Archive for the ‘Graphs’ Category

Q-fever in Spain

Friday, May 3rd, 2013

The following background data on Q-fever in Spain are abstracted from Gideon and the Gideon e-book series. [1,2]

Time and Place:
The first cases of Q-fever in Spain were reported in 1950. Q-fever rates are highest in the Basque region (accounting for 60% of community-acquired pneumonias) and Navarre. Pneumonia is the predominant clinical presentation in the north, and hepatitis in the south. Ten outbreaks were registered during 1981 to 1985. 130 cases of Q-fever were reported in the Basque Country during 1981 to 1984; and 1,261 cases in Gipuzkoa (Basque Country) during 1984 to 2004.

Rates of Q-fever in Spain have been decreasing for over 25 years – see graph:


Prevalence surveys:
5% of community-acquired pneumonia in Palma de Mallorca (1992 to 1994)
18.5% of community-acquired pneumonia (2006 to 2007)
30% of patients with fever exceeding 7 days
20.1% of women with spontaneous abortion vs. 9.7% of controls (Burgos, 2009 to 2010)
13.7% of patients hospitalized with fever lasting 1 to 4 weeks (Grenada, 2000 to 2005)
3% of ovine flocks in northern Spain (1999 to 2003)
22% of sheep flocks in the Basque Country (2009 publication)
5.1% of roe deer (Capreolus capreolus), 4.3% of wild boar (Sus scrofa), 9.1% of European hare (Lepus europaeus), 11% of vultures (Gyps fulvus) , 14% of black kites (Milvus migrans) and 0% of associated ticks (Basque region, 2010 publication)

Coxiella burnetii has been detected in ticks (Haemaphysalis punctata) in the Basque Country (2003 to 2005)

Seroprevalence surveys:
50% of persons in rural Soria Province (1996 to 1999)
38.5% of adults in the rural Basque Country (1993 publication)
40.6% of adults in Leon Province (1996 publication)
48.6% of adults in Eastern Cantabria (1998 publication)
10.02% to 11.02% of veterinary students in Zaragoza (2000 publication)
15.3% of the population of Valles Occidental (2006 publication)
23.1% of blood donors in Albacete (2007 publication)
11.8% of sheep, 8.7% of goats and 6.7% of beef cattle in semi-extensive grazing systems in northern Spain (2010 publication)
30% of herds and 6.76% of cattle in the Madrid region (2012 publication)

Notable outbreaks:
1982 – An outbreak (42 cases) of Q-fever was reported in Valmaseda, Basque region.
1990 – An outbreak (30 cases) was reported in Billabona and Zizurkil, Guipuzcoa.
1998 – An outbreak (14 cases) related to sheep was reported in Soria Province.
2003 – An outbreak (60 cases) was reported in Asturias.
2006 (publication year) – An outbreak (22 cases) was associated with a visit to a school farm.
2012 (publication year) – An outbreak was reported in flock of sheep.

1. Berger SA. Infectious Diseases of Spain, 2013. 575 pages, 194 graphs, 3284 references. Gideon e-books,
2. Berger SA. Q-fever: Global Status, 2013. 78 pages, 58 graphs, 1035 references. Gideon e-books,

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Barmah Forest Disease in Australia

Tuesday, April 16th, 2013

The following background on Barmah Forest Disease in Australia is abstracted from Gideon and the Gideon e-book series. [1,2]

Barmah Forest disease virus was first isolated from mosquitoes (Culex annulirostris) in the Barmah Forest, Northern Victoria in 1974. Human infection was subsequently reported along the south coast of New South Wales during the mid-1980′s; in Queensland during 1988 to 1989; in the Northern Territory in 1992 ; and in southwestern Western Australia in 1993. A new focus was described in Gippsland (Victoria) during 1993 to 1994. The number of localities reporting Barmah Forest Disease increased during 1996 to 1998, and again during 1999 to 2001.

