2.5 percent<br>
dextrose for a total cumulative dosage of 8-26 mg/kg) has also been<br>
effective.<br>
<br>
Relapses after treatment are common with either protocol. In endemic<br>
areas, rapid treatment of infected dogs, control of stray and homeless<br>
dogs, and action against the insect vectors are recommended methods of<br>
control.<br>
<br>
Controlling the sandfly is important. Insecticide spraying of larval<br>
habitat is usually not possible because of the difficulty of accessing<br>
their breeding sites. Removal of dense vegetation discourages<br>
breeding. Spraying of residual insecticides on surfaces in the home is<br>
the main way to control sandflies; however, this is ineffective for<br>
species that bite away from the home. Generally speaking, populations<br>
of sandflies have been reduced as a result of intense mosquito control<br>
programs.<br>
<br>
So while this long bit of information is about canine visceral<br>
leishmaniasis, it is probable this disease is on the move, northward,<br>
and the significance of canine involvement may keep the zoonotic cycle<br>
going longer than had been hoped.<br>
<br>
Portions of this comment have been extracted from<br>
<<a href="http://www.merckvetmanual.com/mvm/index.jsp?cfile=htm/bc/71703.htm&word=leishmania" target="_blank">http://www.merckvetmanual.com/mvm/index.jsp?cfile=htm/bc/71703.htm&word=leishmania</a>>.<br>
- Mod.TG]<br>
<br>
[see also:<br>
Leishmaniasis, outbreak - Argentina: (CN) corr. 20110224.0610<br>
Leishmaniasis, outbreak - Argentina: (CB) 20110222.0584<br>
2010<br>
----<br>
Leishmaniasis, canine - Argentina: (CN) 20100211.0483]<br>
.................................................sb/tg/mj/lm<br>
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