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Dermal leishmaniasis in French Guiana: the sloth (Choloepus didactylus) as a reservoir host
612
TRANSACTIONS OFTH~ROYALSOCIETYOFTROPICALMEDICINEANDHYGIENE,VOL.75,No.4,1981.
by the high prevalence of Endotrypanum and/or Trypanosoma spp. in the blood of at least 50% of the sloths examined, and the fact that approximately the same percentage of anteaters harboured T. legeri. Further observations are in progress on this aspect and a detailed study on the ecology of Lu. umbratilis, in relation to this sandfly’s role as the principal vector of L. b. guyanensis, is to be published shortly (Ready et al., in preparation). We are, etc., R. LAINSON*
hJ.SH;:* * The Wellcome Parasitology Unit*, Department of Parasitology, The Instituto Evandro Chagas, FundaGao SESP, Bele’m, Par& Brazil References Gentile, B., Le Pont, F. & Besnard, R. (1981). Dermal leishmaniasis in French Guiana: the sloth (Choloepus didactylus) as a reservoir host. Transactions of the Roval Societv of Troaical Medicine and &vgiene, 7$ 612-613: A Lainson, R., Ward, R. D. & Shaw, J. J. (1976). Cutaneous leishmaniasis in north Brazil: Lutzomyia anduzei as a major vector. Transactions of the Royal Society of Tropical Medicine and Hygiene, 70, 171-172. Lainson, R., Shaw, J. J., Ward, R. D., Ready, P. D. & Naiff, R. D. (1979). Leishmaniasis in Brazil: XIII. Isolation of Leishmania from armadillos (Dasypus novemcinctus) and observations on the epidemiology of cutaneous leishmaniasis in north Para State. Transactions of the Royal Society of Tropical Medicine and Hygiene, 73, 239-242. Lainson, R., Shaw, J. J., Ready, P. D., Miles, M. A. & Povoa; M. (198i). Leishmaniasis in -Brazil: XVI. Isolation and identification of Leishmania species from sandflies, wild mammals and man in north Para State, with particular reference to Leishmania braziliensis guy&semis, causative agent of “wian-bois”. Transactions of the Roval Society of T>opical Medicine and Hygiene, 75,!%30-536. ”
Accepted for publication
16th January,
1981.
Dermd leishmaniasis in French Guiana: the sloth (Choloepus didactylus) as a reservoir host MAD&r-Preliminary observations on the epidemiology of dermal leishmaniasis in French Guiana have recently been reported (LE PONT es al., 1980) and, in this report, the sandfly Lutzomyia umbratilis was incriminated as the major vector. In addition, two specimens of the rodent Proechimys were found infected with Leishmania : unfortunately the isolates were lost and the nature of the parasite remains uncertain. Infected sandflies were caught
CORRESPONDENCE
off man up to 92 feet in the forest canopy, suggesting a reservoir in arboreal animals. Subsequent attention was therefore given to such animals as kinkajous, sloths and primates. Most of the animals studied were trapped alive, in a proven focus of infection, and smears-from any skin lesions were stained with Giemsa’s stain. Each animal was then killed and small pieces of skin, liver and spleen triturated in saline without antibiotics. Suspensions were inoculated into the feet of hamsters and these were examined regularly, for up to one year, for any signs of infection. When a strain was isolated it was at once sub-inoculated into another hamster and cultured in a modified NNN medium: cultures were maintained at approximately 22-24°C. A total of 74 mammals (five orders and 14 species) was studied and the following found infected with Leishmania: one of seven kinkajous, Potosflavus; seven of 15 sloths, ChoZoepusdidactylus; and two of 19 rodents, Proechimys sp. Isolates were made from pools of organs (liver, spleen and skin). No infections were detected in the following: Marsupialia (opossums)-eight Didelphis mars&alis. two Metachirus nudicaudatus. five Philander opossum and one Marmosa murina; Primates (monkeys)-two Cebus nigrivittatus, two Alouatta sp. and two Marikina midas; Edentata-one Myrmecophaga tridactyla (giant anteater) and four Bradypus griseus (three-toed sloth); Rodentiatwo Dasyprocta acuchy (agouti) and one Coendou sp. (porcupine); Carnivora-three dogs (Canis familiaris). Five of the seven positive sloths came from Cacao, a forest village where dermal leishmaniasis has been very frequent among the Asian tribe (Hmongs): the other two were from another focus of human infection in Sinnamary. A number of hamsters developed typical nodules at the inoculation site, which appeared after six to eight weeks in animals inoculated with sloth material, and seven months in those injected with the kinkajou material. Isolates from a man, a sloth and a sandfly (Lu. umbratilis) were sent -to the Instituto Evandro Chanas. Belem. Para. Brazil. for identification. Afte; biological and biochemical characterization, they proved indistinguishable from each other and from all stocks of L. braziliensis guyanensis isolated from man, sandflies (Lu. umbratilis and Lu. whittetradactyla) and mani), anteaters (Tamandua sloths from north Brazil (LAINSON et al., 1979, 1981, 1981a). The high infection rate (46.7%) in C. didactylus is interesting, because Lu. umbratilis, which feeds very readily on this animal, becomes infected in the canopy during the dry season (SeptemberNovember). With the first rains, in late November, infected flies are found in abundance at ground level, where man becomes infected: the first human cases begin to appear at the end of December (LE PONT & PATOT, 1980). The sloth, C. didactylus, is likely to be the main reservoir of L. b. guianehsis in some active foci such as Cacao and Sinnamary, in French Guiana. Another species, C. hoffmanni, has already been shown to be the principal host of L. b. panamensis in Panama (HERRER et al., 1973).
