Outbreak of Leishmania braziliensis Cutaneous Leishmaniasis, Saül, French Guiana
Identifieur interne : 000164 ( Pmc/Corpus ); précédent : 000163; suivant : 000165Outbreak of Leishmania braziliensis Cutaneous Leishmaniasis, Saül, French Guiana
Auteurs : Guillaume Martin-Blondel ; Xavier Iriart ; Fouad El Baidouri ; Stéphane Simon ; Deborah Mills ; Magalie Demar ; Thierry Pistone ; Thomas Le Taillandier ; Denis Malvy ; Jean-Pierre Gangneux ; Pierre Couppie ; Wendy Munckhof ; Bruno Marchou ; Christophe Ravel ; Antoine BerrySource :
- Emerging Infectious Diseases [ 1080-6040 ] ; 2015.
Url:
DOI: 10.3201/eid2105.141181
PubMed: 25897573
PubMed Central: 4412217
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<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">Outbreak of <italic>Leishmania braziliensis</italic> Cutaneous Leishmaniasis, Saül, French Guiana</title><author><name sortKey="Martin Blondel, Guillaume" sort="Martin Blondel, Guillaume" uniqKey="Martin Blondel G" first="Guillaume" last="Martin-Blondel">Guillaume Martin-Blondel</name></author><author><name sortKey="Iriart, Xavier" sort="Iriart, Xavier" uniqKey="Iriart X" first="Xavier" last="Iriart">Xavier Iriart</name></author><author><name sortKey="El Baidouri, Fouad" sort="El Baidouri, Fouad" uniqKey="El Baidouri F" first="Fouad" last="El Baidouri">Fouad El Baidouri</name></author><author><name sortKey="Simon, Stephane" sort="Simon, Stephane" uniqKey="Simon S" first="Stéphane" last="Simon">Stéphane Simon</name></author><author><name sortKey="Mills, Deborah" sort="Mills, Deborah" uniqKey="Mills D" first="Deborah" last="Mills">Deborah Mills</name></author><author><name sortKey="Demar, Magalie" sort="Demar, Magalie" uniqKey="Demar M" first="Magalie" last="Demar">Magalie Demar</name></author><author><name sortKey="Pistone, Thierry" sort="Pistone, Thierry" uniqKey="Pistone T" first="Thierry" last="Pistone">Thierry Pistone</name></author><author><name sortKey="Le Taillandier, Thomas" sort="Le Taillandier, Thomas" uniqKey="Le Taillandier T" first="Thomas" last="Le Taillandier">Thomas Le Taillandier</name></author><author><name sortKey="Malvy, Denis" sort="Malvy, Denis" uniqKey="Malvy D" first="Denis" last="Malvy">Denis Malvy</name></author><author><name sortKey="Gangneux, Jean Pierre" sort="Gangneux, Jean Pierre" uniqKey="Gangneux J" first="Jean-Pierre" last="Gangneux">Jean-Pierre Gangneux</name></author><author><name sortKey="Couppie, Pierre" sort="Couppie, Pierre" uniqKey="Couppie P" first="Pierre" last="Couppie">Pierre Couppie</name></author><author><name sortKey="Munckhof, Wendy" sort="Munckhof, Wendy" uniqKey="Munckhof W" first="Wendy" last="Munckhof">Wendy Munckhof</name></author><author><name sortKey="Marchou, Bruno" sort="Marchou, Bruno" uniqKey="Marchou B" first="Bruno" last="Marchou">Bruno Marchou</name></author><author><name sortKey="Ravel, Christophe" sort="Ravel, Christophe" uniqKey="Ravel C" first="Christophe" last="Ravel">Christophe Ravel</name></author><author><name sortKey="Berry, Antoine" sort="Berry, Antoine" uniqKey="Berry A" first="Antoine" last="Berry">Antoine Berry</name></author></titleStmt><publicationStmt><idno type="wicri:source">PMC</idno><idno type="pmid">25897573</idno><idno type="pmc">4412217</idno><idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4412217</idno><idno type="RBID">PMC:4412217</idno><idno type="doi">10.3201/eid2105.141181</idno><date when="2015">2015</date><idno type="wicri:Area/Pmc/Corpus">000164</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Corpus" wicri:corpus="PMC">000164</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Outbreak of <italic>Leishmania braziliensis</italic> Cutaneous Leishmaniasis, Saül, French Guiana</title><author><name sortKey="Martin Blondel, Guillaume" sort="Martin Blondel, Guillaume" uniqKey="Martin Blondel G" first="Guillaume" last="Martin-Blondel">Guillaume Martin-Blondel</name></author><author><name sortKey="Iriart, Xavier" sort="Iriart, Xavier" uniqKey="Iriart X" first="Xavier" last="Iriart">Xavier Iriart</name></author><author><name sortKey="El Baidouri, Fouad" sort="El Baidouri, Fouad" uniqKey="El Baidouri F" first="Fouad" last="El Baidouri">Fouad El Baidouri</name></author><author><name sortKey="Simon, Stephane" sort="Simon, Stephane" uniqKey="Simon