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

Am J Trop Med Hyg. 2015 Aug;93(2):340-346. doi: 10.4269/ajtmh.15-0107. Epub 2015 Jun 15.

Abstract

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.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Adolescent
  • Antimony Sodium Gluconate / therapeutic use
  • Disease Outbreaks*
  • Female
  • Humans
  • Leishmania braziliensis / isolation & purification*
  • Leishmania guyanensis / isolation & purification
  • Leishmaniasis, Cutaneous / drug therapy
  • Leishmaniasis, Cutaneous / epidemiology*
  • Male
  • Military Personnel*
  • Peru / epidemiology
  • Real-Time Polymerase Chain Reaction
  • Surveys and Questionnaires
  • Young Adult

Substances

  • Antimony Sodium Gluconate