TRANSACUONS
OF THE ROYAL
SOCIETY
OP
TROPICALMEDICINS
We are indebted to Dr. R. Lainson and his colleagues at the Instituto Evandro Chagas, BelCm, Par& Brazil for identification of parasites isolated. We are, etc., B. GENTILES F. LE I?ONT~ F. x. pAJOT
R. BESNAFCD~ IPasteur Institut of French Guiana, B.P. 304, 97305 Cayenne Cedes French Guiana ZOfJice de la Recherche Scientifque et Technique Outre-Mer, Centre ORSTOM, B.P. 165, 97301 Cayenne, French Guiana References Herrer, A., Christensen, H. A. & Beumer, R. J. (1973). Reservoir hosts of cutaneous leishmaniasis among Panamanian forest mammals. American Yournal of Tropical Medicine and Hygiene, 22, 585-591: Lainson, R., Shaw, J. J., Ward, R. D., Ready, I?. D. & Naiff, R. D. (1979). Leishmaniasis in Brazil: XIII: Isolati& of! Leishmania from armadillos (Dasypus novemcinctus) and observations on the epidemiology of cutaneous leishmaniasis in north Par& State. Transactions of the Royal Society of Tropical Medicine and Hygiene, 73, 239-242. Lainson, R., Shaw, J. J., Ready, I?. D., Miles, M. A. & I%voa, M. (1981). Leishmaniasis in Brazil: XVI. Isolation and identification of Leishmania species from sandflies, wild mammals and man in north ParL State, with particular reference to Leishmania braziliensis guyanensis, causative agent of “pian-bois”. Transactions of the Roval Societv of Tropical Medicine and Hygiene, 75, 530-536.” Lainson, R., Shaw, J. J. & I%voa, M. (1981). The importance of edentates (sloths and anteaters) as primarv reservoirs of Leishmania braziliensis in guyanensis; causative agent of “pian-bois” north Brazil. Transactions of the Roval Societv of Tropical Medicine and Hy&ne, 75,>11-612. s ” Le Pant, F. and Pajot, F. X. (1980). La leishmaniose en Guyane FranCaise. 1. Etude de 1’Ccologie et du taui d’infectibn naturelle du vecteur Lutzomvia umbratilis Ward et Fraiha, 1977 en saison s&he. Considerations CpidCmiologiques. Cahiers ORSTOM, Skrie Entomologie Me’dicale et Parasitologie, 18, 359-382. Le Pont, F., Pajot, F. X. & Reguer, M. (1980). Preliminary observations on the silvatic cycle of leishmaniasis in French Guiana. Transactions of the Royal Society of Tropical Medicine and Hygiene, 74, 133. Accepted for publication 16th January, 1981.
Chloramphenicol
resistant Salmonella typhi in Egypt MADAM-Chloramphenicol-resistant Salmonella typhi occurs most frequently in countries in which typhoid fever is endemic and the drug is freely
AND HYGIENE,
VOL.
75, No.
4,1981.