S" first="Stéphane" last="Simon">Stéphane Simon</name></author><author><name sortKey="Mills, Deborah" sort="Mills, Deborah" uniqKey="Mills D" first="Deborah" last="Mills">Deborah Mills</name></author><author><name sortKey="Demar, Magalie" sort="Demar, Magalie" uniqKey="Demar M" first="Magalie" last="Demar">Magalie Demar</name></author><author><name sortKey="Pistone, Thierry" sort="Pistone, Thierry" uniqKey="Pistone T" first="Thierry" last="Pistone">Thierry Pistone</name></author><author><name sortKey="Le Taillandier, Thomas" sort="Le Taillandier, Thomas" uniqKey="Le Taillandier T" first="Thomas" last="Le Taillandier">Thomas Le Taillandier</name></author><author><name sortKey="Malvy, Denis" sort="Malvy, Denis" uniqKey="Malvy D" first="Denis" last="Malvy">Denis Malvy</name></author><author><name sortKey="Gangneux, Jean Pierre" sort="Gangneux, Jean Pierre" uniqKey="Gangneux J" first="Jean-Pierre" last="Gangneux">Jean-Pierre Gangneux</name></author><author><name sortKey="Couppie, Pierre" sort="Couppie, Pierre" uniqKey="Couppie P" first="Pierre" last="Couppie">Pierre Couppie</name></author><author><name sortKey="Munckhof, Wendy" sort="Munckhof, Wendy" uniqKey="Munckhof W" first="Wendy" last="Munckhof">Wendy Munckhof</name></author><author><name sortKey="Marchou, Bruno" sort="Marchou, Bruno" uniqKey="Marchou B" first="Bruno" last="Marchou">Bruno Marchou</name></author><author><name sortKey="Ravel, Christophe" sort="Ravel, Christophe" uniqKey="Ravel C" first="Christophe" last="Ravel">Christophe Ravel</name></author><author><name sortKey="Berry, Antoine" sort="Berry, Antoine" uniqKey="Berry A" first="Antoine" last="Berry">Antoine Berry</name></author></analytic><series><title level="j">Emerging Infectious Diseases</title><idno type="ISSN">1080-6040</idno><idno type="eISSN">1080-6059</idno><imprint><date when="2015">2015</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><back><div1 type="bibliography"><listBibl><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct></listBibl></div1></back></TEI><pmc article-type="letter"><pmc-dir>properties open_access</pmc-dir>
<front><journal-meta><journal-id journal-id-type="nlm-ta">Emerg Infect Dis</journal-id><journal-id journal-id-type="iso-abbrev">Emerging Infect. Dis</journal-id><journal-id journal-id-type="publisher-id">EID</journal-id><journal-title-group><journal-title>Emerging Infectious Diseases</journal-title></journal-title-group><issn pub-type="ppub">1080-6040</issn><issn pub-type="epub">1080-6059</issn><publisher><publisher-name>Centers for Disease Control and Prevention</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="pmid">25897573</article-id><article-id pub-id-type="pmc">4412217</article-id><article-id pub-id-type="publisher-id">14-1181</article-id><article-id pub-id-type="doi">10.3201/eid2105.141181</article-id><article-categories><subj-group subj-group-type="heading"><subject>Letters to the Editor</subject></subj-group><subj-group subj-group-type="article-type"><subject>Letter</subject></subj-group><subj-group subj-group-type="TOC-title"><subject>Outbreak of <italic>Leishmania braziliensis</italic> Cutaneous Leishmaniasis, Saül, French Guiana</subject></subj-group></article-categories><title-group><article-title>Outbreak of <italic>Leishmania braziliensis</italic> Cutaneous Leishmaniasis, Saül, French Guiana</article-title><alt-title alt-title-type="running-head">Outbreak of <italic>L. braziliensis</italic>, French Guiana</alt-title></title-group><contrib-group><contrib contrib-type="author"><name><surname>Martin-Blondel</surname><given-names>Guillaume</given-names></name></contrib><contrib contrib-type="author"><name><surname>Iriart</surname><given-names>Xavier</given-names></name></contrib><contrib contrib-type="author"><name><surname>El Baidouri</surname><given-names>Fouad</given-names></name></contrib><contrib contrib-type="author"><name><surname>Simon</surname><given-names>Stéphane</given-names></name></contrib><contrib contrib-type="author"><name><surname>Mills</surname><given-names>Deborah</given-names></name></contrib><contrib contrib-type="author"><name><surname>Demar</surname><given-names>Magalie</given-names></name></contrib><contrib contrib-type="author"><name><surname>Pistone</surname><given-names>Thierry</given-names></name></contrib><contrib