bluuebunny/crossref_metadata_2025 huggingface dataset:
HANTAVIRUS PULMONARY SYNDROME IN NORTHWESTERN ARGENTINA: CIRCULATION OF LAGUNA NEGRA VIRUS ASSOCIATED WITH CALOMYS CALLOSUS
Authors: LEVIS SILVANA , GARCIA JORGE , PINI NOEMÍ , CALDERÓN GLADYS , RAMÍREZ JOSEFINA , BRAVO DANIEL , JEOR STEPHEN ST. , RIPOLL CARLOS , BEGO MARIANA , LOZANO ELENA , BARQUEZ RUBÉN , KSIAZEK THOMAS G. , ENRIA DELIA
Published: September 2018

The purpose of this study was to characterize the hantaviruses circulating in northwestern Argentina. Human and rodent studies were conducted in Yuto, where most cases of hantavirus pulmonary syndrome (HPS) occur. Partial virus genome sequences were obtained from the blood of 12 cases of HPS, and from the lungs of 4 Calomys callosus and 1 Akodon simulator. Phylogenetic analysis showed that three genotypes associated with HPS circulate in Yuto. Laguna Negra (LN) virus, associated with C. laucha in Paraguay, was identified for the first time in Argentina; it was recovered from human cases and from C. callosus samples. The high sequence identity between human and rodent samples implicated C. callosus as the primary rodent reservoir for LN virus in Yuto. The genetic analysis showed that the Argentinian LN virus variant differed 16.8% at the nucleotide level and 2.9% at the protein level relative to the Paraguayan LN virus. The other two hantavirus lineages identified were the previously known Bermejo and Orán viruses.
HUMAN IMMUNODEFICIENCY VIRUS TYPE 1 (HIV-1) AND MYCOBACTERIUM LEPRAE CO-INFECTION: HIV-1 SUBTYPES AND CLINICAL, IMMUNOLOGIC, AND HISTOPATHOLOGIC PROFILES IN A BRAZILIAN COHORT
Authors: PEREIRA GISNER A. S. , STEFANI MARIANE M. A. , ARAÚJO FILHO JOÃO A. , SOUZA LUÍS CARLOS S. , STEFANI GERMANA P. , MARTELLI CELINA M. T.
Published: September 2018

Co-infections with human immunodeficiency virus (HIV) and Mycobacterium leprae represent unique opportunities to investigate the interaction of both pathogens. We determined the immunologic, virologic, and histopathologic characteristics of 22 co-infected Brazilian patients (median age = 38 years, 81.8% males, 72.2% with paucibacillary leprosy, and 95.4% with acquired immunodeficiency syndrome). The HIV-1 subtypes B and BF predominated in envelope and gag heteroduplex mobility analysis. Borderline tuberculoid (BT), tuberculoid, lepromatous, and indeterminate morphology with CD3+, CD8+, and CD68+ cell distributions compatible with leprosy patients not infected with HIV were observed. Histologic evidence of nerve damage was observed in BT lesions. IgM antibody to M. leprae-specific phenolic glycolipid I was not detected. Two of six co-infected patients monitored during highly active antiretroviral therapy (HAART) developed a leprosy type 1 reaction after an increase in CD4+ cells, suggesting an immune restoration phenomenon. Clinical, immunologic, histopathologic, and virologic features among these HIV-leprosy co-infected patients indicate that each disease progressed as in single infection. However, HAART immune reconstitution may trigger potential adverse effects, such as leprosy acute inflammatory episodes.
SUSCEPTIBILITY OF LEPTOSPIRA SEROVARS TO ANTIMALARIAL AGENTS
Authors: MURRAY CLINTON K. , ELLIS MICHAEL W. , HOSPENTHAL DUANE R.
Published: September 2018

Leptospirosis has recently been described to cause concomitant infection with malaria. Only doxycycline has proven to have chemoprophylactic and therapeutic efficacy for both malaria and leptospirosis. To assess whether other traditional antimalarial agents have antileptospiral activity, we performed broth microdilution susceptibility testing of 16 Leptospira serovars (6 species/14 serogroups) to various agents. Artemisinin, atovaquone, chloroquine, mefloquine, primaquine, proguanil, pyrimethamine, sulfadoxine, quinine, quinidine, and combinations of atovaquone/proguanil and pyrimethamine/sulfadoxine all had a 90% minimum inhibitory concentration (MIC90) > 25 μg/mL (the upper limit of testing). The only agents identified with the potential to treat both infections other than doxycycline (MIC90 = 1.56 μg/mL) were azithromycin (MIC90 = 0.002 μg/mL) and clindamycin (MIC90 = 0.2 μg/mL).
PREVALENCE OF ANTIBODIES TO SPOTTED FEVER GROUP RICKETTSIAE IN HUMANS AND DOMESTIC ANIMALS IN A BRAZILIAN SPOTTED FEVER-ENDEMIC AREA IN THE STATE OF SÃO PAULO, BRAZIL: SEROLOGIC EVIDENCE FOR INFECTION BY RICKETTSIA RICKETTSII AND ANOTHER SPOTTED FEVER GROUP RICKETTSIA
Authors: HORTA MAURÍCIO C. , LABRUNA MARCELO B. , SANGIONI LUIS A. , VIANNA MANOELLA C. B. , GENNARI SOLANGE M. , GALVÃO MÁRCIO A. M. , MAFRA CLAUDIO L. , VIDOTTO ODILON , SCHUMAKER TERESINHA T. S. , WALKER DAVID H.
Published: September 2018

In serum samples obtained from all the healthy humans, horses, dogs, and donkeys present on three farms in the Pedreira Municipality, an endemic area for Brazilian spotted fever, an indirect immunofluorescence assay (IFA) detected antibodies against Rickettsia rickettsii in 17 (77.3%) horses, 5 (31.3%) dogs (titers ranging from 64 to 4,048), and none of 4 donkeys or 50 humans. Five canine and eight equine sera with high antibody titers to R. rickettsii were also tested by IFA against R. bellii, R. akari, and R. africae antigens. Sera from two horses and two dogs that showed similar high antibody titers against two rickettsial antigens were evaluated after cross-absorption. Sera from seven horses and two dogs contained antibodies specific for R. rickettsii, and one dog serum had antibodies against a Rickettsia species very closely related to R. africae. The latter may have been caused by infection with the recently identified COOPERI strain.
ATYPICAL CLINICAL PRESENTATION OF STRONGYLOIDIASIS IN A PATIENT CO-INFECTED WITH HUMAN T CELL LYMPHOTROPHIC VIRUS TYPE I
Authors: PORTO MARIA AURÉLIA F. , ALCÂNTARA LÊDA M. , LEAL MARCELO , CASTRO NÉVITON , CARVALHO EDGAR M.
Published: September 2018