Disease incidence has increased somewhat since 2000, with most cases reported from Queensland and New South Wales. In the following chart, I have contrasted incidence data for Barmah Forest disease with those of a similar illness, Ross River disease [3]


Seroprevalence surveys:
6.5% of healthy adults in Queensland.
11.3% of horses in Brisbane, 1.2% of dogs, 10.7% of bushtail possum (Trichosaurus volpecula) , 1.5% of cats, 0% of flying foxes (1977 to 1999) 8

- The known vectors are Ochlerotatus vigilax, Culex annulirostris, Ae. (Oc.) camptorhynchus, Ae. normanensis and Coquillettidia species.
- Aedes notoscriptus is considered an additional potential vector.
- BFD virus has also been recovered from Aedes vigilax in eastern Australia (2005 to 2008)

Wallabies and kangaroos serve as reservoirs for the virus; however, antibody is also present in cattle and horses.

Related viruses:
- Similar local illnesses have been ascribed to Trubanaman and Gan Gan viruses (Bunyaviridae); and Kokobera, Stratford and Edge Hill viruses (Flaviviridae).
- A single human case of Edge Hill virus infection has been described.
- A case of Kokobera fever was reported from Darwin in 1998.
- Kokobera virus has been isolated from Culex annulirostris in the Northern Territory and northern Queensland.
- Kokobera virus was isolated from 18 of 25,351 Cx. annulirostris tested in Cape York in 1998.

Notable outbreaks:
1992 to 1994 – An outbreak (22 cases) of Barmah Forest disease was reported in the south-west of Western Australia.
1995 – An outbreak (135 cases) was reported along the south coast of New South Wales.
2002 – An outbreak (47 cases) was reported in Victoria.
2002 to 2003 – An outbreak (297 cases) was reported in Queensland.
2005 to 2006 – An outbreak (1,895 cases) was reported.

1. Berger SA. Infectious Diseases of Australia, 2013. 540 pages, 162 graphs, 3364 references.
2. Berger SA. Australo-Pacific Arboviruses: Global Status, 2013. 32 pages, 20 graphs, 307 references.
3. Gideon Graph Tool, see tutorial at

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Botulism in Argentina

Saturday, March 16th, 2013

The following background data on botulism in Argentina are abstracted from the Gideon e-book series. [1,2]

Most cases of botulism in Argentina are related to home-canned vegetables, airtight packed food with inappropriate refrigeration, and aerosols. Rates of food-borne botulism have remained fairly constant for the past 20 years, and as in many other countries are exceded by those of infant botulism – see graph [3] Virtally all cases of infant botulism have been caused by type A botulinum toxin.


Prevalence surveys (Clostridium botulinum spores):
7.5% of commercial chamomile tea samples (Mendoza, 2008 publication)
1.1% of rural commercial honey samples (Mendoza and San Luis Provinces, 1997 publication)
14.6% of soil samples in Entre Rios (2003 publication)
23.5% of soil samples from five regions (2005 publication)

Linden flower (Tilia spp) tea, a household remedy used as an infant sedative, has also been implicated as a source of Clostridium botulinum.

A single case report of wound botulism was published in 2000.

Notable outbreaks:
1920 to 1926 – Two outbreaks (total 8 cases) of botulism were reported.
1974 – An outbreak (11 cases, 3 fatal) was ascribed to cheese spread.
1979 – An outbreak (9 cases) was ascribed to home-canned vegetables.
1982 – An outbreak (1 case) in Mendoza was ascribed to pickled trout.
1998 – An outbreak (9 cases, none fatal) of type A botulism among Buenos Aires bus drivers was ascribed to matambre (meat roll).
2011 – An outbreak (2 cases) was reported among members of a family from Chile who had eaten in a restaurant in Argentina.

1. Berger SA. Infectious Diseases of Argentina, 2013. 447 pages, 103 graphs, 2145 references. Gideon e-books,
2. Berger SA. Botulism: Global Status, 2013. 85 pages, 90 graphs, 645 references. Gideon e-books,
3. Gideon Graph Tool, see tutorial at

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Botulism Trends in the United States

Sunday, January 20th, 2013

Infants account for most cases of botulism reported in the United States. Although the ratio of infant / food-borne cases was fairly constant prior to 1999, subsequent trends appear to signal a parallel increase in infant and decrease in food-borne botulism. [1,2] See graph [3]