contrib-type="author"><name><surname>Le Taillandier</surname><given-names>Thomas</given-names></name></contrib><contrib contrib-type="author"><name><surname>Malvy</surname><given-names>Denis</given-names></name></contrib><contrib contrib-type="author"><name><surname>Gangneux</surname><given-names>Jean-Pierre</given-names></name></contrib><contrib contrib-type="author"><name><surname>Couppie</surname><given-names>Pierre</given-names></name></contrib><contrib contrib-type="author"><name><surname>Munckhof</surname><given-names>Wendy</given-names></name></contrib><contrib contrib-type="author"><name><surname>Marchou</surname><given-names>Bruno</given-names></name></contrib><contrib contrib-type="author"><name><surname>Ravel</surname><given-names>Christophe</given-names></name></contrib><contrib contrib-type="author" corresp="yes"><name><surname>Berry</surname><given-names>Antoine</given-names></name></contrib><aff id="aff1">Toulouse University Hospital, Toulouse, France (G. Martin-Blondel, X. Iriart, T. Le Taillandier, B. Marchou, A. Berry);</aff><aff id="aff2">INSERM UMR1043, Toulouse, France (G. Martin-Blondel, X. Iriart, A. Berry);</aff><aff id="aff3">French Reference Centre on Leishmaniasis, Montpellier, France (F. El Baidouri, C. Ravel);</aff><aff id="aff4">University of the French West Indies and Guiana, Cayenne, France (S. Simon);</aff><aff id="aff5">Travel Medicine Alliance, Brisbane, Queensland, Australia (D. Mills);</aff><aff id="aff6">Cayenne Hospital, Cayenne (M. Demar, P. Couppie);</aff><aff id="aff7">Bordeaux University Hospital, Bordeaux, France (T. Pistone, D. Malvy);</aff><aff id="aff8">Rennes University Hospital, Rennes, France (J.-P. Gangneux);</aff><aff id="aff9">University of Queensland, Brisbane (W. Munckhof)</aff></contrib-group><author-notes><corresp id="cor1">Address for correspondence: Antoine Berry, Department of Parasitology, Toulouse University Hospital, Place du Docteur Baylac TSA 40031, 31059 Toulouse CEDEX 9, France; email: <email xlink:href="berry.a@chu-toulouse.fr">berry.a@chu-toulouse.fr</email></corresp></author-notes><pub-date pub-type="ppub"><month>5</month><year>2015</year></pub-date><volume>21</volume><issue>5</issue><fpage>892</fpage><lpage>894</lpage><kwd-group kwd-group-type="author"><title>Keywords: </title><kwd>leishmaniasis</kwd><kwd>cutaneous</kwd><kwd>Leishmania braziliensis</kwd><kwd>French Guiana</kwd><kwd>disease outbreaks</kwd><kwd>Amazonian rainforest</kwd><kwd>zoonoses</kwd><kwd>vector-borne infections</kwd><kwd>parasites</kwd></kwd-group></article-meta></front><body><p><bold>To the Editor:</bold> New World cutaneous leishmaniasis (CL), a zoonotic disease, is increasingly seen among travelers returning from Latin American countries, particularly from Bolivia, Belize, and French Guiana (<xref rid="R1" ref-type="bibr"><italic>1</italic></xref>). The epidemiology of CL in the Americas is heterogeneous and has complex variations in transmission cycles, reservoir hosts, and sandfly vectors. Changing human activities that affect these factors may have resulted in the emergence of species with distinct pathogenic potentials and responses to therapy. In the Guianan ecoregion complex, leishmaniasis is endemic, and 5 coexisting <italic>Leishmania</italic> parasite species are known to infect humans: <italic>L. guyanensis, L. braziliensis, L. amazonensis, L. naiffi</italic>, and <italic>L. lainsoni</italic>. Among these species, <italic>L. guyanensis</italic> accounts for ≈85% of CL cases (<xref rid="R2" ref-type="bibr"><italic>2</italic></xref>).</p><p>We report an outbreak of 7 cases of <italic>L. braziliensis</italic> CL that occurred among 24 scientists who participated in a field mission at Limonade Creek in Saül, French Guiana, during October 10–25, 2013. Saül is an isolated village in the Amazonian rainforest (3°55′18′′N, 53°18′02′′W). </p><p>Among the 7 patients, 6 were male; mean age was 32 ± 5 years. None of the patients were immunocompromised. The scientists stayed in Saül a mean of 17 (range 12–30) days. The mean time to symptom onset after they left Saül was 19 (range 0–50) days. The mean number of CL lesions was 2.3 (range 1–5). Lesions were localized mainly on lower limbs (11/14 lesions) but