Tweet
Source: ProMed
Archive Number 20110720.2190
Published Date 20-JUL-2011
Subject PRO/AH/EDR> Undiagnosed illness - Mexico: (SL) RFI
UNDIAGNOSED ILLNESS - MEXICO: (SAN LUIS POTOSI) REQUEST FOR
INFORMATION
************************************************** *********************
A ProMED-mail post
<http://www.promedmail.org>
ProMED-mail is a program of the
International Society for Infectious Diseases
<http://www.isid.org>
Date: Sat 16 Jul 2011
From: Christian A Garcia-Sepulveda <https://www.genomica.uaslp.mx>
[edited]
Three of 6 young Mexican mestizo civil engineers between 19 and 21
years of age remain hospitalized (day +8) due to a febrile illness
accompanied by muscle pain and spasms following contact with bats and
their guano in the state of San Luis Potosi, Mexico. The 6 engineers
were reported to have been working for ICA (a private engineering
company contracted by the state government of San Luis Potosi, Mexico)
cleaning road gullies and drainage channels/tunnels in the highway
connecting Rayon and Tamasopo (roughly 21 deg 51'50.74" N, 99 deg
29'34.09" W). 3 of the men are being attended at the Zonal General
Hospital IMSS [Mexican Social Security Institute] no 2 in the state
capital of San Luis Potosi and maintained in isolation. The
whereabouts of the 3 other men has not been disclosed.
--
Christian A. Garcia-Sepulveda MD PhD
Viral and Human Genomics Laboratory
Facultad de Medicina - Universidad Autonoma San Luis Potosi (UASLP)
Mexico
<https://www.genomica.uaslp.mx>
[The 3 patients described above were reported to have fever and
muscle pain after working in drainage tunnels and having contact with
bats and their guano; no mention was made of contact with other
rodents, although this is a possibility. Acute undifferentiated
febrile illnesses, that is, occurring in the absence of an obvious
focus of infection, have several possible etiologies that vary with
the geographic region in which they occur (1-3). Some are
rodent-associated, such as, leptospirosis, _Hantavirus_ infection,
_Bartonella_ infection, tularemia, and murine typhus. Specifically,
infections with _Leptospira_, _Hantavirus_, and _Bartonella_ have been
associated with bats (4-6). Also, _Histoplasma capsulatum_, the cause
of histoplasmosis, grows in soil contaminated with bat guano. Other
possible etiologies include scrub typhus, dengue, chikungunya,
malaria, brucellosis, enteric fever, and melioidosis.
The clinical manifestations and the epidemiological features of
_Hantavirus_ infection and leptospirosis can be strikingly similar
(7). Rodent-associated _Bartonella_ has been identified as causing
acute febrile illness in immunocompetent adults in the rural
southwestern United States (8). Tularemia and leptospirosis can be
acquired from contact with water contaminated by the urine of infected
hosts; melioidosis is also acquired by contact with contaminated
water. However, melioidosis is usually endemic in parts of Southeast
Asia and northern Australia, although sporadic cases of melioidosis
are reported to have been acquired in Central and South America (9).
Scrub typhus is restricted to a region that extends from northern
Japan and far-eastern Russia in the north, to northern Australia in
the south, and to Pakistan and Afghanistan in the west.
Muscle spasm following bat exposure raises the issue of rabies.
Patients may be unaware of bites by some rabid animals, such as bats.
However, onset of symptoms of rabies usually occurs several weeks to
more than a year after an animal bite, although may be as short as
several days in some patients. A more detailed description of the
clinical manifestations, epidemiology, and laboratory data is clearly
needed.
1. Manock SR, Jacobsen KH, de Bravo NB, et al: Etiology of acute
undifferentiated febrile illness in the Amazon basin of Ecuador. Am J
Trop Med Hyg. 2009; 81(1): 146-51. Available at
<http://www.ajtmh.org/content/81/1/146.long>.