1. Berger SA. Infectious Diseases of the United States, 2012. 1089 pages, 467 graphs, 9760 references. Gideon e-books,
2. Berger SA. Botulism: Global Status, 2012. 84 pages, 89 graphs, 599 references. Gideon e-books,
3. Gideon Graph Tool, see tutorial at

Crimean-Congo Hemorrhagic Fever in South Africa

Tuesday, January 15th, 2013

The following background data are abstracted from Gideon and the Gideon e-book series. [1,2]

Time and Place:
The first indigenous case of Crimean-Congo hemorrhagic fever (CCHF) in South Africa was reported in 1981 – fatal infection acquired in Transvaal.
- At the time of the report, 7% of persons in the area were found to be seropositive.
- Highest incidence is reported in the Karoo, the Western Free State, the Northern Cape and North West Province.
- Most patients are farmers, farm laborers, hunters or abattoir workers.
- 101 cases were reported during 1981 to 1992; 81 during 1993 to 2010.
- 16 outbreaks were reported among animals during 1981 to 1986.
- Imported cases were reported in 1985 (from Democratic Republic of Congo) and 1986 (from Tanzania).

CCHF: Reported cases and deaths per year – see graph [3] :


Seroprevalence surveys:
100% of giraffe (Giraffa camelopardalis), 54% of rhinoceros (Ceratotherium simium and Diceros bicornis), 46% of eland (Taurotragus oryx), 19.5% of buffalo (Syncerus caffer), 22% of kudu (Tragelaphus strepsiceros), 17% of zebra (Equus burchelli), 6.0% of domestic dogs, 13.7% of hares, 1.7% of rodents and 0% of primates (South Africa and Zimbabwe, 1987 publication)
28% of cattle (1987 publication)

- The principal vector is Hyalomma truncatum.
- H. marginatum rufipes and H. m. turanicum have also been incriminated.

Notable outbreaks:
1984 – An outbreak (5 cases, 1 fatal) of Crimean-Congo hemorrhagic fever was reported in Orange Free State.
1985 – An outbreak (6 cases, 1 fatal) was reported at a hospital near Cape Town, among health-care workers who had contact with an index patient or his secretions.
1996 – An outbreak (32 suspect cases, 17 confirmed; one fatal) was reported at an ostrich abattoir in Oudtshoorn (Western Cape).

1. Berger SA. Infectious Diseases of South Africa, 2012. 436 pages, 95 graphs, 1942 references. Gideon e-books,
2. Berger SA. Crimean-Congo Hemorrhagic Fever: Global Status. 2012. 36 pages, 18 graphs, 505 references. Gideon e-books,
3. 3. Gideon Graph Tool, see tutorial at

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Vaccination Uptake in Afghanistan

Tuesday, January 1st, 2013

Although childhood vaccination has registered considerable success during the past three decades, Afghanistan continues to lag behind other nations in the region. In the following charts I have contrasted WHO estimates of vaccine uptake in Afghanstan with those of bordering countries. [1-3]


1. Berger SA. Infectious Diseases of Afghanistan, 2012. 326 pages, 37 graphs, 1239 references. Gideon e-books,
3. Gideon Graph Tool, see tutorial at

Note featured on ProMED

Scrub Typhus in China

Friday, November 30th, 2012

The following background data are abstracted from Gideon and the Gideon e-book series. [1,2]

Time and Place:
Although “chigger fever” may have been described in China as early as 313 C.E., the disease was first reported in Kunming (Yunnan Province) in 1942. Foci of scrub typhus exist in Jiangsu, Liaoning, Shandong, Fujian, Zhejiang, Jiangsu, Jelin, Jenan, Heilongjiang, Hainan, Hunchun, Tibet, Hang Zhou City and Tianjin City. The disease was first reported in Hubei Province in 1997. Newly-discovered foci were reported in the Nan Peng Lie Islands in 2002 and in Fuyang City, Anhui Province in 2008.

Epidemics occur approximately every 20 years, with variable clinical severity (the most severe disease reported from Shanxi Province). In most of the country, cases tend to appear in May 14 , peak during June and July, and decrease in August. Peak incidence in Sichuan and Yunnan occurs in August; September to November in Shandong. Most cases of scrub typhus in Hong Kong are reported in adults, and during the summer and fall.