also appeared on upper limbs (2/14 lesions) and ears (1/14 lesions). CL was associated with nodular lymphangitis, adenitis, and superficial phlebitis of the affected limb in 2, 3, and 1 patient, respectively. No patients had mucosal involvement, fever, or decline in general health. </p><p>Diagnosis of CL was clinically suggested and confirmed by microscope examination of skin scrapings, which revealed typical amastigotes, by a positive <italic>Leishmania</italic> species–specific PCR result, or both. <italic>L. braziliensis</italic> complex was diagnosed by using different molecular techniques, according to the laboratory, and then confirmation of <italic>L. braziliensis</italic> species was conducted by the French National Reference Center for Leishmaniasis on the basis of a putative translation initiation factor α-subunit gene sequence (<xref rid="R3" ref-type="bibr"><italic>3</italic></xref>). <italic>Leishmania</italic> strain genotyping was performed to explore the epidemiology of the implicated strains. Four single-copy genomic loci were amplified from 5 of 7 patient samples; 1 of the samples had a parasite DNA content that was too low to genotype, and 1 was not analyzed. The genetic analysis of the 4 concatenated sequences showed 5 distinct and nonclustered genotypes (<xref ref-type="fig" rid="F1">Figure</xref>). According to local protocols, patients were treated with 20 mg/kg of intramuscular meglumine antimoniate or with 18–38 mg/kg of intravenous liposomal amphotericin B; at publication time, the patients were still being followed.</p><fig id="F1" fig-type="figure" position="float"><label>Figure</label><caption><p>Data display network showing the genetic diversity of 32 <italic>Leishmania braziliensis</italic> (according to the multilocus enzyme electrophoresis–based taxonomy) compared with 5 strains from clinical samples (boldface) obtained from visitors to the Amazonian forest region of French Guiana. The strains were compared at 4 genomic loci (locus 03.0980, 10.0560, 31.0280 and 31.2610) as previously described (<xref rid="R3" ref-type="bibr"><italic>3</italic></xref>). The concatenated nucleotide sequences (2,610 bp) were duplicated to avoid information loss due to heterozygous positions (e.g., A to AA or Y to CT). Neighbor-Net analysis was performed with SplitsTree version 4.11.3 (<ext-link ext-link-type="uri" xlink:href="http://splitstree.org/">http://splitstree.org/</ext-link>) by using p-distances and equal edge lengths (<xref rid="R4" ref-type="bibr"><italic>4</italic></xref>). Two <italic>L. guyanensis</italic> strains were used as an outgroup. The inset represents the genetic distance between L. guyanensis and L. braziliensis. Scale bar indicates evolutionary distance.</p></caption><graphic xlink:href="14-1181-F"></graphic></fig><p>This outbreak of <italic>L. braziliensis</italic> CL in French Guiana raises the question of an overall increase in the incidence of this <italic>Leishmania</italic> species. Until now, outbreaks of <italic>L. braziliensis</italic> infection have been observed in Argentina, Brazil, Panama, and Venezuela but not Guiana (<xref rid="R5" ref-type="bibr"><italic>5</italic></xref>–<xref rid="R7" ref-type="bibr"><italic>7</italic></xref>). In French Guiana, changes in the epidemiology of CL have been observed since 2006; the emergence of <italic>L. braziliensis</italic>, <italic>L. amazonensis</italic>, and <italic>L. lainsoni</italic> infections represented 8.8%, 2.6%, and 1.4%, respectively, of the diagnosed CL cases (<xref rid="R8" ref-type="bibr"><italic>8</italic></xref>). This trend could be due either to an increase of <italic>L. braziliensis</italic> prevalence in the forests of Guiana or to a greater presence of humans (e.g., military personnel, scientists, and tourists) in deep forest areas with hot spots of transmission. Favorable environmental conditions in a well-delimited zoonotic microfocus hot spot might have contributed to this high rate of transmission. However the relative genetic diversity of strains we observed among the 5 analyzed patients was unexpected, given the relatively small spatial and temporal scale of the transmission area, and indicates that the reservoirs in this restricted area were infested by distinct genotypes. Development of a peridomestic cycle, perhaps with specific reservoirs (pets) and vectors, cannot be excluded in the Saül area.