CORRBSPONDFIN~~
613
available (ANDERSON, 1975). We have therefore searched for resistant strains as part of a study on enteric fever conducted in Alexandria, Cairo,-and Uuner Ep.vnt from October 1978 to October 1980. OAiy ong”s&ain from 281 culture-positive typhoid fever patients was resistant to chloramphenicol. It was isolated from the stool of a patient in Qena and had an unusual resistance pattern as determined by the disc method; resistance to chloramphenicol and tetracycline, sensitivity to streptomycin, sulphadiazine, amnicillin, and kanamvcin. The minimum inhibit&y concen&ation of c-hloramphenicol was shown to be >50 pg/ml by plate dilution. Since attempts to transfer the resistance to Escherichia coli were unsuccessful, it appears that it is not due to an R factor. These data suggest that, despite the endemicity of typhoid fever (EL-AKKAD, 1970) and the accessibility and presumed over-use of (FARID et al., 1975) in Egypt, chloramphenicol chloramphenicol-resistant typhoid is not yet a significant problem. The oninions and assertions contained herein are the piivate ones of the authors and are not to be construed as official or as reflecting the views of the Department of the Navy or the naval service at large. This work was supported by the Naval Medical Research and Development Command, Bethesda, Maryland, under Work Unit No. MF58.524.0090090. We are, etc., J. E. .%PPEL A. S. DIAB I. A. MIKHAIL Bacteriology Department, U.S. Naval Medical Research Unit No. 3, c/o American Embassy, Cairo, Egypt. S. H. ISKANDAR Luxor Fevers Hospital, Luxor, Egypt References Anderson, E. S. (1975). The problem and implications of chloramphenicol resistance in the typhoid bacillus. Journal of Hygiene, 74, 289-299. El Akkad, A. M. (1970). Statistics and epidemiology of typhoid fever in UAR. Journal of the Egyptian Public Health Association, 45, 8-16. Farid, Z., Miner, W. F., Hassan, A. & Trabolsi, B. (1975). Misuse of antibiotics. New England Journal of Medicine, 292, 216.
Accepted for publication
Amoebic mentary
16th January,
1981.
liver abscess-serum anticomplescreening for immune complexes MADAM-It was previously reported (ONYEWOTU, 1978) that compared with the radiobioassay (RBA), or rheumatoid factor binding (RFB) method for immune complex determination, the anticomplementary assay method, utilizing 51Cr-labelled sheep red blood cells for back titration of complement remaining in the test (MOWBRAY et al., 1973)
TRANSACTIONS OFTH~ROYALSOCIETYOFTROPICALMEDICINEANDHYGIENE,VOL.75,No.4,1981.
by the high prevalence of Endotrypanum and/or Trypanosoma spp. in the blood of at least 50% of the sloths examined, and the fact that approximately the same percentage of anteaters harboured T. legeri. Further observations are in progress on this aspect and a detailed study on the ecology of Lu. umbratilis, in relation to this sandfly’s role as the principal vector of L. b. guyanensis, is to be published shortly (Ready et al., in preparation). We are, etc., R. LAINSON*
hJ.SH;:* * The Wellcome Parasitology Unit*, Department of Parasitology, The Instituto Evandro Chagas, FundaGao SESP, Bele’m, Par& Brazil References Gentile, B., Le Pont, F. & Besnard, R. (1981). Dermal leishmaniasis in French Guiana: the sloth (Choloepus didactylus) as a reservoir host. Transactions of the Roval Societv of Troaical Medicine and &vgiene, 7$ 612-613: A Lainson, R., Ward, R. D. & Shaw, J. J. (1976). Cutaneous leishmaniasis in north Brazil: Lutzomyia anduzei as a major vector. Transactions of the Royal Society of Tropical Medicine and Hygiene, 70, 171-172. Lainson, R., Shaw, J. J., Ward, R. D., Ready, P. D. & Naiff, R. D. (1979). Leishmaniasis in Brazil: XIII. Isolation of Leishmania from armadillos (Dasypus novemcinctus) and observations on the epidemiology of cutaneous leishmaniasis in north Para State. Transactions of the Royal Society of Tropical Medicine and Hygiene, 73, 239-242. Lainson, R., Shaw, J. J., Ready, P. D., Miles, M. A. & Povoa; M. (198i). Leishmaniasis in -Brazil: XVI. Isolation and identification of Leishmania species from sandflies, wild mammals and man in north Para State, with particular reference to Leishmania braziliensis guy&semis, causative agent of “wian-bois”. Transactions of the Roval Society of T>opical Medicine and Hygiene, 75,!%30-536. ”
Accepted for publication
16th January,
1981.