Alterations in the immunologic response induced by human T cell lymphotrophic virus type I (HTLV-I) predispose the development of disseminated strongyloidiasis. We report a case of an atypical clinical presentation of strongyloidiasis in a patient co-infected with HTLV-I causing scrotal and perineal pain and infertility. Strongyloides stercoralis was found in the analysis of the sperm and specific therapy for strongyloidiasis was associated with disappearance of the symptoms.
EXPERIMENTAL LEPTOSPIROSIS IN MARMOSET MONKEYS (CALLITHRIX JACCHUS): A NEW MODEL FOR STUDIES OF SEVERE PULMONARY LEPTOSPIROSIS
Authors: PEREIRA MARTHA MARIA , DA SILVA JOÃO JOSÉ PEREIRA , PINTO MARCELO ALVES , DA SILVA MAURO FRANÇA , MACHADO MARCELO PELAJO , LENZI HENRIQUE LEONEL , MARCHEVSKY RENATO SERGIO
Published: September 2018

Experimental infection of marmoset monkeys (Callithrix jacchus) with Leptospira interrogans serovar Copenhageni showed microscopic patterns of tissue reactions comparable to those seen in the severe forms of human leptospirosis, including intra-alveolar hemorrhage. The most impressive microscopic changes were seen in the lung and kidney of animals killed at days 6 and 12 after inoculation. There were extensive and irregular areas of hemorrhage predominating around main bronchial branches or diffusely spread to the pulmonary parenchyma, as well as severe tubulointerstitial nephritis. Antibody response detected by the microscopic agglutination test was quantitatively similar to those seen in humans and paralleled severity of tissue lesions. The distribution of leptospires or antigenic debris in infected tissues was observed by immunofluorescence and confocal laser scanning microscopy. Large numbers of typical leptospires were seen in the lumen of proximal renal tubules. Positive reactions showing antigenic debris were closely associated with sites of tissue damage.
CLINICAL CHARACTERISTICS AND RISK FACTORS FOR CONCURRENT BACTEREMIA IN ADULTS WITH DENGUE HEMORRHAGIC FEVER
Authors: LEE ING-KIT , LIU JIEN-WEI , YANG KUENDER D.
Published: September 2018

To better understand the clinical characteristics of concurrent bacteremia (dual infection) in patients with dengue hemorrhagic fever/dengue shock syndrome (DHF/DSS) and identify predictive risk factors for dual infection, 100 patients with DHF/DSS (7 with a dual infection and 93 with DHF/DSS alone [controls]) were enrolled in this study. A patient with DHF/DSS who lacked three or more of the five most frequently observed manifestations other than fever in controls or showed disturbed consciousness was defined as one with unusual dengue manifestations. Patients with a dual infection were older, and tended to have prolonged fever, higher frequencies of acute renal failure, gastrointestinal bleeding, altered consciousness, unusual dengue manifestations, and DSS. Acute renal failure (odds ratio [OR] = 51.45, P = 0.002), and prolonged fever (> 5 days) (OR = 26.07, P = 0.017) were independent risk factors for dual infection. Clinicians should be alert to the potential for concurrent bacteremia when treating patients with DHF/DSS who are at risk for dual infection and manage them accordingly.
SPATIO-TEMPORAL DISTRIBUTION OF PLASMODIUM FALCIPARUM AND P. VIVAX MALARIA IN THAILAND
Authors: ZHOU GUOFA , SIRICHAISINTHOP JEERAPHAT , SATTABONGKOT JETSUMON , JONES JAMES , BJØRNSTAD OTTAR N. , YAN GUIYUN , CUI LIWANG
Published: September 2018

Malaria incidence data at the district level from 1997 to 2002 and total malaria case data from 1965 to 2002 in Thailand were analyzed to determine the spatial and temporal dynamics of Plasmodium falciparum and P. vivax malaria incidence. Over the 37-year period, there was a 35-fold reduction in the incidence rates of P. falciparum malaria (11.86% in 1965 versus 0.34% in 2002) and a 7-fold reduction in P. vivax malaria (2.89% in 1965 versus 0.40% in 2002). The incidence ratio of P. falciparum to P. vivax malaria was reduced from 4.1 to 0.8 during this period. Malaria incidence rate exhibited the most rapid reduction between 1975 and 1985, coinciding with the introduction of a combination of antifolate drugs (sulfadoxine-pyrimethamine). The distribution maps of P. falciparum and P. vivax malaria incidence rates indicated a high spatial heterogeneity. The Thailand-Myanmar and Thailand-Cambodia border areas, where migration of foreign workers was pronounced, had the highest incidence rates for P. falciparum, P. vivax, and mixed-species infections. Transition probability analysis based on the malaria incidence rate among Thai residents indicated that there was an overall trend of decrease in the number of malaria cases and the number of high incidence districts between 1997 and 2002. High spatial variation in malaria incidence and local human migration patterns suggest that malaria control measures need to be adjusted according to local environmental and demographic settings.
SHORT REPORT: INADEQUACY OF YAKS AS HOSTS FOR THE SHEEP DOG STRAIN OF ECHINOCOCCUS GRANULOSUS OR FOR E. MULTILOCULARIS
Authors: HEATH DAVID D. , ZHANG LI HUA , MCMANUS DONALD P.
Published: September 2018

Hydatid disease (echinococcosis) has a two-host cycle involving the domestic dog and grazing animals. Humans are also infected by the dog. Both unilocular (Echinococcus granulosus in yaks, sheep, and goats) and multilocular (alveolar) (E. multilocularis in hares and rodents) hydatids are common in western Sichuan in the People’s Republic of China. Humans and dogs are equally infected with both species. Many yaks (Bos grunniens) were found with multilocular cysts that visually were deemed to be E. multilocularis. However, a histologic and molecular study showed that they were actually E. granulosus. No infective cysts were found in 125 necropsied yaks. We conclude that the yak is an inadequate and dead-end host for the sheep dog (G1) strain of Echinococcus granulosus and also for E. multilocularis.
SIMPLE CLINICAL MANIFESTATIONS OF GENITAL SCHISTOSOMA HAEMATOBIUM INFECTION IN RURAL ZIMBABWEAN WOMEN
Authors: KJETLAND EYRUN FLOERECKE , NDHLOVU PATRICIA D. , MDULUZA TAKAFIRA , GOMO EXENEVIA , GWANZURA LOVEMORE , MASON PETER R. , KUREWA EDITH NYARADZAI , MIDZI NICHOLAS , FRIIS HENRIK , GUNDERSEN SVEIN GUNNAR
Published: September 2018

