       Document 0386
 DOCN  M9440386
 TI    [Outbreak of malaria induced among users of injectable drugs]
 DT    9404
 AU    Barata LC; Andriguetti MT; de Matos MR; SUCEN, Sao Paulo, Brasil.
 SO    Rev Saude Publica. 1993 Feb;27(1):9-14. Unique Identifier : AIDSLINE
       MED/94143707
 AB    Five cases of malaria were detected among cocaine users by the local
       health service in Bauru, a city with a population of 260,000, located
       324 km from S. Paulo, Brazil, during the first three weeks of July 1990.
       Autochthonous malaria had not occurred in Bauru since 1978, and all the
       five cases denied having recently traveled to endemic areas. An
       extensive epidemiologic survey conducted from July 19 to September 13
       revealed that the 5 cases were in fact part of a malaria outbreak among
       endovenous drug users. Moreover, at least 114 other people, who had in
       the last three months shared syringes and needles with one or more
       proved cases, were also involved in the outbreak. One hundred and two
       people were identified and interviewed orally. The examination of thick
       smears made from samples collected from 99 of them confirmed 21 cases of
       vivax malaria. Three people with negative blood smears had an indirect
       immunofluorescent assay positive to P. vivax antigen. Although the index
       case could not be discovered, the investigation suggested that one or
       more people who had recently traveled to the Amazon region might have
       introduced the disease. The control of the outbreak was achieved after
       offering treatment with chloroquine (10 tablets) to confirmed cases and
       contacts, followed by weekly suppressive chloroquine (2 tablets) until
       the last contact was detected. Malaria examination of 91 blood samples
       also revealed a high prevalence of hepatitis B virus infection (40%) and
       HIV infection (58%) among those involved in the outbreak. The strategy
       used to identify the cases and the contacts and the difficulties
       overcome in carrying it through are described.(ABSTRACT TRUNCATED AT 250
       WORDS)
 DE    Acquired Immunodeficiency Syndrome/EPIDEMIOLOGY  Adolescence  Adult
       Brazil/EPIDEMIOLOGY  Child  Chloroquine/THERAPEUTIC USE  Cocaine
       *Disease Outbreaks/PREVENTION & CONTROL  English Abstract  Female
       Hepatitis/EPIDEMIOLOGY  Human  Malaria/DRUG
       THERAPY/*EPIDEMIOLOGY/PREVENTION & CONTROL/  TRANSMISSION  Male  *Needle
       Sharing  *Substance Abuse, Intravenous/COMPLICATIONS  Support, Non-U.S.
       Gov't  JOURNAL ARTICLE

       SOURCE: National Library of Medicine.  NOTICE: This material may be
       protected by Copyright Law (Title 17, U.S.Code).