Dermd leishmaniasis in French Guiana: the sloth (Choloepus didactylus) as a reservoir host MAD&r-Preliminary observations on the epidemiology of dermal leishmaniasis in French Guiana have recently been reported (LE PONT es al., 1980) and, in this report, the sandfly Lutzomyia umbratilis was incriminated as the major vector. In addition, two specimens of the rodent Proechimys were found infected with Leishmania : unfortunately the isolates were lost and the nature of the parasite remains uncertain. Infected sandflies were caught
CORRESPONDENCE
off man up to 92 feet in the forest canopy, suggesting a reservoir in arboreal animals. Subsequent attention was therefore given to such animals as kinkajous, sloths and primates. Most of the animals studied were trapped alive, in a proven focus of infection, and smears-from any skin lesions were stained with Giemsa’s stain. Each animal was then killed and small pieces of skin, liver and spleen triturated in saline without antibiotics. Suspensions were inoculated into the feet of hamsters and these were examined regularly, for up to one year, for any signs of infection. When a strain was isolated it was at once sub-inoculated into another hamster and cultured in a modified NNN medium: cultures were maintained at approximately 22-24°C. A total of 74 mammals (five orders and 14 species) was studied and the following found infected with Leishmania: one of seven kinkajous, Potosflavus; seven of 15 sloths, ChoZoepusdidactylus; and two of 19 rodents, Proechimys sp. Isolates were made from pools of organs (liver, spleen and skin). No infections were detected in the following: Marsupialia (opossums)-eight Didelphis mars&alis. two Metachirus nudicaudatus. five Philander opossum and one Marmosa murina; Primates (monkeys)-two Cebus nigrivittatus, two Alouatta sp. and two Marikina midas; Edentata-one Myrmecophaga tridactyla (giant anteater) and four Bradypus griseus (three-toed sloth); Rodentiatwo Dasyprocta acuchy (agouti) and one Coendou sp. (porcupine); Carnivora-three dogs (Canis familiaris). Five of the seven positive sloths came from Cacao, a forest village where dermal leishmaniasis has been very frequent among the Asian tribe (Hmongs): the other two were from another focus of human infection in Sinnamary. A number of hamsters developed typical nodules at the inoculation site, which appeared after six to eight weeks in animals inoculated with sloth material, and seven months in those injected with the kinkajou material. Isolates from a man, a sloth and a sandfly (Lu. umbratilis) were sent -to the Instituto Evandro Chanas. Belem. Para. Brazil. for identification. Afte; biological and biochemical characterization, they proved indistinguishable from each other and from all stocks of L. braziliensis guyanensis isolated from man, sandflies (Lu. umbratilis and Lu. whittetradactyla) and mani), anteaters (Tamandua sloths from north Brazil (LAINSON et al., 1979, 1981, 1981a). The high infection rate (46.7%) in C. didactylus is interesting, because Lu. umbratilis, which feeds very readily on this animal, becomes infected in the canopy during the dry season (SeptemberNovember). With the first rains, in late November, infected flies are found in abundance at ground level, where man becomes infected: the first human cases begin to appear at the end of December (LE PONT & PATOT, 1980). The sloth, C. didactylus, is likely to be the main reservoir of L. b. guianehsis in some active foci such as Cacao and Sinnamary, in French Guiana. Another species, C. hoffmanni, has already been shown to be the principal host of L. b. panamensis in Panama (HERRER et al., 1973).