Yearly incidence data are not available for China as a whole; however, reports from Hong Kong and other regional countries suggest that rates of scrub typhus have been increasing since the 1980′s – see graph [3]

Additional geographic notes:
Fujian – Over 1% of persons on Pingtan Island developed scrub typhus during the 1950′s, with a case-fatality rate of 13.6%. 28 cases were reported on the island during 2000 to 2005.
Guangzhou – Over 500 cases were reported during 1952 to 1954, 5.4% fatal.
Hainan – Over 10,000 cases were reported during 1956 to 1985.
Hong Kong – 136 cases (0 fatal) of scrub typhus were reported in Hong Kong during 1999 to 2008
Shandong – 1,291 cases were reported during 2006 to 2010 – 49.5% above age 55, and m/f = 1/1.02. 480 cases were reported from Feixian County during 1995 to 2006; and 56 cases of pediatric infection were reported in Fei County during 1993 to 2004.

Prevalence surveys:
16.13% of mice in Xinyang, Henan Province (2007 publication)

Seroprevalence surveys:
36.1% of healthy persons in Xinjiang Uygur Autonomous region (1980′s)
31.8% of persons on Hainan Island (1983)
6.3% of healthy farmers in Yiyuan County, Shandong Province (2005 to 2007)
1.8% to 39.8% of farm workers near Tianjin (2007 to 2009)

The local reservoirs are Rattus flavipectus, R. niviventer, R. losea, R. rattus, R. norvegicus, R. confucianus and Apodemis agrarius. Rodents and mites coinfected by Hantavirus and Orientia tsutsugamushi have been identified in endemic areas. A known mite vector, Leptotrombidium scutellare, has been identified on 30 species of rodents in Yunnan.

The local vectors are Leptotrombidium pallidum, L. deliense (Hong Kong), L. scutellare (Shandong Province and Yunnan Province) and L. gaohuensis (Zhejiang Province). L. intermedium has also been identified as a possible vector.

Published outbreaks:
1986 – An outbreak (138 cases) of scrub typhus was reported in Menying County, Shandong Province.
2007 (publication year) – An outbreak (19 cases) was reported in Henan Province.

1. Berger SA. Infectious Diseases of China, 2012. 685 pages, 261 graphs, 3848 references. Gideon e-books,
2. Berger SA. Australo-Asian Spotted Fevers: Global Status, 2012. 41 pages, 14 graphs, 392 references, Gideon e-books,
3. Gideon Graph Tool, see tutorial at

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Brucellosis in Spain

Sunday, November 18th, 2012

Rates of human brucellosis in Spain and surrounding countries have been decreasing for several years. As recently as 1990, reports suggested that brucellosis was as common as salmonellosis – see graphs [1-3]


1. Berger SA. Infectious Diseases of Spain, 2012. 557 pages, 194 graphs, 2850 references. Gideon e-books,
2. Berger SA. Brucellosis: Global Status, 2012. 130 pages, 135 graphs, 833 references.
3. Gideon Graph Tool, see tutorial at

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Visceral Leishmaniasis in Brazil

Sunday, November 11th, 2012

The following review of visceral leishmaniasis in Brazil is abstracted from Gideon and the Gideon e-book series. [1-2] Primary references are available on request.

Time and Place:
- Visceral leishmaniasis was first described in Brazil in 1934 and first reported from Rio de Janeiro state in 1977.
- Brazil accounts for over 90% of cases in the New World.
- 90% of cases are reported from the north (mouth of Amazon) and eastern region.
- 44,289 cases were reported during 1980 to 2000 – 89.9% of these from the northeast
- The disease is endemic to Alagoas, Bahia , Ceara, Espirito Santo, Goias, Maranhao , Mato Grosso do Sul, Minas Gerais, Para, Paraiba, Pernambuco, Piaui , Rio Grande do Norte, Roraima and Sergipe.
- Urban transmission was first reported in 1981, from Teresina (Piaui State).
- A large focus extends from Roraima into Venezuela and Guyana.

