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Am. J. Trop. Med. Hyg., 61(2), 1999, pp. 344-349
Copyright © 1999 by The American Society of Tropical Medicine and Hygiene

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American Journal of Tropical Medicine and Hygiene, Vol 61, Issue 2, 344-349
Copyright © 1999 by American Society of Tropical Medicine and Hygiene

Research Articles


An outbreak of acute bartonellosis (Oroya fever) in the Urubamba region of Peru, 1998

BA Ellis, LD Rotz, JA Leake, F Samalvides, J Bernable, G Ventura, C Padilla, P Villaseca, L Beati, R Regnery, JE Childs, JG Olson, and CP Carrillo

During May 1998, we conducted a case-control study of 357 participants from 60 households during an outbreak of acute bartonellosis in the Urubamba Valley, Peru, a region not previously considered endemic for this disease. Blood and insect specimens were collected and environmental assessments were done. Case-patients (n = 22) were defined by fever, anemia, and intra-erythrocytic coccobacilli seen in thin smears. Most case-patients were children (median age = 6.5 years). Case-patients more frequently reported sand fly bites than individuals of neighboring households (odds ratio [OR] = 5.8, 95% confidence interval [CI] = 1.2-39.2), or members from randomly selected households > or = 5 km away (OR = 8.5, 95% CI = 1.7-57.9). Bartonella bacilliformis isolated from blood was confirmed by nucleotide sequencing (citrate synthase [g/tA], 338 basepairs). Using bacterial isolation (n = 141) as the standard, sensitivity, specificity, and positive predictive value of thin smears were 36%, 96%, and 44%, respectively. Patients with clinical syndromes compatible with bartonellosis should be treated with appropriate antibiotics regardless of thin-smear results.


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Copyright © 1999 by the American Society of Tropical Medicine and Hygiene.