Tegumentary leishmaniasis outbreak in Bella Vista City, Corrientes, Argentina during 2003

Abstract

Tegumentary leishmaniasis (TL) is endemic in area of Northern Argentina that includes nine political provinces and three bio-regions: the 'Yungas' and 'Paranaense' subtropical forests, and the xeric 'Chaco'. Although TL was identified in Argentina almost a century ago, the first recorded outbreak took place in 1984-1987 in the 'Yungas' region, and this was found to be due to Leishmania braziliensis (Sosa Estani et al. 2000. After this outbreak, the relative increased incidence of TL both children and females suggested a transmission shift from the forest to peridomestic habitats (Sosa Estani et al. 2001, Sosa Estani & Salomon 2002. In addition, since the early 1980s the re-emergence of TL has been reported for many countries in the region, and urban transmission was proposed by many other investigators (Mott et al. 1990, Desjeux 2001, Campbell-Lendrum et al. 2001, Bejarano et al. 2002, Leonardo & Rebêlo 2004, Lemos & Lima 2005.Lutzomyia intermedia sensu lato, currently termed Lu. neivai (Marcondes 1996), is widely distributed in the province of Corrientes. This species of Lutzomyia was first recorded in Corrientes City in 1926 and again in 1997(Bejarano & Duret 1950, Borda et al. 2002, it was also reported in Santo Tomé, Colonia Pellegrini, and Apipé Grande (San Antonio) during 1951 (Duret 1952), in Santa Tecla, Ituzaingó, Villa Olivari and Ita-Ibaté (Spinelli et al. 1999) during 1993, and in Bella Vista in 1998(Borda et al. 1998b). Other phlebotomine species also found in the province of Corrientes include Lu. cortelezzii, Lu. migonei, Lu. pessoai, Lu. shannoni, Lu. fischeri, Brumptomyia guimaraesi, and Br. avellari, the former four species were recorded in Corrientes City (Borda et al. 2002), the last seven were recorded in Santa Tecla and the last species was found in Ituzaingó (Spinelli et al. 1999 (Fig. 1) The average incidence of TL in the province of Corrientes, in the 'Paranaense' northeastern region was 2.2, 6.8, and 11.7 cases/year for the whole province in the periods 1955-1974, 1975-1994, and 1995-2004 respectively, according to the records of the National Surveillance System and the Dermatologic Dispensary of Corrientes.Bella Vista City, on the Paraná river shore, according to the Dermatologic Dispensary had two TL cases in 1988, one in 1991, and six in 1998. However during 2003 an outbreak took place in the City, the first recorded for the province, with suspected urban transmission. It was the southernmost known epidemic focus, and one of the scarce epidemics located in the eastern region of Argentina. Thus, this study was conducted in order to define the distribution of vectors and cases, and the risk factors for TL infection in this area. The results characterize the risk distribution of TL infection in time and space, and are discussed in the frame of the TL urbanization hypotheses and the appropriate strategies of surveillance and control. 140 km south of Corrientes City. The city is located 32 m above the Parana river and 66 m above sea level, in front of the Ramsar site 'Jaakanigás'. T...

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