Up to 75% of women with urinary schistosomiasis have Schistosoma haematobium ova in the genitals. This study aimed to describe the prevalence of gynecologic S. haematobium infection and to differentiate the disease from sexually transmitted infections (STIs). Gynecologic and laboratory investigations for S. haematobium and STIs were performed in 527 women between the ages of 20 and 49 in rural Zimbabwe. Genital homogenous yellow and/or grainy sandy patches, the commonest type of genital pathology, were identified in 243 (46%) women. Grainy sandy patches were significantly associated with S. haematobium ova only. Genital S. haematobium ova was also significantly associated with homogenous yellow sandy patches, mucosal bleeding, and abnormal blood vessels. The presence of ova was not a predictor for ulcers, papillomata, leukoplakia, polyps, or cell atypia. Mucosal sandy patches seem to be pathognomonic for S. haematobium infection in the female genitals. Coexistence of ova and other lesions may not be causal.
EMERGENCE OF ATOVAQUONE-PROGUANIL RESISTANCE DURING TREATMENT OF PLASMODIUM FALCIPARUM MALARIA ACQUIRED BY A NON-IMMUNE NORTH AMERICAN TRAVELLER TO WEST AFRICA
Authors: KUHN SUSAN , GILL M. JOHN , KAIN KEVIN C.
Published: September 2018

The importation of drug-resistant malaria is a growing public health problem in non-endemic countries. The combination of atovaquone and proguanil (Malarone™) has become established as an agent of choice to prevent and treat chloroquine-resistant Plasmodium falciparum malaria in travelers. We describe the first reported case in North America of genetically confirmed atovaquone/proguanil-resistant P. falciparum malaria. Polymerase chain reaction and sequence analysis of the primary and recrudescent isolates confirmed the acquisition of a point mutation (Tyr268Ser) in the cytochrome b gene of the recrudescent isolate known to confer high-level resistance to atovaquone. Suboptimal therapy may have played a contributory role in the emergence of resistance.
EVALUATION OF 7SL RNA GENE SEQUENCES FOR THE IDENTIFICATION OF LEISHMANIA SPP.
Authors: ZELAZNY ADRIAN M. , FEDORKO DANIEL P. , LI LI , NEVA FRANKLIN A. , FISCHER STEVEN H.
Published: September 2018

We evaluated the use of 7SL RNA gene sequences for the identification of Leishmania spp. A fragment (~137 basepairs) of the 7SL RNA gene from 13 reference strains and 18 clinical isolates of 11 different Leishmania species was amplified and sequenced using conserved primers. Reference strains from each Leishmania spp. complex showed unique sequences. The nucleotide sequences were compared pairwise and a range of 81.0–99.3% intercomplex similarity was observed. Clinical isolates of the same species had sequences identical to the corresponding reference strains; thus, the intraspecies similarity was 100%. A phylogenetic tree derived from the 7SL RNA gene partial sequences was constructed and is in agreement with accepted phylogenetic schemes.
INDUCTION OF PROTECTIVE IMMUNITY AGAINST SCRUB TYPHUS WITH A 56-KILODALTON RECOMBINANT ANTIGEN FUSED WITH A 47-KILODALTON ANTIGEN OF ORIENTIA TSUTSUGAMUSHI KARP
Authors: YU YUEFEI , WEN BOHAI , WEN BOGUI , NIU DONGSHENG , CHEN MEILING , QIU LING
Published: September 2018

A partial gene sequence encoding the 56-kD scrub typhus antigen (Sta56) was amplified from genomic DNA of the Orientia tsutsugamushi Karp strain by a polymerase chain reaction (PCR). The PCR product was ligated with the 47-kD scrub typhus antigen (Sta47) gene in the pQE30/47 expression vector, and the resulting recombinant expression vector was designated pQE30/56-47. A fusion antigen (Sta56-47) was expressed in Escherichia coli cells transformed with pQE30/56-47 after induction with isopropyl-β-d-thiogalactopyranoside. The Sta56-47 antigen was recognized by both Sta47 and Sta56 immune sera and by immune serum to Sta56-47 in an immunoblot assay. This antigen was purified and used to immunize BALB/c mice. The animals immunized with Sta56-47 exhibited profound humoral and cellular immune responses, as well as increased resistance to O. tsutsugamushi Karp compared with mice immunized with Sta56 or Sta47. These results strongly suggest that Sta56-47 contains antigenic epitopes of the Sta56 and Sta47 antigens of O. tsutsugamushi Karp, and is a more suitable candidate for replacing whole-cell antigen of O. tsutsugamushi Karp to induce protective immunity against scrub typhus.
DURATION OF INFECTIVITY AND RNA OF VENEZUELAN EQUINE ENCEPHALITIS, WEST NILE, AND YELLOW FEVER VIRUSES DRIED ON FILTER PAPER AND MAINTAINED AT ROOM TEMPERATURE
Authors: GUZMAN HILDA , DING XIAOHUA , XIAO SHU-YUAN , TESH ROBERT B.
Published: September 2018

Samples of laboratory propagated Venezuelan equine encephalitis (VEE), West Nile (WN), and yellow fever (YF) viruses were blotted onto filter paper discs, air-dried, and stored at room temperature. At regular intervals over a 90-day period, the dried virus samples were eluted, tested for infectivity by culture and titration in Vero cells, and examined for viral RNA by a reverse transcriptase–polymerase chain reaction. The VEE, WN, and YF viral RNA was detected throughout the 90-day period in all samples examined. Infectious VEE virus could be recovered for up to 40 days; WN and YF viruses were cultured in Vero cells for up to 60 and 90 days, respectively. The results of this study demonstrate that viral nucleic acids and infectious virus can be recovered from arbovirus samples air-dried on filter paper and stored at room temperature for a month or more after collection. This procedure offers a simple and inexpensive method for collecting arbovirus field specimens and transporting them to diagnostic laboratories.
RELATIONSHIP BETWEEN SCHISTOSOMA JAPONICUM AND NUTRITIONAL STATUS AMONG CHILDREN AND YOUNG ADULTS IN LEYTE, THE PHILIPPINES
Authors: FRIEDMAN JENNIFER F. , KANZARIA HEMAL K. , ACOSTA LUZ P. , LANGDON GRETCHEN C. , MANALO DARIA L. , WU HAIWEI , OLVEDA REMIGIO M. , MCGARVEY STEPHEN T. , KURTIS JONATHAN D.
Published: September 2018

