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<p class=MsoNormal><font size=3 color=blue face="Times New Roman"><span
style='font-size:12.0pt;color:blue'>Ricardo<o:p></o:p></span></font></p>
<p class=MsoNormal><st1:country-region w:st="on"><st1:place w:st="on"><font
size=3 color=blue face="Times New Roman"><span style='font-size:12.0pt;
color:blue'>Israel</span></font></st1:place></st1:country-region><font
color=blue><span style='color:blue'><o:p></o:p></span></font></p>
<p class=MsoNormal><font size=3 color=blue face="Times New Roman"><span
style='font-size:12.0pt;color:blue'><o:p> </o:p></span></font></p>
<p class=MsoNormal><font size=3 color=blue face="Times New Roman"><span
style='font-size:12.0pt;color:blue'>Excellent update and clarification! Good
job! Congratulations to you both and to the full leishmaniasis team who
investigated the outbreak. <o:p></o:p></span></font></p>
<p class=MsoNormal><font size=3 color=blue face="Times New Roman"><span
style='font-size:12.0pt;color:blue'><o:p> </o:p></span></font></p>
<p class=MsoNormal><font size=3 color=blue face="Times New Roman"><span
style='font-size:12.0pt;color:blue'>Best personal regards<o:p></o:p></span></font></p>
<p class=MsoNormal><font size=3 color=blue face="Times New Roman"><span
style='font-size:12.0pt;color:blue'><o:p> </o:p></span></font></p>
<p class=MsoNormal><font size=3 color=blue face="Times New Roman"><span
style='font-size:12.0pt;color:blue'>Philippe<o:p></o:p></span></font></p>
<p class=MsoNormal><font size=3 color=blue face="Times New Roman"><span
style='font-size:12.0pt;color:blue'><o:p> </o:p></span></font></p>
<div>
<p class=MsoNormal><font size=2 color=blue face=Arial><span style='font-size:
10.0pt;font-family:Arial;color:blue'>Dr Philippe Desjeux</span></font><font
color=blue><span style='color:blue'><o:p></o:p></span></font></p>
<p class=MsoNormal><font size=2 color=blue face=Arial><span style='font-size:
10.0pt;font-family:Arial;color:blue'>Senior program Officer</span></font><font
color=blue><span style='color:blue'><o:p></o:p></span></font></p>
<p class=MsoNormal><font size=2 color=blue face=Arial><span style='font-size:
10.0pt;font-family:Arial;color:blue'>Institute for OneWorld Health</span></font><font
color=blue><span style='color:blue'><o:p></o:p></span></font></p>
<p class=MsoNormal><font size=2 color=blue face=Arial><span style='font-size:
10.0pt;font-family:Arial;color:blue'>899 rue Jean de Gingins</span></font><font
color=blue><span style='color:blue'><o:p></o:p></span></font></p>
<p class=MsoNormal><font size=2 color=blue face=Arial><span style='font-size:
10.0pt;font-family:Arial;color:blue'>01220 <st1:place w:st="on"><st1:City
w:st="on">Divonne</st1:City>, <st1:country-region w:st="on">France</st1:country-region></st1:place></span></font><font
color=blue><span style='color:blue'><o:p></o:p></span></font></p>
<p class=MsoNormal><font size=3 color=blue face="Times New Roman"><span
style='font-size:12.0pt;color:blue'> <o:p></o:p></span></font></p>
<p class=MsoNormal><font size=2 color=blue face=Arial><span style='font-size:
10.0pt;font-family:Arial;color:blue'>Tel: +</span></font><font size=2
color=blue face=Arial><span lang=IT style='font-size:10.0pt;font-family:Arial;
color:blue'>33 4 50 20 44 61</span></font><font color=blue><span lang=IT
style='color:blue'><o:p></o:p></span></font></p>
