Leishmaniasis in Texas: Epidemiology and Clinical Aspects of Human Cases

McHugh, Chad P.; Melby, Peter C.; LaFon, Sandra G.

doi:10.4269/ajtmh.1996.55.547

Cited by 75 publications

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“…The diseases they cause are most prevalent in the tropics and subtropics, although leishmaniasis is also endemic in Southern Europe and has been reported in the United States (20). There is a pressing need to improve ways of treating the diseases; and in particular, there is a requirement for better chemotherapy (21).…”

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confidence: 99%

3-Mercaptopyruvate Sulfurtransferase of LeishmaniaContains an Unusual C-terminal Extension and Is Involved in Thioredoxin and Antioxidant Metabolism

Williams

Kelly

Mottram

et al. 2003

Journal of Biological Chemistry

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Cytosolic 3-mercaptopyruvate sulfurtransferases (EC 2.8.1.2) of Leishmania major and Leishmania mexicana have been cloned, expressed as active enzymes in Escherichia coli, and characterized. The leishmanial singlecopy genes predict a sulfurtransferase that is structurally peculiar in possessing a C-terminal domain of some 70 amino acids. Homologous genes of Trypanosoma cruzi and Trypanosoma brucei encode enzymes with a similar C-terminal domain, suggesting that this feature, not known in any other sulfurtransferase, is a characteristic of trypanosomatid parasites. Short truncations of the C-terminal domain resulted in misfolded inactive proteins, demonstrating that the domain plays some key role in facilitating correct folding of the enzymes. The leishmanial recombinant enzymes exhibited high activity toward 3-mercaptopyruvate and catalyzed the transfer of sulfane sulfur to cyanide to form thiocyanate. They also used thiosulfate as a substrate and reduced thioredoxin as the accepting nucleophile, the latter being oxidized. The enzymes were expressed in all life cycle stages, and the expression level was increased under peroxide or hypo-sulfur stress. The results are consistent with the enzymes having an involvement in the synthesis of sulfur amino acids per se or iron-sulfur centers of proteins and the parasite's management of oxidative stress.

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confidence: 99%

3-Mercaptopyruvate Sulfurtransferase of LeishmaniaContains an Unusual C-terminal Extension and Is Involved in Thioredoxin and Antioxidant Metabolism

Williams

Kelly

Mottram

et al. 2003

Journal of Biological Chemistry

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“…[3][4][5] We hypothesized that enzootic foci of L. mexicana could exist in the United States wherever sand flies occur in close association with rodents or other potential hosts of Leishmania. 2 Mead and Cupp 6 found Lu. anthophora associated with white-throated woodrats (Neotoma albigula) and rock squirrels (Spermophilus variegatus) at the Buenos Aires National Wildlife Refuge (BANWR) in Pima County, Arizona, motivating us to collect and screen rodents from that area for L. mexicana.…”

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confidence: 99%

“…diabolica may be necessary to act as a bridge between the enzootic cycle and humans. 2 To date, no anthropophilic sand flies have been reported from southern Arizona.…”

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confidence: 99%

“…1 Twenty-nine autochthonous cases of human cutaneous leishmaniasis are known from the United States, all in southern or central Texas. 2 Enzootic foci have been identified only in the semi-arid brush country of southern Texas, in a southern plains woodrat (Neotoma micropus)-sand fly (Lutzomyia anthophora) cycle. [3][4][5] We hypothesized that enzootic foci of L. mexicana could exist in the United States wherever sand flies occur in close association with rodents or other potential hosts of Leishmania.…”

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confidence: 99%

“…In Texas, some foci, including some inside the city limits of San Antonio, have existed for years in close proximately to humans, 5 yet human cases of leishmaniasis are rare. 2 The factor determining whether zoonotic transmission of Leishmania is possible may be what species of Lutzomyia occur in an area. At the BANWR, Lu.…”

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confidence: 99%

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Short report: a focus of Leishmania mexicana near Tucson, Arizona.

Kerr¹,

McHugh²,

Merkelz³

1999

The American Journal of Tropical Medicine and Hygiene

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Abstract. Twenty-eight white-throated woodrats (Neotoma albigula) collected in Pima County, Arizona were screened for Leishmania using culture and the polymerase chain reaction (PCR). Two rodents were culture positive. Isoenzyme analysis determined the isolates to be Leishmania mexicana. The two culture-positive and four additional rodents were determined to be Leishmania-positive by the PCR. These isolates extend the geographic and ecologic range of enzootic leishmaniasis in the United States and represent a new host record.

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Incidence of Endemic Human Cutaneous Leishmaniasis in the United States

2018

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IMPORTANCE Leishmaniasis is recognized as an endemic human disease in Africa, the Middle East, Asia, and South America. Yet despite case reports of endemic human leishmaniasis in the United States, and well-documented occurrences of disease in various animal vectors and reservoirs, the endemicity of leishmaniasis in North America has not yet been established. Moreover, leishmaniasis is not a federally reportable disease in the United States. Clinical awareness of endemic disease therefore remains low, with North American physicians considering leishmaniasis a tropical disease. OBJECTIVE To assess the endemicity of human leishmaniasis in the United States. DESIGN, SETTING, AND PARTICIPANTS This cross-sectional multicenter observational study reviewed cases of human leishmaniasis occurring in the United States from 2007 through 2017. Previously diagnosed, deidentified cases of leishmaniasis were reported by the institutions of the authors and acknowledged contributors, as well as the Texas Department of State Health Services. Cases of leishmaniasis were identified by searching by disease name (leishmaniasis) or International Classification of Diseases, 9th and 10th Revisions diagnosis codes in the respective laboratory information systems. EXPOSURES Via examination of deidentified demographics, cases of leishmaniasis were classified as one of the following: (1) documentation of no history of travel outside of the United States within 10 years; (2) positive history of travel outside of the United States within 10 years; or (3) unknown or no documentation of travel history. MAIN OUTCOMES AND MEASURES Cases of leishmaniasis were considered endemic if identified in patients with documentation of no travel history outside of the United States within 10 years. RESULTS Of the 69 novel cases of human cutaneous leishmaniasis identified in this study, 41 (59%) were endemic; the median age at diagnosis was 61 years (range, 3-89 years), and 28 (68%) of the endemic cases occurred in female patients. Twenty-two (32%) cases had documentation of Leishmania speciation performed by polymerase chain reaction, and in 100% of these cases the infectious organism was identified as Leishmania mexicana. CONCLUSIONS AND RELEVANCE Human cutaneous leishmaniasis is endemic in the United States, and, at least regionally, is acquired endemically more frequently than it is via travel. Our data argue in favor of making leishmaniasis a federally reportable disease and may have substantial implications on North American public health initiatives, with climate models predicting the number of citizens exposed to leishmaniasis will double by 2080.

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Leishmaniasis in Texas: Epidemiology and Clinical Aspects of Human Cases

Cited by 75 publications

References 0 publications

3-Mercaptopyruvate Sulfurtransferase of LeishmaniaContains an Unusual C-terminal Extension and Is Involved in Thioredoxin and Antioxidant Metabolism

3-Mercaptopyruvate Sulfurtransferase of LeishmaniaContains an Unusual C-terminal Extension and Is Involved in Thioredoxin and Antioxidant Metabolism

Short report: a focus of Leishmania mexicana near Tucson, Arizona.

Incidence of Endemic Human Cutaneous Leishmaniasis in the United States

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