The objectives of this study were 1) to provide more accurate estimates of the relationship between Schistosoma japonicum infection and both protein energy malnutrition (PEM) and anemia through better adjustment for potential confounders such as socioeconomic status (SES) and geo-helminth infections and 2) to assess the role of occult blood loss in mediating S. japonicum–associated anemia. We examined cross-sectionally 729 individuals (86.7% S. japonicum–infected and 13.3% S. japonicum–uninfected) aged 7–30 years in Leyte, The Philippines. The main outcome measures were height-for-age Z-score (HAZ), body-mass-index Z-score (BMIZ), triceps skinfold Z-score, hemoglobin, and fecal occult blood loss. Multivariate models were created to assess the relationship between S. japonicum infection and nutritional status after adjusting for age, gender, other helminths, and SES. After controlling for confounders, intensity of S. japonicum infection was inversely related to hemoglobin in all age groups (P < 0.0001) and HAZ among children ≤ 12 years (P = 0.03), but not to BMIZ (P = 0.52) or triceps skinfold Z-score (P = 0.11). Individuals with high-intensity S. japonicum infection were 3.5 times more likely to have occult blood in the stool. Adjustment for occult blood did not attenuate the relationship between S. japonicum and hemoglobin, suggesting other mechanisms are involved. Adjustment for SES allows more accurate assessment of the relationship between S. japonicum and both PEM and anemia. Exploration of the mechanisms of S. japonicum–associated anemia suggests that processes other than extracorporeal blood loss, such as anemia or inflammation, may be involved.
DETECTION OF ORIENTIA TSUTSUGAMUSHI IN CLINICAL SAMPLES BY QUANTITATIVE REAL-TIME POLYMERASE CHAIN REACTION
Authors: SINGHSILARAK TASAWAN , LEOWATTANA WATTANA , LOOAREESUWAN SORNCHAI , WONGCHOTIGUL VAREE , JIANG JU , RICHARDS ALLEN L. , WATT GEORGE
Published: September 2018

Orientia tsutsugamushi infection causes scrub typhus, a common zoonosis of rural Asia. Orientia tsutsugamushi was recently detected by a real-time quantitative polymerase chain reaction (qPCR) assay in animal specimens. We evaluated the same qPCR assay in specimens obtained from patients with serologically proven scrub typhus infections. The 47-kDa qPCR assay was more sensitive than was mouse inoculation; it was reactive in whole blood specimens from all 10 isolate-positive patients and in 7 of 17 isolate-negative individuals (P = 0.003, Fisher’s two-tailed exact test). As few as 1,076 O. tsutsugamushi copies/μL were detected in whole blood. Four of 7 sera from isolate-proven scrub typhus infections were also reactive by qPCR. The assay was unreactive in all 12 individuals without scrub typhus infection. This is the first demonstration of a sensitive and specific real-time qPCR assay for human scrub typhus infection.
ANTI–PLASMODIUM VIVAX DUFFY BINDING PROTEIN ANTIBODIES MEASURE EXPOSURE TO MALARIA IN THE BRAZILIAN AMAZON
Authors: CERÁVOLO ISABELA P. , BRUÑA-ROMERO OSCAR , BRAGA ÉRIKA M. , FONTES COR J. F. , BRITO CRISTIANA F. A. , SOUZA JOSÉ M. , KRETTLI ANTONIANA U. , ADAMS JOHN H. , CARVALHO LUZIA H.
Published: September 2018

Plasmodium vivax Duffy binding protein (DBP) is functionally important in the erythrocyte invasion process and provides a logical target for vaccine-mediated immunity. In the current study, we demonstrated that DBP is naturally immunogenic in different populations of the Brazilian Amazon, and the proportions of DBP IgG positive subjects increased with exposure to malaria, reaching a peak in those subjects with long-term exposure (> 15 years) in the Amazon area. This profile of antibody response was significantly different from the one observed for the P. vivax merozoite surface protein 1 (MSP119), which was relatively uniform in areas with markedly different levels of malaria transmission. In a small sample of adults with symptomless P. vivax infection, we could not detect any significant correlation between antibodies against these P. vivax proteins and asymptomatic infection. Our study provided an additional insight by demonstrating cumulative exposure as a determinant that acts independently of host age in generation of anti-DBP IgG response.
RECOMBINANT LARVICIDAL BACTERIA WITH MARKEDLY IMPROVED EFFICACY AGAINST CULEX VECTORS OF WEST NILE VIRUS
Authors: PARK HYUN-WOO , BIDESHI DENNIS K. , WIRTH MARGARET C. , JOHNSON JEFFREY J. , WALTON WILLIAM E. , FEDERICI BRIAN A.
Published: September 2018

An urgent need exists for new agents to control mosquito vectors of disease. Mosquito larvicides based on the bacteria Bacillus thuringiensis subsp. israelensis (Bti) or B. sphaericus (Bs) are effective in many habitats, but use is limited by their high cost. Moreover, mosquito resistance evolves rapidly to Bs where it is used intensively. The efficacy of these bacteria is due to a binary protein (BsB) in Bs and four proteins (Cry4A, Cry4B, Cry11A, and Cyt1A) in Bti. Here we report the use of cyt1A promoters and a 5′ mRNA stabilizing sequence to synthesize high levels of Bs2362 binary toxin in Bti strains. The recombinant BtiIPS-82/BsB showed high potency against fourth instars of Culex quinquefasciatus, a vector of West Nile virus, being 21-fold as potent as BtiIPS-82, and 32-fold as potent as Bs2362. Similar improved efficacy was obtained against larvae of Cx. tarsalis. Moreover, BtiIPS-82/BsB suppressed resistance to Bs2362 in Cx. quinquefasciatus.
LONGITUDINAL STUDY OF DOGS LIVING IN AN AREA OF SPAIN HIGHLY ENDEMIC FOR LEISHMANIASIS BY SEROLOGIC ANALYSIS AND THE LEISHMANIN SKIN TEST
Authors: SOLANO-GALLEGO LAIA , LLULL JOAN , RAMIS ANTONIO , FERNÁNDEZ-BELLON HUGO , RODRÍGUEZ ALHELÍ , FERRER LLUÍS , ALBEROLA JORDI
Published: September 2018

