Volume 88, Issue 3
  • ISSN: 0002-9637
  • E-ISSN: 1476-1645



Cutaneous leishmaniasis is endemic in Salta, the northwestern province of Argentina. We describe an outbreak involving five recreational hunters whose exposure was limited to several hours in a residual patch of primary forest. All patients presented with typical cutaneous lesions after a mean incubation period of 59 days (range 15–78), and one developed simultaneous mucosal involvement. Polymerase chain reaction analysis of lesions confirmed () as the etiologic agent in three cases. All patients were cured with anti- treatment. Entomologic surveys in the transmission area revealed a predominance of . This outbreak report confirms a microfocal transmission pattern of tegumentary leishmaniasis in the Americas and based on a well-determined exposure, allows the determination of incubation times for leishmaniasis caused by .


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  1. Desjeux P, , 2001. Worldwide increasing risk factors for leishmaniasis. Med Microbiol Immunol (Berl) 190: 7779.[Crossref] [Google Scholar]
  2. Salomon OD, Zaidenberg M, Burgos R, Heredia VI, Caropresi SL, , 2001. American cutaneous leishmaniasis outbreak, Tartagal city, province of Salta, Argentina, 1993. Rev Inst Med Trop Sao Paulo 43: 105108.[Crossref] [Google Scholar]
  3. Gil JF, Nasser JR, Cajal SP, Juarez M, Acosta N, Cimino RO, Diosque P, Krolewiecki AJ, , 2010. Urban transmission of American cutaneous leishmaniasis in Argentina: spatial analysis study. Am J Trop Med Hyg 82: 433440.[Crossref] [Google Scholar]
  4. Salomon OD, Sosa Estani S, Canini L, Cordoba Lanus E, , 2001. Tegumentary leishmaniasis in area with epidemic levels of transmission, Salta, Argentina, 1998. Medicina (B Aires) 61: 284290. [Google Scholar]
  5. Sosa-Estani S, Segura EL, Gomez A, Salomon OD, Peralta M, Coutada V, Ruiz LM, , 2001. Cutaneous leishmaniasis in northern Argentina: identification of risk factors in a case-cohort study of three municipalities in Salta. Rev Soc Bras Med Trop 34: 511517.[Crossref] [Google Scholar]
  6. Krolewiecki AJ, Romero HD, Cajal SP, Abraham D, Mimori T, Matsumoto T, Juarez M, Taranto NJ, , 2007. A randomized clinical trial comparing oral azithromycin and meglumine antimoniate for the treatment of American cutaneous leishmaniasis caused by Leishmania (Viannia) braziliensis . Am J Trop Med Hyg 77: 640646. [Google Scholar]
  7. Marco JD, Barroso PA, Calvopina M, Kumazawa H, Furuya M, Korenaga M, Cajal SP, Mora MC, Rea MM, Borda CE, Basombrio MA, Taranto NJ, Hashiguchi Y, , 2005. Species assignation of Leishmania from human and canine American tegumentary leishmaniasis cases by multilocus enzyme electrophoresis in north Argentina. Am J Trop Med Hyg 72: 606611. [Google Scholar]
  8. Barrio A, Parodi CM, Locatelli F, Mora MC, Basombrio MA, Korenaga M, Hashiguchi Y, Garcia Bustos MF, Gentile A, Marco JD, , 2012. Leishmania infantum and human visceral leishmaniasis, Argentina. Emerg Infect Dis 18: 354355.[Crossref] [Google Scholar]
  9. Cordoba-Lanus E, De Grosso ML, Pinero JE, Valladares B, Salomon OD, , 2006. Natural infection of Lutzomyia neivai with Leishmania spp. in northwestern Argentina. Acta Trop 98: 15.[Crossref] [Google Scholar]
  10. Walton BC, Person DA, Bernstein R, , 1968. Leishmaniasis in the U.S. military in the Canal Zone. Am J Trop Med Hyg 17: 1924. [Google Scholar]
  11. Salomon OD, Sosa Estani S, Monzani AS, Studer C, , 2001. Epidemic outbreak of tegumentary leishmaniasis in Puerto Esperanza, Misiones, 1998. Medicina (B Aires) 61: 385390. [Google Scholar]
  12. Jumaian N, Kamhawi SA, Halalsheh M, Abdel-Hafez SK, , 1998. Short report: Outbreak of cutaneous leishmaniasis in a nonimmune population of soldiers in Wadi Araba, Jordan. Am J Trop Med Hyg 58: 160162. [Google Scholar]
  13. Takafuji ET, Hendricks LD, Daubek JL, McNeil KM, Scagliola HM, Diggs CL, , 1980. Cutaneous leishmaniasis associated with jungle training. Am J Trop Med Hyg 29: 516520. [Google Scholar]
  14. Desjeux P, , 2004. Leishmaniasis: current situation and new perspectives. Comp Immunol Microbiol Infect Dis 27: 305318.[Crossref] [Google Scholar]
  15. Chaves LF, Cohen JM, Pascual M, Wilson ML, , 2008. Social exclusion modifies climate and deforestation impacts on a vector-borne disease. PLoS Negl Trop Dis 2: e176.[Crossref] [Google Scholar]
  16. Marcondes C, , 1996. A redescription of Lutzomyia (Nyssomyia) intermedia (Lutz & Neiva, 1912), and resurrection of L. neivai (Pinto, 1926) (Diptera: Psychodidae, Phlebotominae). Mem Inst Oswaldo Cruz, Rio de Janeiro 91: 457462.[Crossref] [Google Scholar]