Annual rates have remained fairly constant since 1995, and are strikingly similar to those reported in India – see graph [3] : 95 to 278 fatal cases per year were reported during this period – see graph.

Incidence by district and state:
- Aracatuba (Sao Paulo) reported 43 cases (4 fatal) in 2002.
- Bahia reported 12,413 cases during 1985 to 1999. 7% of municipalities were endemic in 1985; 18% in 1990; 30% in 1996.
- Belo Horizonte reported only one case prior to 1994; 35 during an epidemic in 1994.
- Brasilia, Federal District reported 21 autochthonous cases during 2005 to 2009.
- Ceara: Fortaleza registered 1,379 cases during 2001 to 2006.
- Ipanema, Minas Gerais reported six cases during September 2009 to February 2010.
- Mato Grosso reported 123 cases of canine infection in 2007; 301 (and 6 cases of human infection) in 2008.
- Mato Grosso do Sul reported 114 cases (9 fatal) in 2001; 25 (6 fatal) during January to April 2002; 149 (12 fatal) during 2000 to 2003. 10 577 cases were reported in Campo Grande in 2001.
- Natal reported 316 cases Natal during 1989 to 1993.
- Pernambuco reported 1,310 cases during 1990 to 1999; 427 during 2000 to 2001.
- Piaui and Maranhao reported 1,400 cases in 1994 (over 50% of Brazilian cases).
- Rio de Janeiro reported 87 cases during 1977 to 2006.
- Roraima reported 82 cases among Indians during 1989 to 1993.
- Teresina reported almost 1,000 cases during 1981 to 1985; 1,200 during 1993 to 1996.
- Tres Lagoas, Mato Grosso do Sul State reported 149 cases during 2000 to 2003.

Prevalence surveys:
0.3% of solid organ transplant recipients (2001 to 2006)
1% of renal transplant recipients in Fortaleza, Ceara State (2008 publication)

Seroprevalence surveys:
4.5% of inhabitants of 15 villages (L. infantum, Paco do Lumiar County, 2007 publication)
4.8% to 20% of asymptomatic inhabitants of northeastern Sao Paulo (2007 publication)
20.6% of persons in rural Rio Grande do Norte (2008 publication)
24.6% of asymptomatic persons in Natal (2011 publication)
47% in Pancas, Espirito Santo (2003 to 2004)
18.9% of persons in Raposa, Maranhao State (2011 publication)
12.6% of persons in Barcarena, PA (2003)
24.4% of persons in an endemic region of Para State (2008 publication)
22.3% of hemodialysis patients in Natal (2009 publication)

The rate of infection among children ages 1 to 11 years in rural Ceara is 4.6% per year (1987 to 1989).
- 61.7% of children age – Acquisition through blood transfusion has been reported. Nine percent of volunteer blood donors and 37% of multiply-transfused hemodialysis patients from Natal (Rio Grande do Norte) are seropositive (1994 to 1996).

HIV-AIDS and visceral leishmaniasis:
25 cases of HIV-Leishmania coinfection were reported to November 1995; 100 to June 2003.
- An additional 15 cases were reported in a 2009 publication.
- The estimated rate of visceral leishmaniasis among HIV-positive patients treated at a tertiary medical center in Brasilia was 16% (2009 publication) 31
- HIV-positive patients with visceral leishmaniasis were found to have a mean age of 37.3 years, vs. 12.5 years among HIV-negative leishmaniasis patients. Co-infected patients were more likely to be male (88% vs. 65%, Rio Grande do Norte, 1990 to 2009).
- Asymptomatic leishmaniasis was identified in 10.8% of HIV-positive patients (ELISA, Minas Gerais, 1999 to 2001)