The literature contains few longitudinal studies that have assessed areas endemic for canine leishmaniasis and over the same time interval Leishmania-specific cellular and humoral immunity in healthy dogs. Fourteen dogs, three mixed breed and 11 Ibizian hounds, living in an area of Spain that was highly endemic for leishmaniasis were followed-up over a three-year period by serologic analysis and the leishmanin skin test (LST). All but one of these dogs remained clinically healthy during the study period. Seroconversion was observed in four dogs. The three mixed breed dogs had a negative reaction in the LST in the first and third years. The general trend in the Ibizian hounds was an increase in the diameter of the LST reaction at both the 48- and 72-hour readings in the third year. This study demonstrates that in addition to an increase in Leishmania-specific humoral immune response in Ibizian hounds, a parallel increase in cellular immune response was observed.
DETECTION AND IDENTIFICATION OF LEISHMANIA SPECIES WITHIN NATURALLY INFECTED SAND FLIES IN THE ANDEAN AREAS OF ECUADOR BY A POLYMERASE CHAIN REACTION
Authors: KATO HIROTOMO , UEZATO HIROSHI , KATAKURA KEN , CALVOPIÑA MANUEL , MARCO JORGE D. , BARROSO PAOLA A. , GOMEZ EDUARDO A. , MIMORI TATSUYUKI , KORENAGA MASATAKA , IWATA HIROYUKI , NONAKA SHIGEO , HASHIGUCHI YOSHIHISA
Published: September 2018

The surveillance of prevalent Leishmania and sand fly species in endemic areas is important for prediction of the risk and expansion of leishmaniasis. In this study, we developed a polymerase chain reaction (PCR)-based method for detection of Leishmania minicircle DNA within individual sand flies. Using this method, we detected minicircle DNA in 6 (3.3%) of 183 sand flies, while 5 (3.5%) of 143 were positive for Leishmania promastigotes in the same areas by microscopic examination. The species were identified as Leishmania (Leishmania) mexicana by nucleotide sequencing of the cytochrome b gene. Additionally, all the Leishmania-positive sand flies were identified as Lutzomyia ayacuchensis by the restriction enzyme digestion of the PCR-amplified 18S ribosomal RNA gene fragments. Since this combined method is relatively easy and can process a large number of samples, it will be a powerful tool for the rapid identification of prevalent sand fly and Leishmania species as well as monitoring the infection rate in sand fly populations in endemic areas.
A PHASE II DOSE-RANGING STUDY OF SITAMAQUINE FOR THE TREATMENT OF VISCERAL LEISHMANIASIS IN INDIA
Authors: JHA TARA K. , SUNDAR SHYAM , THAKUR CHANDRESHWAR P. , FELTON J. MARK , SABIN ANTONY J. , HORTON JOHN
Published: September 2018

This randomized, open label, multicenter study assessed the dose-response and safety profile for oral sitamaquine in 120 Indian subjects with visceral leishmaniasis (VL). Patients aged 5–64 years (mean age 21.2 years) received one of four sitamaquine doses (1.5, 1.75, 2.0, or 2.5 mg kg−1 day−1) daily for 28 days. At Day 180 in the intent-to-treat population, final cure (primary efficacy outcome) was achieved in 92 of 106 (87%) patients overall and 25 of 31 (81%), 24 of 27 (89%), 23 of 23 (100%), and 20 of 25 (80%) patients at doses of 1.5, 1.75, 2.0, or 2.5 mg kg−1 day−1 sitamaquine, respectively. Sitamaquine was generally well tolerated. The most common adverse events during the active treatment phase were vomiting (8% [10 of 120]), dyspepsia (8% [9 of 120]) and cyanosis (3% [4 of 120]). Nephrotic syndrome (3% [3 of 120]) and glomerulonephritis (2% [2 of 120]) were also reported and require further investigation. Oral sitamaquine demonstrated efficacy in Indian VL and was well tolerated.
EFFECT OF HURRICANE ISIDORE ON TRIATOMA DIMIDIATA DISTRIBUTION AND CHAGAS DISEASE TRANSMISSION RISK IN THE YUCATÁN PENINSULA OF MEXICO
Authors: GUZMAN-TAPIA YADIRA , RAMIREZ-SIERRA MARIA JESUS , ESCOBEDO-ORTEGON JAVIER , DUMONTEIL ERIC
Published: September 2018

Hurricanes can have devastating effects on health and may directly modulate vector-borne diseases. Chagas disease is a zoonosis caused by the protozoan parasite Trypanosoma cruzi and transmitted by triatomine bugs, and the effect of hurricanes on these bugs is largely unknown. We thus performed a detailed study of the changes in Triatoma dimidiata geographic distribution and infection rates after Hurricane Isidore devastated the Yucatán Peninsula in September 2002. Bugs were collected in 34 villages from the entire peninsula, during a year, starting 3 months after the hurricane. Pre- and posthurricane bug collections were compared to assess changes. The most notable effect was a large increase in domestic abundance of T. dimidiata during the 6 months after the hurricane. This increase was maximum along the path of the hurricane. These results suggest that vector control programs should be implemented along the path of hurricanes to prevent an increase in Chagas disease transmission risk in the ensuing months.
CHROMOSOMAL DIFFERENTIATION OF ANOPHELES FUNESTUS FROM LUANDA AND HUAMBO PROVINCES, WESTERN AND CENTRAL ANGOLA
Authors: BOCCOLINI DANIELA , CARRARA GIAN CARLO , DIA IBRAHIMA , FORTES FILOMENO , CANI PEDRO JORGE , COSTANTINI CARLO
Published: September 2018

The chromosomal polymorphism of Anopheles funestus sensu stricto from Angola was analyzed from indoor-resting samples collected in 11 peri-urban and rural sites of the Luanda and Huambo Provinces, which are > 450 km apart and have distinct eco-climatic conditions. Five polymorphic paracentric inversions were observed (scored chromatids range = 202 to 248): 2Ra, 2Rh, 3Ra, 3Rb, and 3La. Inversions 3Rb and 3La were highly polymorphic; the 2Ra and 3Ra arrangements were absent in Luanda. No significant departures from Hardy-Weinberg and linkage equilibria were found at the locality, commune, or province level (sites ≤ 50 km from each other), indicating panmixia in each locale. Pooling the Luanda and Huambo samples produced a Wahlund effect, with significant levels of genetic differentiation suggestive of restrictions to gene flow due to geographic distance. The observation that differentiation was limited to inversions 2Ra and 3Ra can also be interpreted as divergent selection acting on these chromosomal regions between populations from the two provinces.
PLASMODIUM FALCIPARUM TRANSMISSION BLOCKING IMMUNITY IN THREE AREAS WITH PERENNIAL OR SEASONAL ENDEMICITY AND DIFFERENT LEVELS OF TRANSMISSION
Authors: BOUDIN CHRISTIAN , DIOP ABDOULAYE , GAYE ABDOULAYE , GADIAGA LIBASSE , GOUAGNA CLÉMENT , SAFEUKUI INNOCENT , BONNET SARAH
Published: September 2018