<p class=MsoNormal><font size=2 color=blue face=Arial><span lang=IT
style='font-size:10.0pt;font-family:Arial;color:blue'>Mobile: +33 6 73 52 99 44</span></font><font
color=blue><span lang=IT style='color:blue'><o:p></o:p></span></font></p>
<p class=MsoNormal><font size=3 color=blue face="Times New Roman"><span
lang=IT style='font-size:12.0pt;color:blue'> <o:p></o:p></span></font></p>
<p class=MsoNormal><font size=2 color=blue face=Arial><span style='font-size:
10.0pt;font-family:Arial;color:blue'><a
href="mailto:pdesjeux@oneworldhealth.org"><span lang=IT>pdesjeux@oneworldhealth.org</span></a></span></font><font
color=blue><span lang=IT style='color:blue'><o:p></o:p></span></font></p>
<p class=MsoNormal><font size=2 color=blue face=Arial><span style='font-size:
10.0pt;font-family:Arial;color:blue'><a href="http://www.oneworldhealth.org"><span
lang=IT>www.oneworldhealth.org</span></a></span></font><span lang=IT><o:p></o:p></span></p>
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<p class=MsoNormal><b><font size=2 face=Tahoma><span style='font-size:10.0pt;
font-family:Tahoma;font-weight:bold'>From:</span></font></b><font size=2
face=Tahoma><span style='font-size:10.0pt;font-family:Tahoma'>
leish-l-bounces@lineu.icb.usp.br [mailto:leish-l-bounces@lineu.icb.usp.br] <b><span
style='font-weight:bold'>On Behalf Of </span></b>Ricardo Molina<br>
<b><span style='font-weight:bold'>Sent:</span></b> Monday, April 02, 2012 4:05
AM<br>
<b><span style='font-weight:bold'>To:</span></b> leish-l@lineu.icb.usp.br<br>
<b><span style='font-weight:bold'>Subject:</span></b> [Leish-l] <st1:State
w:st="on"><st1:place w:st="on">Madrid</st1:place></st1:State> visceral
lerishmaniasis outbreak</span></font><o:p></o:p></p>
</div>
<p class=MsoNormal><font size=3 face="Times New Roman"><span style='font-size:
12.0pt'><o:p> </o:p></span></font></p>
<p class=MsoNormal><font size=2 color="#1f497d" face=Calibri><span
style='font-size:11.0pt;font-family:Calibri;color:#1F497D'>Dear All,<o:p></o:p></span></font></p>
<p class=MsoNormal><font size=2 color="#1f497d" face=Calibri><span
style='font-size:11.0pt;font-family:Calibri;color:#1F497D'><o:p> </o:p></span></font></p>
<p class=MsoNormal><font size=2 color="#1f497d" face=Calibri><span
style='font-size:11.0pt;font-family:Calibri;color:#1F497D'>We are very
surprised about the information circulating about <st1:State w:st="on"><st1:place
w:st="on">Madrid</st1:place></st1:State> visceral leishmaniasis outbreak that
contains many mistakes.<o:p></o:p></span></font></p>
<p class=MsoNormal><font size=2 color="#1f497d" face=Calibri><span
style='font-size:11.0pt;font-family:Calibri;color:#1F497D'><o:p> </o:p></span></font></p>
<p class=MsoNormal><font size=2 color="#1f497d" face=Calibri><span
style='font-size:11.0pt;font-family:Calibri;color:#1F497D'>Since 2010 a marked
increase of leishmaniasis cases in the southwestern <st1:State w:st="on"><st1:place
w:st="on">Madrid</st1:place></st1:State> region, mainly in Fuenlabrada, that
has been considered as an outbreak. Indeed the mean leishmaniasis incidence
rate in the Madrid Autonomous Community is 0.2-0.3/100.000 while in the first
39 weeks of 2011 it was 27.1/100.000 (111 cases in the <st1:place w:st="on"><st1:PlaceType
w:st="on">Hospital</st1:PlaceType> of <st1:PlaceName w:st="on">Fuenlabrada</st1:PlaceName></st1:place>).<o:p></o:p></span></font></p>
