Outbreak of Cutaneous Leishmaniasis in Peruvian Military Personnel Undertaking Training Activities in the Amazon Basin, 2010

Oré,Marianela; Sáenz, Eliana; Sanchez, Juan F.; De Los Santos, Maxy; Lucas, Carmen M.; Núñez, Jorge; Edgel, Kimberly A.; Sopan, Justino; Fernández, Jorge; Carnero, G, Andres M.; Baldeviano, Christian; Arrasco, Juan C.; Graf, Paul C. F.; Lescano, Andres G.; Cabrera, Rufino · Universidad Peruana de Ciencias Aplicadas (UPC) (2015) · DOI: 10.4269/ajtmh.15-0107

Resumen

Military personnel deployed to the Amazon Basin are at high risk for cutaneous leishmaniasis (CL). We responded to an outbreak among Peruvian Army personnel returning from short-term training in the Amazon, conducting active case detection, lesion sample collection, and risk factor assessment. The attack rate was 25% (76/303); the incubation period was 2–36 weeks (median = 8). Most cases had one lesion (66%), primarily ulcerative (49%), and in the legs (57%). Real-time polymerase chain reaction (PCR) identified Leishmania (Viannia) braziliensis (59/61 = 97%) and L. (V.) guyanensis (2/61 = 3%). Being male (risk ratio [RR] = 4.01; P = 0.034), not wearing long-sleeve clothes (RR = 1.71; P = 0.005), and sleeping in open rooms (RR = 1.80; P = 0.009) were associated with CL. Sodium stibogluconate therapy had a 41% cure rate, less than previously reported in Peru (70%; P < 0.001). After emphasizing pre-deployment education and other basic prevention measures, trainees in the following year had lower incidence (1/278 = 0.4%; P < 0.001). Basic prevention can reduce CL risk in deployed militaries.

Instituciones: Universidad Peruana de Ciencias Aplicadas