TRANSACUONS
OF THE ROYAL
SOCIETY
OP
TROPICALMEDICINS
We are indebted to Dr. R. Lainson and his colleagues at the Instituto Evandro Chagas, BelCm, Par& Brazil for identification of parasites isolated. We are, etc., B. GENTILES F. LE I?ONT~ F. x. pAJOT
R. BESNAFCD~ IPasteur Institut of French Guiana, B.P. 304, 97305 Cayenne Cedes French Guiana ZOfJice de la Recherche Scientifque et Technique Outre-Mer, Centre ORSTOM, B.P. 165, 97301 Cayenne, French Guiana References Herrer, A., Christensen, H. A. & Beumer, R. J. (1973). Reservoir hosts of cutaneous leishmaniasis among Panamanian forest mammals. American Yournal of Tropical Medicine and Hygiene, 22, 585-591: Lainson, R., Shaw, J. J., Ward, R. D., Ready, I?. D. & Naiff, R. D. (1979). Leishmaniasis in Brazil: XIII: Isolati& of! Leishmania from armadillos (Dasypus novemcinctus) and observations on the epidemiology of cutaneous leishmaniasis in north Par& State. Transactions of the Royal Society of Tropical Medicine and Hygiene, 73, 239-242. Lainson, R., Shaw, J. J., Ready, I?. D., Miles, M. A. & I%voa, M. (1981). Leishmaniasis in Brazil: XVI. Isolation and identification of Leishmania species from sandflies, wild mammals and man in north ParL State, with particular reference to Leishmania braziliensis guyanensis, causative agent of “pian-bois”. Transactions of the Roval Societv of Tropical Medicine and Hygiene, 75, 530-536.” Lainson, R., Shaw, J. J. & I%voa, M. (1981). The importance of edentates (sloths and anteaters) as primarv reservoirs of Leishmania braziliensis in guyanensis; causative agent of “pian-bois” north Brazil. Transactions of the Roval Societv of Tropical Medicine and Hy&ne, 75,>11-612. s ” Le Pant, F. and Pajot, F. X. (1980). La leishmaniose en Guyane FranCaise. 1. Etude de 1’Ccologie et du taui d’infectibn naturelle du vecteur Lutzomvia umbratilis Ward et Fraiha, 1977 en saison s&he. Considerations CpidCmiologiques. Cahiers ORSTOM, Skrie Entomologie Me’dicale et Parasitologie, 18, 359-382. Le Pont, F., Pajot, F. X. & Reguer, M. (1980). Preliminary observations on the silvatic cycle of leishmaniasis in French Guiana. Transactions of the Royal Society of Tropical Medicine and Hygiene, 74, 133. Accepted for publication 16th January, 1981.
Chloramphenicol
resistant Salmonella typhi in Egypt MADAM-Chloramphenicol-resistant Salmonella typhi occurs most frequently in countries in which typhoid fever is endemic and the drug is freely
AND HYGIENE,
VOL.
75, No.
4,1981.
CORRBSPONDFIN~~
613
available (ANDERSON, 1975). We have therefore searched for resistant strains as part of a study on enteric fever conducted in Alexandria, Cairo,-and Uuner Ep.vnt from October 1978 to October 1980. OAiy ong”s&ain from 281 culture-positive typhoid fever patients was resistant to chloramphenicol. It was isolated from the stool of a patient in Qena and had an unusual resistance pattern as determined by the disc method; resistance to chloramphenicol and tetracycline, sensitivity to streptomycin, sulphadiazine, amnicillin, and kanamvcin. The minimum inhibit&y concen&ation of c-hloramphenicol was shown to be >50 pg/ml by plate dilution. Since attempts to transfer the resistance to Escherichia coli were unsuccessful, it appears that it is not due to an R factor. These data suggest that, despite the endemicity of typhoid fever (EL-AKKAD, 1970) and the accessibility and presumed over-use of (FARID et al., 1975) in Egypt, chloramphenicol chloramphenicol-resistant typhoid is not yet a significant problem. The oninions and assertions contained herein are the piivate ones of the authors and are not to be construed as official or as reflecting the views of the Department of the Navy or the naval service at large. This work was supported by the Naval Medical Research and Development Command, Bethesda, Maryland, under Work Unit No. MF58.524.0090090. We are, etc., J. E. .%PPEL A. S. DIAB I. A. MIKHAIL Bacteriology Department, U.S. Naval Medical Research Unit No. 3, c/o American Embassy, Cairo, Egypt. S. H. ISKANDAR Luxor Fevers Hospital, Luxor, Egypt References Anderson, E. S. (1975). The problem and implications of chloramphenicol resistance in the typhoid bacillus. Journal of Hygiene, 74, 289-299. El Akkad, A. M. (1970). Statistics and epidemiology of typhoid fever in UAR. Journal of the Egyptian Public Health Association, 45, 8-16. Farid, Z., Miner, W. F., Hassan, A. & Trabolsi, B. (1975). Misuse of antibiotics. New England Journal of Medicine, 292, 216.
Accepted for publication
Amoebic mentary
16th January,
1981.
liver abscess-serum anticomplescreening for immune complexes MADAM-It was previously reported (ONYEWOTU, 1978) that compared with the radiobioassay (RBA), or rheumatoid factor binding (RFB) method for immune complex determination, the anticomplementary assay method, utilizing 51Cr-labelled sheep red blood cells for back titration of complement remaining in the test (MOWBRAY et al., 1973)