<p class=MsoNormal><font size=2 color="#1f497d" face=Calibri><span
style='font-size:11.0pt;font-family:Calibri;color:#1F497D'><o:p> </o:p></span></font></p>
<p class=MsoNormal><font size=2 color="#1f497d" face=Calibri><span
style='font-size:11.0pt;font-family:Calibri;color:#1F497D'>The studies carried
out at the present time in the focus show the following data:<o:p></o:p></span></font></p>
<p class=MsoNormal><font size=2 color="#1f497d" face=Calibri><span
style='font-size:11.0pt;font-family:Calibri;color:#1F497D'>Canine leishmaniasis
prevalence in Fuenlabrada (rK39): 3.6 %, lower than the mean prevalence in this
region (5-6%).<o:p></o:p></span></font></p>
<p class=MsoNormal><font size=2 color="#1f497d" face=Calibri><span
style='font-size:11.0pt;font-family:Calibri;color:#1F497D'>Prevalence in cats
(lnPCR): 7.3 %<o:p></o:p></span></font></p>
<p class=MsoNormal><font size=2 color="#1f497d" face=Calibri><span
style='font-size:11.0pt;font-family:Calibri;color:#1F497D'>Prevalence in rabbit
(lnPCR): 1.5%<o:p></o:p></span></font></p>
<p class=MsoNormal><font size=2 color="#1f497d" face=Calibri><span
style='font-size:11.0pt;font-family:Calibri;color:#1F497D'>Prevalence in hares
(Lepus granatensis) (skinlnPCR): 28.2%<o:p></o:p></span></font></p>
<p class=MsoNormal><font size=2 color="#1f497d" face=Calibri><span
style='font-size:11.0pt;font-family:Calibri;color:#1F497D'>Prevalence in hares
(rK39): 84%<o:p></o:p></span></font></p>
<p class=MsoNormal><font size=2 color="#1f497d" face=Calibri><span
style='font-size:11.0pt;font-family:Calibri;color:#1F497D'>Xenodiagnosis of
hares with <i><span style='font-style:italic'>P. perniciosus</span></i>: 57%.<o:p></o:p></span></font></p>
<p class=MsoNormal><font size=2 color="#1f497d" face=Calibri><span
style='font-size:11.0pt;font-family:Calibri;color:#1F497D'><o:p> </o:p></span></font></p>
<p class=MsoNormal><font size=2 color="#1f497d" face=Calibri><span
style='font-size:11.0pt;font-family:Calibri;color:#1F497D'>Regarding to the
data from xenodiagnosis in hares they were carried out by R. Molina and M.
Jiménez (ISCIII):<o:p></o:p></span></font></p>
<p class=MsoNormal><font size=2 color="#1f497d" face=Calibri><span
style='font-size:11.0pt;font-family:Calibri;color:#1F497D'>Seven apparently
healthy hares rK39 positive were selected. Xenodiagnosis studies were carried
out in two sessions (December 2011 and January 2012). Four out of seven rK39
positive hares (57,14%) were able to infect a mean 4,7 % <i><span
style='font-style:italic'>P. perniciosus</span></i> sand flies (0 to 10,6%).<o:p></o:p></span></font></p>
<p class=MsoNormal><font size=2 color="#1f497d" face=Calibri><span
style='font-size:11.0pt;font-family:Calibri;color:#1F497D'><o:p> </o:p></span></font></p>
<p class=MsoNormal><font size=2 color="#1f497d" face=Calibri><span
style='font-size:11.0pt;font-family:Calibri;color:#1F497D'>Xenodiagnosis of
leishmaniasis in hares (<i><span style='font-style:italic'>Lepus granatensis</span></i>)
proved that they are infective to <i><span style='font-style:italic'>Phlebotomus
perniciosus</span></i>. Molecular characterization (carried out by Israel Cruz)
demonstrates that hares were infected by <i><span style='font-style:italic'>Leishmania
infantum</span></i>. In conclusion, the data provide evidence on the
infectivity of apparently healthy <i><span style='font-style:italic'>L.