2. Suttinont C, Losuwanaluk K, Niwatayakul K, et al: Causes of acute,
undifferentiated, febrile illness in rural Thailand: results of a
prospective observational study. Ann Trop Med Parasit. 2006; 100 (4):
363-70. Available at
<http://www.ingentaconnect.com/content/maney/atmp/2006/00000100/00000004/art00008>.
3. Chrispal A, Boorugu H, Gopinath? KG, et al: Acute undifferentiated
febrile illness in adult hospitalized patients: the disease spectrum
and diagnostic predictors - an experience from a tertiary care
hospital in South India. Tropical Doctor 2010; 40 (4): 230-4. Abstract
available at
<http://td.rsmjournals.com/cgi/content/abstract/40/4/230>.
4. Matthias MA, Diaz MM, Campos KJ, et al: Diversity of
bat-associated _Leptospira_ in the Peruvian Amazon inferred by
bayesian phylogenetic analysis of 16S ribosomal DNA sequences. Am J
Trop Med Hyg. 2005; 73(5): 964-74. Available at
<http://www.ajtmh.org/content/73/5/964.long>.
5. Kim GR, Lee YT, Park CH: A new natural reservoir of hantavirus:
isolation of hantaviruses from lung tissues of bats. Arch Virol. 1994;
134(1-2): 85-95. Abstract vailable at
<http://www.ncbi.nlm.nih.gov/pubmed/8279962>.
6. Reeves WK, Rogers TE, Durden LA, Dasch GA: Association of
_Bartonella_ with the fleas (_Siphonaptera_) of rodents and bats using
molecular techniques. J Vector Ecol. 2007; 32(1): 118-22. Abstract
available at <http://www.ncbi.nlm.nih.gov/pubmed/17633432>.
7. Clement J, Neild G, Lemos Hinrichsen S, et al: Urban leptospirosis
versus urban hantavirus infection in Brazil. Lancet 1999; 354(9194):
2003-4. Available at
<http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(05)76782-9/fulltext>.
8. Iralu J, Y Bai, L Crook, et al: Rodent-Associated _Bartonella_
Febrile Illness, Southwestern United States. Emerg Infect Dis 2006;
12(7): 1081-6. Available at
<http://www.cdc.gov/ncidod/eid/vol12no07/pdfs/04-0397.pdf>.
9. Inglis TJ, Rolim DB, De Queroz Sousa A: Melioidosis in the
Americas. Am J Trop Med Hyg. 2006; 75 (5): 947-54. Available at
<http://www.ncbi.nlm.nih.gov/pubmed/17123994>.
Mestizo is a term used to describe people of mixed European and
Native American descent. San Luis Potosi, one of the 31 states which,
with the Federal District, comprise the 32 Federal Entities of Mexico
is located in North-Central Mexico. San Luis Potosi can be located on
a map of Mexico at
<http://en.wikipedia.org/wiki/File:San_Luis_Potos%C3%AD_en_México.svg>
and on an HealthMap/ProMED-mail interactive map at
<http://healthmap.org/r/00ap>. - Mod.ML]
.................................................m l/mj/mpp
*################################################# #########*
************************************************** **********
ProMED-mail makes every effort to verify the reports that
are posted, but the accuracy and completeness of the
information, and of any statements or opinions based
thereon, are not guaranteed. The reader assumes all risks in
using information posted or archived by ProMED-mail. ISID
and its associated service providers shall not be held
responsible for errors or omissions or held liable for any
damages incurred as a result of use or reliance upon posted
or archived material.
************************************************** **********
Donate to ProMED-mail. Details available at:
<http://www.isid.org/ProMEDMail_Donations.shtml>
************************************************** **********
Visit ProMED-mail's web site at <http://www.promedmail.org>.
Send all items for posting to: promed@promedmail.org (NOT to
an individual moderator). If you do not give your full name
name and affiliation, it may not be posted. You may unsub-
scribe at <http://www.isid.org/promedmail/subscribe.lasso>.
For assistance from a human being, send mail to:
<postmaster@promedmail.org>.