- Dogs are key reservoirs in this country; in addition to foxes (Cerdocyon thous) in northeastern Brazil.
- The role of additional fox species (Dusicyon vetulus) in the north; and of opossums (Didelphis albiventris and D. marsupialis ) is unclear.
- Leishmania chagasi infection has been documented in a bush dog (Speothos venaticus) in Mato Grosso State (2007 publication)
- The first case in the Americas of natural infection in a cat (Felis catus) was reported from Sao Paulo State.
An infected cat was subsequently identified in Belo Horizonte City.
5.8% of cats in Andradina Municipality, Sao Paulo State were found to be infected (2010 publication)
21.85% of cats in an endemic area of Sao Paulo State were found to be infected (2012 publication)
23.0% of cats in Aracatuba, Sao Paulo State were found to be seropositive (CAG-ELISA, 2011 publication)
49.1% of cats with dermatological problems were found to be infected by Leishmania chagasi (Aracatuba, 2008 to 2009)
- An opossum (Didelphis albiventris) from Jacobina, Bahia State, was found naturally infected with Leishmania donovani . Natural infection has also been demonstrated in Didelphis aurita in the region of Rio de Janeiro and in 20.4% of Didelphis albiventris in Mato Grosso do Sul.
- Infection has been identified in wild canids in Belo Horizonte: bush dog (Speothos venaticus), hoary zorro (Lycalopex vetulus), crab-eating fox (Cerdocyon thous) 46 and maned wolf (Chrysocyon brachyurus).
- Infection has also been identified in wild and captive felids (jaguars and pumas).
- There is evidence for infection by Leishmania (Leishmania) amazonensis and Leishmania (Leishmania) infantum chagasi in Brazilian bats.
- There is no evidence for infection of capybaras (Hydrochoerus hydrochaeris) in Sao Paulo (2009 publication)
- Evidence for natural infection has been found in a variety of captive primates in Belo Horizonte: a black-fronted titi (Callicebus nigrifrons), a howler monkey (Alouatta guariba), golden-bellied capuchins (Cebus xanthosternos), a golden-headed lion tamarin (Leontopithecus crysomelas), a black-headed owl monkey (Aotus nigriceps), Rio Tapajos sakis (Pithecia irrorata) and emperor tamarins (Saguinus imperator).
- 23% of fleas and 50% of ticks from dogs infected by Leishmania chagasi were found to carry the parasite (2011 publication)

Canine infection rates:
- 21.4% of stray dogs and 26.2% of in domestic dogs in Fortaleza, Ceara State (2008 publication)
- 36% in Jacobina (1993 publication)
- 47.8% in Raposa, Maranhao State (2011 publication)
- 42.5% in Anastacio, Mato Grosso do Sul (2004 publication)
- 11.2% in Cuiaba/Mato Grosso (2011 publication)
- 2% to 5% in Belo Horizonte; 5% in Montes Claros, Minas Gerais (2002 and 2007)
- 24.7% in Belo Horizonte, Minas Gerais (2011 publication)
- 7.8% in Belo Horizonte, Minas Gerais (2010 publication)
- 23.47% in northern Minas Gerais (positive by at least one test, 2008 to 2009)
- 77.0% to 77.5% of asymptomatic and 87.5% to 95.0% of symptomatic dogs in Minas Gerais (conjunctival PCR, 2012 publication)
- 46% in the Krenak indigenous community, Minas Gerais (2007)
- 23.3% in Para State (2010 publication)
- 78% in Piaui (2011 publication)
- 4.2% of domiciled dogs in Paracatu (2010 publication)
- 0.0027% (a single dog) in Parana State (2010 publication)
- 6% to 20% in various areas of Parana (2007 publication)
- 40.3% in Pernambuco (2006 publication)
- 16% in Garanhuns, Pernambuco (2010 publication)
- 4.7% (L. infantum) in Sao Paulo (2007 publication)
- 1% of sick dogs in Sao Paulo State (2007 publication)
- 0% in rural Botucatu, Sao Paulo State (2011 publication)
- 3.79% in Sao Paulo (1999 publication)
- 64.7% of euthanized dogs in Ilha Solteira, Sao Paulo (2009 publication)
- 57% in Pancas, Espirito Santo (2003 to 2004)
- 58.5% in the rural northeast (2010 publication)
- 18% in Lago Norte, Federal District (2008)
- 4.6% in Rio de Janeiro in 1984; 1.6% in 2008.
- 2.9% in Rio de Janeiro (2011 publication)
- 27.9% in Monte Negro, Rondonia (2010 publication)
- 40% in Salvador (spleen PRC, 2011 publication)