Plasmodium falciparum transmission blocking immunity (TBI) was investigated in 3 different endemic areas. Reared Anopheles gambiae s.s. were experimentally infected with the blood of gametocyte carriers, either in the presence of autologous plasma (OWN) or after replacement of the OWN plasma with a nonimmune serum of AB blood group (control). Transmission reduction was defined by a lower level of mosquito infection in the OWN batch compared with the control. After controlling for the effect of gametocytemia, the proportion of “transmission reducers” was lower in the town of Yaounde in Cameroon (UC), (14%, N = 75) than in the two rural areas of South Cameroon (RC) (29%, N = 31) and Sénégal (RS) (44%, N = 32). The contribution of TBI relative to the total inhibition of the parasite development (including human, parasite, and mosquito factors) was higher in RS (49.6%) than in RC (12.6%) and UC (9.5%).
SUBCUTANEOUS IVERMECTIN AS A SAFE SALVAGE THERAPY IN STRONGYLOIDES STERCORALIS HYPERINFECTION SYNDROME: A CASE REPORT
Authors: PACANOWSKI JEROME , SANTOS MARIE DOS , ROUX ANTOINE , LE MAIGNAN CHRISTINE , GUILLOT JACQUES , LAVARDE VERONIQUE , CORNET MURIEL
Published: September 2018

Strongyloides stercoralis hyperinfection syndrome due to the acceleration of the autoinfective cycle of the nematode is a life-threatening form of the infection occurring in immunocompromised hosts. Intestinal ileus, which is commonly encountered in this form, may reduce the bioavailability and thus the efficacy of oral anthelminthic drugs used in the treatment of the S. stercoralis hyperinfection syndrome. We report the efficacy and safety of subcutaneous administration of ivermectin in a patient infected with human T cell lymphotropic virus type I with S. stercoralis hyperinfection syndrome who was unresponsive to an oral combination of ivermectin and albendazole.
EFFECT OF SUSTAINED INSECTICIDE-TREATED BED NET USE ON ALL-CAUSE CHILD MORTALITY IN AN AREA OF INTENSE PERENNIAL MALARIA TRANSMISSION IN WESTERN KENYA
Authors: EISELE THOMAS P. , LINDBLADE KIM A. , WANNEMUEHLER KATHLEEN A. , GIMNIG JOHN E. , ODHIAMBO FRANK , HAWLEY WILLIAM A. , TER KUILE FEIKO O. , PHILLIPS-HOWARD PENNY , ROSEN DANIEL H. , NAHLEN BERNARD L. , VULULE JOHN M. , SLUTSKER LAURENCE
Published: September 2018

We present results from a study conducted in western Kenya where all-cause child mortality was assessed among a population with high levels of sustained insecticide-treated bed net (ITN) use for up to six years. Although ITNs were associated with significant reductions in all-cause mortality among infants 1–11 months old, there was no difference in the rate of all-cause mortality among children 12–59 months old with ITNs for 2–4 years, compared historically with children from villages without ITNs, after controlling for seasonality and underlying child mortality across calendar years (adjusted hazard ratio [AHR] = 0.91, 95% confidence interval [CI] = 0.77–1.07). There was no increase in the proportion of child deaths at older ages (12–59 months old) of all child deaths within villages with ITNs for 5–6 years (48.1%) compared historically with villages without ITNs (47.9%), after controlling for seasonality (AHR = 1.03, P = 0.834). We find no evidence that sustained ITN use increased the risk of mortality in older children in this area of intense perennial malaria transmission.
THE REPRODUCTIVE ENDOCRINE RESPONSE TO PLASMODIUM VIVAX INFECTION IN HONDURANS
Authors: MUEHLENBEIN MICHAEL P. , ALGER JACKELINE , COGSWELL FRANK , JAMES MARK , KROGSTAD DONALD
Published: September 2018

Reproductive physiology and endocrinology change with the onset of illness and injury in a variety of species, including humans. To assess the human reproductive endocrine response to malaria, serial serum samples were collected from 8 male and 9 female residents of Honduras infected with Plasmodium vivax (plus 19 male and 23 female healthy age-matched controls) and were analyzed for associations between testosterone, parasitemia, and cytokine levels. Because testosterone has been negatively associated with measures of immune function under various circumstances, it was hypothesized that testosterone would be directly associated with P. vivax parasitemia and inversely associated with proinflammatory cytokine levels. The findings presented here suggest that 1) testosterone levels are positively associated with P. vivax parasitemia in adult males, and 2) males infected with P. vivax exhibit significantly lower testosterone levels and significantly higher cortisol levels than healthy individuals. Depressed androgen levels during physiologic perturbations may be an advantageous, adaptive host response to ameliorate immunosuppression by higher testosterone levels and to curb the use of energetic resources for metabolically expensive anabolic functions.
OCCULT PLASMODIUM VIVAX INFECTION DIAGNOSED BY A POLYMERASE CHAIN REACTION–BASED DETECTION SYSTEM: A CASE REPORT
Authors: BLOSSOM DAVID B. , KING CHARLES H. , ARMITAGE KEITH B.
Published: September 2018

After a trip to Zambia, a previously healthy adult traveler presented with a prolonged illness characterized by low-grade fevers and fatigue. Although malaria smears and antibody tests results for Plasmodium species were negative, a diagnosis of malaria was ultimately determined by polymerase chain reaction (PCR) amplification and species-specific nucleic acid hybridization techniques. The patient was successfully treated and cured. Clinical use of PCR technology may facilitate the identification of cases of smear-negative malaria, which up to the present time, have been difficult to diagnose.
MICROSPORIDIOSIS IN TRAVEL-ASSOCIATED CHRONIC DIARRHEA IN IMMUNE-COMPETENT PATIENTS
Authors: WICHRO ERIKA , HOELZL DAVID , KRAUSE ROBERT , BERTHA GEORG , REINTHALER FRANZ , WENISCH CHRISTOPH
Published: September 2018