  17. Frank FM, Fernandez MM, Taranto NJ, Cajal SP, Margni RA, Castro E, Thomaz-Soccol V, Malchiodi EL, , 2003. Characterization of human infection by Leishmania spp. in the northwest of Argentina: immune response, double infection with Trypanosoma cruzi and species of Leishmania involved. Parasitology 126: 3139.[Crossref] [Google Scholar]
  18. Gil JF, Hoyos CL, Cimino RO, Krolewiecki AJ, Lopez Quiroga I, Cajal SP, Juarez M, Garcia Bustos MF, Mora MC, Marco JD, Nasser JR, , 2011. Role of three ELISA tests using promastigote homogenates of Leishmania braziliensis, L. amazonensis and L. guyanensis in the diagnosis of tegumentary leishmaniasis. Medicina (B Aires) 71: 420428. [Google Scholar]
  19. du Breuil RM, Patel JM, Mendelow BV, , 1993. Quantitation of beta-actin-specific mRNA transcripts using xeno-competitive PCR. PCR Methods Appl 3: 5759.[Crossref] [Google Scholar]
  20. Dweik A, Schonian G, Mosleh IM, Karanis P, , 2007. Evaluation of PCR-RFLP (based on ITS-1 and HaeIII) for the detection of Leishmania species, using Greek canine isolates and Jordanian clinical material. Ann Trop Med Parasitol 101: 399407.[Crossref] [Google Scholar]
  21. Passos VM, Lasmar EB, Gontijo CM, Fernandes O, Degrave W, , 1996. Natural infection of a domestic cat (Felis domesticus) with Leishmania (Viannia) in the metropolitan region of Belo Horizonte, State of Minas Gerais, Brazil. Mem Inst Oswaldo Cruz 91: 1920.[Crossref] [Google Scholar]
  22. Schonian G, Nasereddin A, Dinse N, Schweynoch C, Schallig HD, Presber W, Jaffe CL, , 2003. PCR diagnosis and characterization of Leishmania in local and imported clinical samples. Diagn Microbiol Infect Dis 47: 349358.[Crossref] [Google Scholar]
  23. Sosa-Estani S, Segura EL, Salomon OD, Gomez A, Peralta M, Coutada V, Ruiz LM, , 2000. Tegumentary leishmaniasis in northern Argentina: distribution of infection and disease, in three municipalities of Salta, 1990–1992. Rev Soc Bras Med Trop 33: 573582.[Crossref] [Google Scholar]
  24. Quintana MG, Salomon OD, De Grosso MS, , 2010. Distribution of phlebotomine sand flies (Diptera: Psychodidae) in a primary forest-crop interface, Salta, Argentina. J Med Entomol 47: 10031010.[Crossref] [Google Scholar]
  25. Sanchez JL, Diniega BM, Small JW, Miller RN, Andujar JM, Weina PJ, Lawyer PG, Ballou WR, Lovelace JK, , 1992. Epidemiologic investigation of an outbreak of cutaneous leishmaniasis in a defined geographic focus of transmission. Am J Trop Med Hyg 47: 4754. [Google Scholar]
  26. Andrade MS, Brito ME, Silva ST, Ishikawa E, Carvalho SM, Brandao-Filho SP, , 2009. New outbreak of American tegumentary leishmaniasis in a military training center in the Zona da Mata region, in the north of the State of Pernambuco. Rev Soc Bras Med Trop 42: 594596.[Crossref] [Google Scholar]
  27. Melby PC, , 1991. Experimental leishmaniasis in humans: review. Rev Infect Dis 13: 10091017.[Crossref] [Google Scholar]
  28. Kerr S, Emmons L, Melby P, Liu C, Perez L, Villegas M, Miranda R, , 2006. Leishmania amazonensis infection in Oryzomys acritus and Oryzomys nitidus from Bolivia. Am J Trop Med Hyg 75: 10691073. [Google Scholar]
  29. Telleria J, Bosseno M, Tarifa T, Buitrago R, Martinez E, Torrez M, Le Pont F, Brenière S, , 1999. Putative reservoirs of Leishmania amazonensis in a sub-andean focus of Bolivia identified by kDNA-polymerase chain reaction. Mem Inst Oswaldo Cruz 94: 56.[Crossref] [Google Scholar]
  30. Wasserberg G, Abramsky Z, Kotler B, Ostfeld R, Yarom I, Warburg A, , 2003. Anthropogenic disturbances enhance occurrence of cutaneous leishmaniasis in Israel deserts: patterns and mechanisms. Ecol Appl 13: 868881.[Crossref] [Google Scholar]
  31. Keesing F, Holt RD, Ostfeld RS, , 2006. Effects of species diversity on disease risk. Ecol Lett 9: 485498.[Crossref] [Google Scholar]
  32. Gil JF, Nasser JR, Cajal SP, Juarez M, Acosta N, Cimino RO, Diosque P, Krolewiecki AJ, , 2010. Urban transmission of American cutaneous leishmaniasis in Argentina: spatial analysis study. Am J Trop Med Hyg 82: 433440.[Crossref] [Google Scholar]
  33. Despommier D, Ellis B, Wilcox B, , 2006. The role of ecotones in emerging infectious diseases. EcoHealth 3: 281289.[Crossref] [Google Scholar]
  34. Dobson A, , 2004. Population dynamics of pathogens with multiple host species. Am Nat 164 (Suppl 5): S64S78.[Crossref] [Google Scholar]

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  • Received : 03 Aug 2012
  • Accepted : 11 Dec 2012
  • Published online : 06 Mar 2013

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