infantum </span></i>infected hares (<i><span style='font-style:italic'>Lepus
granatensis</span></i>) to phlebotomine sand flies (<i><span style='font-style:
italic'>P. perniciosus</span></i>). Moreover, they provide
significant information related to the role of potential sylvatic reservoirs in
spread of leishmaniasis that always have to be taken into account in
epidemiological studies.<o:p></o:p></span></font></p>
<p class=MsoNormal><font size=2 color="#1f497d" face=Calibri><span
style='font-size:11.0pt;font-family:Calibri;color:#1F497D'><o:p> </o:p></span></font></p>
<p class=MsoNormal><font size=2 color="#1f497d" face=Calibri><span
style='font-size:11.0pt;font-family:Calibri;color:#1F497D'>We hope that this
information should be clarified.<o:p></o:p></span></font></p>
<p class=MsoNormal><font size=2 color="#1f497d" face=Calibri><span
style='font-size:11.0pt;font-family:Calibri;color:#1F497D'><o:p> </o:p></span></font></p>
<p class=MsoNormal><font size=2 color="#1f497d" face=Calibri><span
style='font-size:11.0pt;font-family:Calibri;color:#1F497D'>Kind regards,<o:p></o:p></span></font></p>
<p class=MsoNormal><font size=2 color="#1f497d" face=Calibri><span lang=ES
style='font-size:11.0pt;font-family:Calibri;color:#1F497D'><o:p> </o:p></span></font></p>
<p class=MsoNormal><font size=2 color="#1f497d" face=Calibri><span lang=ES
style='font-size:11.0pt;font-family:Calibri;color:#1F497D'><o:p> </o:p></span></font></p>
<div>
<p class=MsoNormal><i><font size=1 color="#1f497d" face=Arial><span lang=ES
style='font-size:9.0pt;font-family:Arial;color:#1F497D;font-style:italic'>Dr.
Ricardo Molina <o:p></o:p></span></font></i></p>
<p class=MsoNormal><i><font size=1 color="#1f497d" face=Arial><span lang=ES
style='font-size:9.0pt;font-family:Arial;color:#1F497D;font-style:italic'>Unidad
de Entomología Médica <o:p></o:p></span></font></i></p>
<p class=MsoNormal><i><font size=1 color="#1f497d" face=Arial><span lang=ES
style='font-size:9.0pt;font-family:Arial;color:#1F497D;font-style:italic'>Servicio
de Parasitología <o:p></o:p></span></font></i></p>
<p class=MsoNormal><i><font size=1 color="#1f497d" face=Arial><span lang=ES
style='font-size:9.0pt;font-family:Arial;color:#1F497D;font-style:italic'>Centro
Nacional de Microbiología <o:p></o:p></span></font></i></p>
<p class=MsoNormal><i><font size=1 color="#1f497d" face=Arial><span lang=ES
style='font-size:9.0pt;font-family:Arial;color:#1F497D;font-style:italic'>Instituto
de Salud Carlos III <o:p></o:p></span></font></i></p>
<p class=MsoNormal><i><font size=1 color="#1f497d" face=Arial><span lang=ES
style='font-size:9.0pt;font-family:Arial;color:#1F497D;font-style:italic'>Ctra.
Majadahonda-Pozuelo, km 2,3 <o:p></o:p></span></font></i></p>
<p class=MsoNormal><i><font size=1 color="#1f497d" face=Arial><span lang=ES
style='font-size:9.0pt;font-family:Arial;color:#1F497D;font-style:italic'>28220
MAJADAHONDA, MADRID (SPAIN) <o:p></o:p></span></font></i></p>
<p class=MsoNormal><i><font size=1 color="#1f497d" face=Arial><span lang=ES
style='font-size:9.0pt;font-family:Arial;color:#1F497D;font-style:italic'>Tel.
+34 918223674 <o:p></o:p></span></font></i></p>
<p class=MsoNormal><i><font size=1 color="#1f497d" face=Arial><span lang=ES
style='font-size:9.0pt;font-family:Arial;color:#1F497D;font-style:italic'>Fax.
+34 915097034 <o:p></o:p></span></font></i></p>
<p class=MsoNormal><i><font size=1 color="#1f497d" face=Arial><span lang=ES
style='font-size:9.0pt;font-family:Arial;color:#1F497D;font-style:italic'>e-mail:
rmolina@isciii.es <o:p></o:p></span></font></i></p>
<p class=MsoNormal><i><font size=1 color="#1f497d" face=Arial><span lang=ES
style='font-size:9.0pt;font-family:Arial;color:#1F497D;font-style:italic'>URL:
http://www.isciii.es<o:p></o:p></span></font></i></p>
</div>
<p class=MsoNormal><font size=2 color="#1f497d" face=Calibri><span lang=ES
style='font-size:11.0pt;font-family:Calibri;color:#1F497D'><o:p> </o:p></span></font></p>
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<table><tr><td bgcolor=#ffffff><font color=#000000><pre>************************* AVISO LEGAL *************************
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