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HUMAN TRYPANOSOMIASIS CAUSED BY TRYPANOSOMA EVANSI IN INDIA: THE FIRST CASE REPORT

We report an Indian farmer who had fluctuating trypanosome parasitemia associated with febrile episodes for five months. Morphologic examination of the parasites indicated the presence of large numbers of trypanosomes belonging to the species Trypanosoma evansi, which is normally a causative agent of animal trypanosomiasis known as surra. Basic clinical and biologic examinations are described, using several assays, including parasitologic, serologic, and molecular biologic tests, all of which confirmed the infecting species as T. evansi. Analysis of cerebrospinal fluid indicated no invasion of the central nervous system (CNS) by trypanosomes. Suramin, a drug used exclusively for treatment of early-stage human African trypanosomiasis with no CNS involvement, effected apparent cure in the patient. This is the first case reported of human infection due to Trypanosoma evansi, which was probably caused by transmission of blood from an infected animal.

Received February 7, 2005. Accepted for publication March 30, 2005.

Acknowledgments: We thank Dr. S. Salunke, Dr. P. P. Doke, Dr. A. Chaudhari, and Dr. A.R. Thosar in India for their cooperation. We also thank Professor P. Büscher (Institute of Tropical Medicine, Antwerp Belgium), Professor E. Delaporte (Institut de Recherche pour le Développement, Montpellier France) for their kind help. We warmly thank Dr. M. Barrett (University of Glasgow, Glasgow, United Kingdom) for his critical reading of the manuscript.

Financial support: This work was supported by the Directorate of Health Services, Maharashstra State, India, the World Health Organization, and the Institut de Recherche pour le Développement, France.

^* Address correspondence to Philippe Truc, Institut de Recherche pour le Développement, Unité de Recherche 117 Trypanosomoses Africaines, TA 207/G Campus International de Baillarguet, 34 398 Montpellier Cedex 5, France. E-mail: truc{at}mpl.ird.fr

Authors’ addresses: Prashant P. Joshi and Harsha R. Salkar, Department of Medicine, Government Medical College, Nagpur, India. Vijay R. Shegokar, Rajaram M. Powar, and Aradhana Bhargava, Department of Microbiology, Government Medical College, Nagpur, India. Stephane Herder and Philippe Truc, Institut de Recherche pour le Développement, Unité de Recherche 117 Trypanosomoses Africaines, TA 207/G, Campus International de Baillarguet, 34 398 Montpellier Cedex 5, France. Rahul Katti, Directorate of Health Services, Maharashtra State, Mumbay, India. Vibhawari S. Dani, Government Medical College, Nagpur, India. Jean Jannin, Communicable Diseases Control, Prevention and Eradication, World Health Organization, 1211 Geneva 27, Switzerland.

Reprint requests: Philippe Truc, Institut de Recherche pour le Développement, Unité de Recherche 117 Trypanosomoses Africaines, TA 207/G Campus International de Baillarguet, 34 398 Montpellier Cedex 5, France, Telephone: 33-6-11-88-88-28, Fax: 33-4-67-59-39-20. E-mail: truc{at}mpl.ird.fr.

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