################################################## ##########
################################################## ##########
Archive Number 20110720.2190
Published Date 20-JUL-2011
Subject PRO/AH/EDR> Undiagnosed illness - Mexico: (SL) RFI
UNDIAGNOSED ILLNESS - MEXICO: (SAN LUIS POTOSI) REQUEST FOR
INFORMATION
************************************************** *********************
A ProMED-mail post
<http://www.promedmail.org>
ProMED-mail is a program of the
International Society for Infectious Diseases
<http://www.isid.org>
Date: Sat 16 Jul 2011
From: Christian A Garcia-Sepulveda <https://www.genomica.uaslp.mx>
[edited]
Three of 6 young Mexican mestizo civil engineers between 19 and 21
years of age remain hospitalized (day +8) due to a febrile illness
accompanied by muscle pain and spasms following contact with bats and
their guano in the state of San Luis Potosi, Mexico. The 6 engineers
were reported to have been working for ICA (a private engineering
company contracted by the state government of San Luis Potosi, Mexico)
cleaning road gullies and drainage channels/tunnels in the highway
connecting Rayon and Tamasopo (roughly 21 deg 51'50.74" N, 99 deg
29'34.09" W). 3 of the men are being attended at the Zonal General
Hospital IMSS [Mexican Social Security Institute] no 2 in the state
capital of San Luis Potosi and maintained in isolation. The
whereabouts of the 3 other men has not been disclosed.
--
Christian A. Garcia-Sepulveda MD PhD
Viral and Human Genomics Laboratory
Facultad de Medicina - Universidad Autonoma San Luis Potosi (UASLP)
Mexico
<https://www.genomica.uaslp.mx>
[The 3 patients described above were reported to have fever and
muscle pain after working in drainage tunnels and having contact with
bats and their guano; no mention was made of contact with other
rodents, although this is a possibility. Acute undifferentiated
febrile illnesses, that is, occurring in the absence of an obvious
focus of infection, have several possible etiologies that vary with
the geographic region in which they occur (1-3). Some are
rodent-associated, such as, leptospirosis, _Hantavirus_ infection,
_Bartonella_ infection, tularemia, and murine typhus. Specifically,
infections with _Leptospira_, _Hantavirus_, and _Bartonella_ have been
associated with bats (4-6). Also, _Histoplasma capsulatum_, the cause
of histoplasmosis, grows in soil contaminated with bat guano. Other
possible etiologies include scrub typhus, dengue, chikungunya,
malaria, brucellosis, enteric fever, and melioidosis.
The clinical manifestations and the epidemiological features of
_Hantavirus_ infection and leptospirosis can be strikingly similar
(7). Rodent-associated _Bartonella_ has been identified as causing
acute febrile illness in immunocompetent adults in the rural
southwestern United States (8). Tularemia and leptospirosis can be
acquired from contact with water contaminated by the urine of infected
hosts; melioidosis is also acquired by contact with contaminated
water. However, melioidosis is usually endemic in parts of Southeast
Asia and northern Australia, although sporadic cases of melioidosis
are reported to have been acquired in Central and South America (9).
Scrub typhus is restricted to a region that extends from northern
Japan and far-eastern Russia in the north, to northern Australia in
the south, and to Pakistan and Afghanistan in the west.
Muscle spasm following bat exposure raises the issue of rabies.
Patients may be unaware of bites by some rabid animals, such as bats.
However, onset of symptoms of rabies usually occurs several weeks to
more than a year after an animal bite, although may be as short as
several days in some patients. A more detailed description of the
clinical manifestations, epidemiology, and laboratory data is clearly
needed.
1. Manock SR, Jacobsen KH, de Bravo NB, et al: Etiology of acute
undifferentiated febrile illness in the Amazon basin of Ecuador. Am J
Trop Med Hyg. 2009; 81(1): 146-51. Available at
<http://www.ajtmh.org/content/81/1/146.long>.
