       Document 0124
 DOCN  M9610124
 TI    An urban outbreak of visceral leishmaniasis in Natal, Brazil.
 DT    9601
 AU    Jeronimo SM; Oliveira RM; Mackay S; Costa RM; Sweet J; Nascimento ET;
       Luz KG; Fernandes MZ; Jernigan J; Pearson RD; Department of
       Biochemistry, Universidade Federal do Rio Grande do; Norte, Brazil.
 SO    Trans R Soc Trop Med Hyg. 1994 Jul-Aug;88(4):386-8. Unique Identifier :
       AIDSLINE MED/96031247
 AB    The epidemiological pattern of visceral leishmaniasis in north-eastern
       Brazil is changing. The disease was typically seen in rural, endemic
       areas, but is now occurring as an epidemic in the city of Natal where
       316 cases have been reported since 1989; 49% were in children less than
       5 years of age. The principle clinical and laboratory findings were
       weight loss, fever, hepato-splenomegaly, anaemia, leucopenia and
       hypergammaglobulinaemia. Elevated transaminases and hyperbilirubinaemia
       were also observed. The diagnosis was confirmed in 87% of cases by
       identifying amastigotes in aspirates from bone marrow or spleen. Five
       isolates were identified as Leishmania (L.) chagasi by isoenzyme
       analysis. The mortality rate was 9%; all deaths occurred during the
       first week in hospital. One person had concurrent human immunodeficiency
       virus infection. Among 210 household contacts and neighbours of patients
       from the endemic area examined for evidence of L. (L.) chagasi
       infection, 6 additional cases of visceral leishmaniasis were diagnosed.
       Thirty-eight percent of house-mates and neighbours gave a positive
       Montenegro skin test reaction, indicating prior subclinical infection.
 DE    Adolescence  Adult  Age Factors  Aged  Bone Marrow/PARASITOLOGY
       Brazil/EPIDEMIOLOGY  Child  Child, Preschool  *Disease Outbreaks  Female
       Human  Infant  Leishmaniasis, Visceral/DIAGNOSIS/*EPIDEMIOLOGY/MORTALITY
       Male  Middle Age  Pregnancy  Spleen/PARASITOLOGY  Support, U.S. Gov't,
       P.H.S.  Urban Population  JOURNAL ARTICLE

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