The etiologic agent of visceral leishmaniasis is Leishmania chagasi (L. infantum), and the local vector is Lutzomyia longipalpis.
- Lu. forattinii has also been implicated in Mato Grosso do Sul; and Lu. whitmani in Parana state; and Lu. corelezzi in Santa Luzia, Minas Gerais state
- Lutzomyia longipalpis (95%) was the most common vector identified in Mato Grosso do Sul State; trypanosomoids were detected in 10.39%. Brumptomyia avellari, Evandromyia cortelezzii, Evandromyia lenti and Nyssomyia whitmani were also found. (2003)
- Lutzomyia longipalpis was identified in a coastal area of Rio de Janeiro (2008 to 2009)
- 1.1% of female sandflies (all Lu. longipalpis) carry Leishmania species (Teresina, Piaui, 2004 to 2005)
- Lutzomyia complexa is the most common sandfly species in Sao Vicente Ferrer, followed by Lu. migonei. (northern Zona da Mata, Pernambuco State, 2002 to 2003)
- 1.5% of Lu. cruzi and 0.7% of Lu. forattinii sandflies were infected with L. chagasi (L. infantum). (Corumba, Mato Grosso do Sul, 2006) Lu. almerioi has also been identified as a vector in the area.
- 1.6% of Lutzomyia longipalpis in Raposa, Maranhao State were found to be infected (2011 publication)
- Vectors in Maranhao include L. longipalpis, L. evandroi, L. lenti, L. termitophila, L. flaviscutellata, L. migonei, L. infraspinosa, L. sordellii, L. wellcomei, L. antunesi, and L. trinidadensis.
- Vectors identified in Espirito Santo do Pinhal include Nyssomyia whitmani and Pintomyia pessoai in the rural area, Lutzomyia longipalpis and Ny. whitmani in the periurban area and Lu. longipalpis in the urban area.
- 3.9% of Lu. longipalpis in Janauba, Minas Gerais were found to carry Leishmania infantum chagasi (2011 publication)
- Lutzomyia cruzi has been identified as a vector in Jaciara, Mato Grosso.
- Migonemyia migonei has been implicated as a vector in Pernambuco.
- 1.9% of phlebotomine sandflies (99.15% Lu. longipalpis) carry Leishmania chagasi. (Mato Grosso do Sul, 2005 to 2006)
- Viannamya furcata, Lutzomyia neivai and Lutzomyia sallesi have also been implicated.
- Leishmania infantum has been identified in ticks Rhipicephalus sanguineus in Italy and Brazil (2010 publication)
- Leishmania infantum was found in 19% of Lutzomyia longipalpis, 3.8% of Nyssomyia whitmani, 33.3% of Evandromyia termitophila and Nyssomyia intermedia (southeastern Brazil, 2006 to 2007)

Notable outbreaks:
1964 (publication year) – An outbreak of visceral leishmaniasis was reported in Bahia.
1980 to 1986 – An outbreak was reported in Piaui.
1981 to 1985 – An outbreak (1,000 cases) was reported in Terasina.
1986 (publication year) – An outbreak was reported in Santarem, Para State.
1993 to 1996 – An outbreak (1,200 cases) was reported in Terasina.
1994 (publication year) – An outbreak (316 cases) was reported in Natal.
2008 – An outbreak (17 cases, 6 fatal) was reported in Rondonopolis, Mato Grosso.

1. Berger SA. Infectious Diseases of Brazil, 2012. 553 pages, 118 graphs, 4191 references. Gideon e-books,
2. Berger SA. Visceral Leishmaniasis: Global Status, 2012. 88 pages, 73 graphs, 832 references. Gideon e-books,
3. Gideon Graph Tool, see tutorial at

Pertussis in Colombia

Thursday, November 8th, 2012

Rates of pertussis in Colombia and neighboring countries have remained low since 1990, in parallel with increasing regional vaccine uptake [1-3] – see graph.

1. Berger SA. Infectious Diseases of Colombia, 2012. 424 pages, 94 graphs, 1,483 references. Gideon e-books,
2. Berger SA. Pertussis: Global Status, 2012. 340 pages, 506 graphs, 401 references. Gideon e-books,
3. Gideon Graph Tool, see tutorial at