RESUMO
An outbreak of cutaneous leishmaniasis occurred in a unit of 608 Puerto Rican national guardsmen conducting jungle warfare training in the Panama Canal Area in July 1984. An epidemiologic investigation of reported nonhealing, ulcerating skin lesions was conducted among 540 (89%) unit members in November and December 1984. Fifteen (88%) of 17 individuals with chronic, ulcerating skin lesions were confirmed as cases of cutaneous leishmaniasis by culture or histopathology. Twelve cases yielded positive Leishmania cultures, identified as L. braziliensis panamensis by cellulose acetate electrophoresis. Evaluation of different diagnostic techniques revealed that direct examination of tissues by Giemsa-stained histological examination was the most sensitive test (87% sensitivity), with an indirect immunofluorescent antibody test being rather insensitive (67%). All but one of the confirmed cases operated in small units that trained and slept overnight at a mortar firing site for a period of three days, yielding a site-specific attack rate of 22% (14 of 64). This contrasted with a much lower attack rate of 0.2% (1 of 476), experienced by unit members who trained at other locations during the same time frame (P less than 0.001). The median incubation period calculated from day of arrival at the mortar firing site was 17 days (range 2-78) for the 15 confirmed cases. Available personal protection methods, such as the use of insect repellents, were not appropriately implemented by unit personnel and thus, were not found to effectively protect against Leishmania infection. This is the largest reported outbreak of cutaneous leishmaniasis in military personnel associated with a single geographic focus of infection and contrasts with the usual sporadic disease experience in Panama.
Assuntos
Surtos de Doenças , Leishmaniose Cutânea/epidemiologia , Militares , Adulto , Fatores Etários , Animais , Anticorpos Antiprotozoários/sangue , Eletroforese em Acetato de Celulose , Imunofluorescência , Humanos , Repelentes de Insetos/administração & dosagem , Leishmania braziliensis/imunologia , Leishmania braziliensis/isolamento & purificação , Leishmaniose Cutânea/diagnóstico , Leishmaniose Cutânea/prevenção & controle , Masculino , Zona do Canal do Panamá/epidemiologia , Porto Rico/etnologia , Sensibilidade e Especificidade , Inquéritos e Questionários , Viagem , Estados UnidosRESUMO
Young adult (60-70-g) male golden hamsters (Mesocricetus auratus) each were injected intradermally at the dorsal base of the tail with 15 x 10(6) promastigotes of Leishmania (Viannia) panamensis (MHOM/PA/83/WR539), and progression and regression of subsequent lesions were evaluated for up to 17 wk postinfection (PI) as to area, weight, and number of amastigotes within lesions in untreated hamsters and in hamsters treated with meglumine antimoniate (Glucantime). In untreated hamsters total area of lesion, weight, and numbers of amastigotes generally increased rapidly and concomitantly up to 3-4 wk PI. Amastigote numbers tended to decrease from 4 to 11 wk PI and subsequently the numbers of amastigotes within the lesions decreased rapidly, whereas relatively little change occurred in the area and weight of the lesions. Meglumine antimoniate treatment of cutaneous hamster lesions resulted in marked concomitant decrease in size of the lesions and numbers of amastigotes within the lesions examined 1 wk after treatment. Measurement of the area of cutaneous leishmanial lesions thus would appear to be a valid method of evaluating the efficacy of promising compounds against L. panamensis in hamsters when measurements are taken 3-5 wk after experimental infection and reflects the number of amastigotes present in the lesion.
Assuntos
Antimônio/uso terapêutico , Antiprotozoários/uso terapêutico , Leishmania braziliensis/fisiologia , Leishmaniose Mucocutânea/parasitologia , Meglumina/uso terapêutico , Compostos Organometálicos/uso terapêutico , Animais , Antimônio/farmacologia , Antiprotozoários/farmacologia , Cricetinae , Leishmaniose Mucocutânea/tratamento farmacológico , Leishmaniose Mucocutânea/patologia , Masculino , Meglumina/farmacologia , Antimoniato de Meglumina , Mesocricetus , Compostos Organometálicos/farmacologia , Pele/parasitologia , Pele/patologiaRESUMO
Results of a serologic survey for Toxoplasma gondii among 408 Ticuna Indians from five villages in western Brazil are presented and compared with the results of 61 non-Indian inhabitants of the town of Codajas, Amazonas. Indirect hemagglutination antibody titers greater than or equal to 64 were found in 39% of the Ticuna population as compared to 77% of the Codajas population. Prevalence rates of titers greater than or equal to 256 were 20.3% for Ticunas and 39.3% for Codajas. Prevalence rates of titers greater than or equal to 256 in Ticuna villages where dietary habits were most variable were higher and more similar to those of non-Indian populations than were the prevalence rates of this titer range in villages where the animal food source was predominantly fish.