2. Suttinont C, Losuwanaluk K, Niwatayakul K, et al: Causes of acute,
undifferentiated, febrile illness in rural Thailand: results of a
prospective observational study. Ann Trop Med Parasit. 2006; 100 (4):
363-70. Available at
<http://www.ingentaconnect.com/content/maney/atmp/2006/00000100/00000004/art00008>.
3. Chrispal A, Boorugu H, Gopinath? KG, et al: Acute undifferentiated
febrile illness in adult hospitalized patients: the disease spectrum
and diagnostic predictors - an experience from a tertiary care
hospital in South India. Tropical Doctor 2010; 40 (4): 230-4. Abstract
available at
<http://td.rsmjournals.com/cgi/content/abstract/40/4/230>.
4. Matthias MA, Diaz MM, Campos KJ, et al: Diversity of
bat-associated _Leptospira_ in the Peruvian Amazon inferred by
bayesian phylogenetic analysis of 16S ribosomal DNA sequences. Am J
Trop Med Hyg. 2005; 73(5): 964-74. Available at
<http://www.ajtmh.org/content/73/5/964.long>.
5. Kim GR, Lee YT, Park CH: A new natural reservoir of hantavirus:
isolation of hantaviruses from lung tissues of bats. Arch Virol. 1994;
134(1-2): 85-95. Abstract vailable at
<http://www.ncbi.nlm.nih.gov/pubmed/8279962>.
6. Reeves WK, Rogers TE, Durden LA, Dasch GA: Association of
_Bartonella_ with the fleas (_Siphonaptera_) of rodents and bats using
molecular techniques. J Vector Ecol. 2007; 32(1): 118-22. Abstract
available at <http://www.ncbi.nlm.nih.gov/pubmed/17633432>.
7. Clement J, Neild G, Lemos Hinrichsen S, et al: Urban leptospirosis
versus urban hantavirus infection in Brazil. Lancet 1999; 354(9194):
2003-4. Available at
<http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(05)76782-9/fulltext>.
8. Iralu J, Y Bai, L Crook, et al: Rodent-Associated _Bartonella_
Febrile Illness, Southwestern United States. Emerg Infect Dis 2006;
12(7): 1081-6. Available at
<http://www.cdc.gov/ncidod/eid/vol12no07/pdfs/04-0397.pdf>.
9. Inglis TJ, Rolim DB, De Queroz Sousa A: Melioidosis in the
Americas. Am J Trop Med Hyg. 2006; 75 (5): 947-54. Available at
<http://www.ncbi.nlm.nih.gov/pubmed/17123994>.
Mestizo is a term used to describe people of mixed European and
Native American descent. San Luis Potosi, one of the 31 states which,
with the Federal District, comprise the 32 Federal Entities of Mexico
is located in North-Central Mexico. San Luis Potosi can be located on
a map of Mexico at
<http://en.wikipedia.org/wiki/File:San_Luis_Potos%C3%AD_en_México.svg>
and on an HealthMap/ProMED-mail interactive map at
<http://healthmap.org/r/00ap>. - Mod.ML]
.................................................m l/mj/mpp
*################################################# #########*
************************************************** **********
ProMED-mail makes every effort to verify the reports that
are posted, but the accuracy and completeness of the
information, and of any statements or opinions based
thereon, are not guaranteed. The reader assumes all risks in
using information posted or archived by ProMED-mail. ISID
and its associated service providers shall not be held
responsible for errors or omissions or held liable for any
damages incurred as a result of use or reliance upon posted
or archived material.
************************************************** **********
Donate to ProMED-mail. Details available at:
<http://www.isid.org/ProMEDMail_Donations.shtml>
************************************************** **********
Visit ProMED-mail's web site at <http://www.promedmail.org>.
Send all items for posting to: promed@promedmail.org (NOT to
an individual moderator). If you do not give your full name
name and affiliation, it may not be posted. You may unsub-
scribe at <http://www.isid.org/promedmail/subscribe.lasso>.
For assistance from a human being, send mail to:
<postmaster@promedmail.org>.
################################################## ##########
################################################## ##########