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Bartonella bacilliformis
causes Oroya fever, verruga peruana and Carrión disease.
This disease commonly affects the pediatric population in Peru and Ecuador. Mortality and morbidity of
the acute phase vary because of superimposed infections and
other complications.
Contacts initiated by
Mauricio Lascano, a doctoral student at the Tropical
Disease Institute (TDI) at Ohio University, lead to the
initiation of an ongoing collaboration with Shari Lydy,
Ph.D., at the
Rickettsial and Zoonoses Branc,
Division of Viral and Rickettsial Diseases
(DVRD), National Center for Zoonotic, Vector-borne and
Enteric Diseases, Centers for Disease Control and Prevention
(CDC) in Atlanta, GA. Dr. Lydy traveled to Ecuador in the
summer of 2007 to conduct, along with Lascano and
Josselyn Garcia, an undergraduate biology major working
in the Center for Infectious Diseases Research (CIDR) at
Catholic University in Ecuador, preliminary field research
related to Bartonella bacilliformis infection in
Manabi and Loja Provinces.
"The results of the preliminary survey were very
interesting and suggest that this disease might be more
prevalent in the region than previously thought" said
Lascano.
Lascano and Garcia completed a training internship under the
direction of Dr. Lydy at CDC DVRD. During their
training, Lascano and Garcia worked with different
analytical techniques for the diagnosis of Bartonella
infections. The training included: isolation of
Bartonella from clinical blood samples and insect
vectors; cultivation and harvest of Bartonella from
laboratory cultures (blood agar and biphasic media);
diagnostic Giemsa and flagella staining; immunofluorescence
assays; DNA extraction from clinical samples and insect
vectors for analysis by PCR (ribC and 23S rRNA ITS);
polyacrylamide gel electrophoresis; and, development of a
diagnostic ELISA for screening. Mauricio Lascano was also
invited to give a seminar about Chagas disease to the
researchers at the DVRD.
"This was not only an
amazing opportunity to learn new techniques, but also to
expand my vision of what tools are available in one of the
leading public health research centers in the world, that
could be used to alleviate the suffering of people in
developing countries" said Garcia. She will conduct her
undergraduate theses work at CIDR within this project.
Preliminary results suggest that human Bartonella
infection in Ecuador could be widespread and misdiagnosed.
This research project will continue during 2008 with
screening of human blood samples, and collection and
analysis of vectors and reservoirs of Bartonella.
Dr. Lydy said that "The
collaboration between TDI and the Rickettsial Zoonoses
Branch at CDC, to investigate the seroprevalence and
epidemiology of Bartonella bacilliformis infection in
Ecuador, is very exciting and a wonderful opportunity.
Preliminary serological data indicates the presence of
infection without the usual disease presentation of Oroya
fever or verruga, thus indicating that infection may be
significantly underreported due to atypical clinical
disease. Laboratory diagnosis of human Bartonella infections
remains a challenge, so it is imperative to re-evaluate
diagnostic strategies to recognize atypical disease and to
develop new diagnostic tests for use in the field."
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Financial support for this actitiy was provided by:
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