We analyzed retrospectively 21 immune-competent travelers with chronic traveler’s diarrhea (3–6 weeks) after returning from recreational travel to the tropics with stool samples positive for microsporidia. Nine patients had been treated with albendazole and 12 patients had been treated symptomatically. Diarrhea resolved in 8 of 9 and 12 of 12 patients, respectively. In the albendazole group, Encephalitozoon intestinalis was cleared in 4 of 4 patients and Enterocytozoon bieneusi persisted in 7of 7 patients (2 patients were lost to follow-up). In the symptomatic treated group microsporidia persisted in stool samples of all patients. We conclude that there is only a transient correlation between detection of microsporidia in stool and gastrointestinal symptoms, and suggest that microsporidia infection may cause clinical symptoms during the early stages of infection that resolve even though the microsporidia may persist.
ENZYME IMMUNOASSAY OF CRYPTOSPORIDIUM-SPECIFIC IMMUNOGLOBULIN G ANTIBODIES TO ASSESS LONGITUDINAL INFECTION TRENDS IN SIX COMMUNITIES IN BRITISH COLUMBIA, CANADA
Authors: ONG CORINNE S. , LI ANNA S. , PRIEST JEFFREY W. , COPES RAY , KHAN MOHAMAD , FYFE MURRAY W. , MARION STEPHEN A. , ROBERTS JACQUELIN M. , LAMMIE PATRICK J. , ISAAC-RENTON JUDITH L.
Published: September 2018

A newly developed enzyme-linked immunosorbent assay (ELISA) that detects immunoglobulin G antibodies to the 27-kDa Cryptosporidium parvum sporozoite surface antigen was used to test 4,097 sera collected from pregnant women in 6 communities in British Columbia, Canada, between January 1996, and December 1997. Waterborne outbreaks of cryptosporidiosis occurred in two of the study communities during the period of follow-up, and ELISA seropositivity was high in all six communities during the study period (77% positive to 92% positive). In the community with the largest outbreak, levels of antibody to the 27-kDa antigen increased rapidly and then decayed to background levels within 3–4 months of the peak of the epidemic curve. Trends in serologic reactivity were complex in all communities, and increased antibody levels not related temporally to known waterborne outbreaks were also observed. Serological assays may provide more accurate information regarding community levels of Cryptosporidium infection.
MOLECULAR TAXONOMIC STUDY OF CHAGAS DISEASE VECTORS FROM THE PHYLLOSOMA, LECTICULARIA, AND RUBROFASCIATA COMPLEXES
Authors: MARTÍNEZ FERNANDO , ALEJANDRE-AGUILAR RICARDO , MONCADA YOLANDA HORTELANO , ESPINOZA BERTHA
Published: September 2018

The Triatiominae (Hemiptera: Reduviidae) are hematophagous hemipters of importance because they transmit Trypanosoma cruzi, the causal agent of Chagas disease. The aim of this study was to define the possible relationships between species of the Phyllosoma complex (Triatoma mazzottii, Triatoma pallidipennis, and Triatoma longipennis) and species of other complexes present in Mexico that have not been previously analyzed (Triatoma lecticularia and Triatoma rubida). In addition, it was determined the inclusion of Triatoma bassolsae in the Phyllosoma complex by using 10 isoenzymatic systems (corresponding to the 14 loci). Results of isoenzymatic study show that between the species of the Phyllosoma complex including Triatoma bassolsae, the polymorphism of the analyzed enzymes ranges from 14% to 50% (P ≤ 0.95) and the species from external complexes showed polymorphism values of 43% (Triatoma lecticularia), 43% (Triatoma rubida), and 36% (Triatoma infestans). The genetic tree shows a clear difference between species of the Phyllosoma complex and the other complexes.
DETECTION AND CHARACTERIZATION OF WOLBACHIA INFECTIONS IN WUCHERERIA BANCROFTI (SPIRURIDA: ONCHOCERCIDAE) VAR. PACIFICA AND AEDES (STEGOMYIA) POLYNESIENSIS (DIPTERA: CULICIDAE)
Authors: PLICHART CATHERINE , LEGRAND ANNE-MARIE
Published: September 2018

Despite control programs based on mass drug administration (MDA) of microfilaricidal compounds, Bancroftian lymphatic filariasis remains a problem in French Polynesia. For an alternative strategy to MDA, we investigated the potential role of Wolbachia to control filarial transmission. Wolbachia are intracellular α-proteobacteria endosymbionts that infect a broad range of insects and nematodes. These bacteria have a suspected role in the pathogenesis of filariasis. They also may be useful in mosquito control through cytoplasmic incompatibility. To detect and characterize these bacteria in the filarial and mosquito-vectors in French Polynesia, a survey was conducted on field-collected mosquitoes and microfilariae from infected people. Samples were analyzed by a polymerase chain reaction and gene sequencing. The results indicate that these bacteria are widespread. Sequence analysis of the wsp and ftsZ genes positioned the Aedes polynesiensis Wolbachia in cluster A and Wuchereria bancrofti var. pacifica Wolbachia in cluster D. The implications for possible improved treatment and vector control are discussed.
ACUTE PANCREATITIS CAUSED BY TAPEWORM IN THE BILIARY TRACT
Authors: LIU YU-MIN , BAIR MING-JONG , CHANG WEN-HSIUNG , LIN SHEE-CHAN , CHAN YU-JAN
Published: September 2018

Taeniasis is a helminthic infection endemic in southeast Asia, including Taiwan. Recent studies suggest that Asian Taenia is a new subspecies of Taenia saginata and has been renamed as Taenia saginata asiatica. It is usually asymptomatic or associated with only mild gastrointestinal symptoms. We report the case of a 52-year-old woman with acute epigastric pain and vomiting. Her levels of amylase and lipase were significantly elevated on admission. Gastrointestinal endoscopy showed proglottids of a tapeworm in the papilla of the duodenum. The epigastric pain subsided and the amylase and lipase levels decreased after removal of the tapeworm by endoscopy and anthelminthic treatment. Although parasites are not an uncommon cause of pancreatitis, especially in disease-endemic areas, it is rare for Taenia to cause acute pancreatitis.
ENDOSCOPIC FINDINGS AND MANAGEMENT OF DENGUE PATIENTS WITH UPPER GASTROINTESTINAL BLEEDING
Authors: CHIU YI-CHUN , WU KENG-LIANG , KUO CHUNG-HUANG , HU TSUNG-HUI , CHOU YEH-PIN , CHUAH SENG-KEE , KUO CHUNG-MOU , KEE KWONG-MING , CHANGCHIEN CHI-SIN , LIU JIEN-WEI , CHIU KING-WAH
Published: September 2018

