viernes, 12 de enero de 2018

TRYPANOSOMIASIS - SOUTH AFRICA: ex ZAMBIA (SOUTH LUANGWA NATIONAL PARK)

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Published Date: 2018-01-12 01:00:56
Subject: PRO/AH/EDR> Trypanosomiasis - South Africa: ex Zambia (S Luangwa Natl Park)
Archive Number: 20180112.5552966
TRYPANOSOMIASIS - SOUTH AFRICA: ex ZAMBIA (SOUTH LUANGWA NATIONAL PARK)
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Date: Thu 11 Jan 2018
From: John Frean [edited]


Trypanosomiasis was confirmed on peripheral blood smear from a 52-year-old tourist who visited South Luangwa National Park, Zambia.

He stayed in a number of lodges over a 14-day period, and received numerous tsetse fly bites. Ten days after entering the Park, he developed an acute febrile illness, received antibiotics for suspected infected insect bites, and was airlifted to a hospital in Johannesburg, South Africa, with multisystem pathology, for diagnosis and management.

A typical trypanosomal chancre was observed and a peripheral blood smear showed numerous trypomatigotes of _Trypanosoma brucei rhodesiense_. There was laboratory evidence of leukopenia, moderate thrombocytopenia, liver dysfunction with raised transaminases and bilirubin, and mild renal dysfunction.

Suramin was obtained from a strategic WHO supply that is maintained in Johannesburg, and commenced after an initial test dose was well tolerated. The patient was conscious with no evidence of central nervous system involvement; however CSF examination will be done in the next few days when the peripheral blood is clear of parasites. The patient is in a serious but stable condition.

--
Evan Shoul, infectious disease physician
Johannesburg, South Africa
Lucille Blumberg
Centre for Emerging Zoonotic and Parasitic Diseases,
National Institute for Communicable Diseases, Johannesburg, South Africa

John Frean
Centre for Emerging Zoonotic and Parasitic Diseases,
National Institute for Communicable Diseases, Johannesburg, South Africa


[ProMED thanks Dr Evan Shoul, Lucille Blumberg and John Frean for reporting this case. Trypanosomiasis in southern Africa including Zambia is caused by _Trypanosoma rhodesiense_ and has a reservoir in wild game. Trypanosomiasis is transmitted by bites of the tsetse fly. Cases of trypanosomiasis in game parks in Zambia are well known (see previous ProMED reports below). Tsetse flies are strictly day-biters and disappear at sunset. Protection depends on long trousers and long-sleeved shirts. - Mod.EP

HealthMap/ProMED-mail maps:
South Africa: http://healthmap.org/promed/p/179.
South Luangwa National Park, Zambia: http://healthmap.org/promed/p/13702.]

See Also

2017
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Trypanosomiasis - Germany: ex Zambia: 20170817.5255709
2016
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Trypanosomiasis, African - USA: (MD) ex Botswana, Zambia: 20161226.4723752
2015
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Trypanosomiasis, African - Canada: ex Zambia 20150904.3625005
2014
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Trypanosomiasis, African - Zambia: (LS) 20140428.2435399
2010
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Trypanosomiasis, African - Zambia: (EA) 20101111.4093
Trypanosomiasis - USA ex Zambia: (EA) 20100915.3338
2007
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Trypanosomiasis - South Africa ex Malawi (02) : 20071120.3754
Trypanosomiasis - South Africa ex Malawi: 20070212.0532
2005
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Trypanosomiasis - South Africa ex Malawi (Kasungu Natl. Park) 20051224.3675
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