There are 100 million cases of dengue infection, 500,000 cases of dengue hemorrhagic fever, and 25,000 deaths annually due to dengue worldwide. Gastrointestinal bleeding is the most common type of severe hemorrhage in dengue fever. However, there are no reports about the clinical applications of endoscopic therapy for upper gastrointestinal bleeding (UGI) in dengue patients. From June 17, 2002 to January 30, 2003, 1,156 patients with confirmed dengue virus infection were treated at Kaohsiung Chang Gung Memorial Hospital in Taiwan. We analyzed those patients who had received endoscopic therapy for UGI. The characteristic endoscopic findings, therapeutic courses, and amount of blood component transfused were collected from their charts for statistical analysis. Among the 1,156 dengue patients, 97 (8.4%) had complications of UGI bleeding during hospitalization. The endoscopic findings included hemorrhagic (and/or erosive) gastritis in 67% of the patients, gastric ulcer in 57.7%, duodenal ulcer in 26.8%, and esophageal ulcer in 3.1%. Of the 73 patients with peptic ulcer, 42 (57.5%) met the endoscopic criteria (recent hemorrhage) for endoscopic hemostasis therapy. Peptic ulcer patients with recent hemorrhage required more transfusions with packed red blood cells (P = 0.002) and fresh frozen plasma (P = 0.05) than those without recent hemorrhage. Among these 42 patients with recent hemorrhage, endoscopic injection therapy was conducted in 15 patients (group A). The other 27 patients (group B) did not receive endoscopic therapy. After endoscopy, patients in group A required more transfusions with packed red blood cells (P = 0.03) and fresh frozen plasma (P = 0.014) than did patients in group B. There were no significant differences between groups A and B in duration of hospital stay and amounts of transfused platelet concentrate after endoscopy. Medical treatment with blood transfusion is the mainstay of management of UGI bleeding in dengue patients. Patients having peptic ulcer with recent hemorrhage require more transfusions with packed red blood cells and fresh frozen plasma for management of UGI bleeding than those without recent hemorrhage. However, when peptic ulcer with recent hemorrhage is encountered during the endoscopic procedure, endoscopic injection therapy is not an effective adjuvant treatment of hemostasis in dengue patients with UGI bleeding.
LOW RISK OF MOTHER-TO-CHILD TRANSMISSION OF HEPATITIS C VIRUS IN YAOUNDÉ, CAMEROON: THE ANRS 1262 STUDY
Authors: NJOUOM RICHARD , PASQUIER CHRISTOPHE , AYOUBA AHIDJO , TEJIOKEM MATHURIN CYRILLE , VESSIERE AURELIA , MFOUPOUENDOUN JERMIE , TENE GILBERT , ETEKI NICOLE , LOBE MARCEL MONNY , IZOPET JACQUES , NERRIENET ERIC
Published: September 2018

To assess mother-to-child transmission (MTCT) of hepatitis C virus (HCV) in Cameroon, 5,008 pregnant women were screened for HCV antibodies. Eighty-nine (1.8%) were HCV-antibody (HCV-Ab) positive. Among these, 7 (7.9%) were HBsAg positive, 6 (6.7%) HIV-positive, and one (1.1%) was co-infected by both hepatitis B virus (HBV) and HIV. Sixty-eight (76%) out of 89 HCV-Ab positive pregnant women were HCV-RNA positive. The HCV genotype determination indicated the predominance of genotype 4 (45.3%), followed by the genotypes 1 (28.1%) and 2 (26.6%). The mean HCV-RNA levels of 41 women at the time of delivery was 4.8 (range 0.06–34.7) × 106 RNA copies/mL. Finally, 35 women delivered 36 live children. None of those screened at 6 weeks and 6 months of age were HCV-RNA positive. The failure to detect HCV vertical transmission suggests that the mother-to-child transmission (MTCT) is not a major route of HCV transmission in Cameroon.
EXPERIMENTAL AND NATURAL INFECTION OF NORTH AMERICAN BATS WITH WEST NILE VIRUS
Authors: DAVIS APRIL , BUNNING MICHEL , GORDY PAUL , PANELLA NICHOLAS , BLITVICH BRADLEY , BOWEN RICHARD
Published: September 2018

Big brown (Eptesicus fuscus) and Mexican free-tailed (Tadarida brasiliensis) bats were inoculated with the New York 99 strain of West Nile virus to assess their potential to serve as amplifying hosts and determine the clinical effect of infection. Groups of three or four bats were bled at daily intervals between 1 and 6 days after inoculation to determine the pattern of viremia. Beginning 2 days after inoculation, virus was isolated each day from one or more E. fuscus bats, in titers ranging from 10 to 180 plaque-forming units per milliliter of serum. Virus was not isolated from any of the sera collected from T. brasiliensis bats. None of the bats from either species showed clinical signs associated with exposure to virus. Sera from an additional 149 bats collected in Louisiana in 2002 during an epizootic of West Nile fever were tested for antibodies to virus, and two were found to be positive. These data suggest that bats from these two widely distributed species are unlikely to serve as amplifying hosts for West Nile virus.
HUMAN TRYPANOSOMIASIS CAUSED BY TRYPANOSOMA EVANSI IN INDIA: THE FIRST CASE REPORT
Authors: JOSHI PRASHANT P. , SHEGOKAR VIJAY R. , POWAR RAJARAM M. , HERDER STEPHANE , KATTI RAHUL , SALKAR HARSHA R. , DANI VIBHAWARI S. , BHARGAVA ARADHANA , JANNIN JEAN , TRUC PHILIPPE
Published: September 2018

We report an Indian farmer who had fluctuating trypanosome parasitemia associated with febrile episodes for five months. Morphologic examination of the parasites indicated the presence of large numbers of trypanosomes belonging to the species Trypanosoma evansi, which is normally a causative agent of animal trypanosomiasis known as surra. Basic clinical and biologic examinations are described, using several assays, including parasitologic, serologic, and molecular biologic tests, all of which confirmed the infecting species as T. evansi. Analysis of cerebrospinal fluid indicated no invasion of the central nervous system (CNS) by trypanosomes. Suramin, a drug used exclusively for treatment of early-stage human African trypanosomiasis with no CNS involvement, effected apparent cure in the patient. This is the first case reported of human infection due to Trypanosoma evansi, which was probably caused by transmission of blood from an infected animal.