</p><p>This case series suggests that caution should be taken in the diagnosis and treatment of CL in patients returning from the Amazonian rainforest, and a species-specific approach based on molecular identification should be proposed to provide appropriate medical management (<xref rid="R9" ref-type="bibr"><italic>9</italic></xref>). Indeed, although <italic>L. braziliensis</italic> parasites cause <10% of CL acquired in French Guiana, this species is noteworthy for its involvement of the mucous membranes of the lips, nose, soft palate, or larynx. Also, <italic>L. braziliensis</italic> parasites usually fail to respond to pentamidine isethionate, the first-line treatment of <italic>L. guyanensis</italic> CL in French Guiana; instead, treatment of <italic>L. braziliensis</italic> infection relies on parenteral meglumine antimoniate or liposomal amphotericin B (<xref rid="R1" ref-type="bibr"><italic>1</italic></xref>).</p><p>In summary, the geographic extension of and numeric increase in <italic>L. braziliensis</italic> cases in the Guiana ecoregion complex, as observed in the rest of South America, are worrisome, and continuous epidemiologic surveillance is needed. Infection with <italic>L. braziliensis</italic>, which is emerging and has potential to disseminate, must be considered in cases of CL acquired in this region. These issues have key implications for leishmaniasis treatment, which should be directed to the identified species (<xref rid="R10" ref-type="bibr"><italic>10</italic></xref>).</p></body><back><fn-group><fn fn-type="citation"><p><italic>Suggested citation for this article</italic>: Martin-Blondel G, Iriart X, El Baidouri F, Simon S, Mills D, Demar M, et al. Outbreak of <italic>Leishmania braziliensis</italic> cutaneous leishmaniasis, Saül, French Guiana [letter]. Emerg Infect Dis. 2015 May [<italic>date cited</italic>]. <ext-link ext-link-type="uri" xlink:href="http://dx.doi.org/10.3201/eid2105.141181">http://dx.doi.org/10.3201/eid2105.141181</ext-link></p></fn></fn-group><ack><p>We thank all the patients who actively participated in this study.</p></ack><app-group><app><title>Acknowledgement</title></app></app-group><ref-list><title>References</title><ref id="R1"><label>1. </label><mixed-citation publication-type="journal"><string-name><surname>Schwartz</surname><given-names>E</given-names></string-name>, <string-name><surname>Hatz</surname><given-names>C</given-names></string-name>, <string-name><surname>Blum</surname><given-names>J</given-names></string-name>. <article-title>New World cutaneous leishmaniasis in travellers.</article-title><source>Lancet Infect Dis</source>. <year>2006</year>;<volume>6</volume>:<fpage>342</fpage>–<lpage>9</lpage>. <pub-id pub-id-type="doi">10.1016/S1473-3099(06)70492-3</pub-id><pub-id pub-id-type="pmid">16728320</pub-id></mixed-citation></ref><ref id="R2"><label>2. </label><mixed-citation publication-type="journal"><string-name><surname>Desjeux</surname><given-names>P</given-names></string-name>, <string-name><surname>Dedet</surname><given-names>JP</given-names></string-name>. <article-title>Isoenzyme characterization of 112 <italic>Leishmania</italic> isolates from French Guiana.</article-title><source>Trans R Soc Trop Med Hyg</source>. <year>1989</year>;<volume>83</volume>:<fpage>610</fpage>–<lpage>2</lpage>. <pub-id pub-id-type="doi">10.1016/0035-9203(89)90373-8</pub-id><pub-id pub-id-type="pmid">2617620</pub-id></mixed-citation></ref><ref id="R3"><label>3. </label><mixed-citation publication-type="journal"><string-name><surname>El Baidouri</surname><given-names>F</given-names></string-name>, <string-name><surname>Diancourt</surname><given-names>L</given-names></string-name>, <string-name><surname>Berry</surname><given-names>V</given-names></string-name>, <string-name><surname>Chevenet</surname><given-names>F</given-names></string-name>, <string-name><surname>Pratlong</surname><given-names>F</given-names></string-name>, <string-name><surname>Marty</surname><given-names>P</given-names></string-name>, <etal></etal><article-title>Genetic structure and evolution of the <italic>Leishmania</italic> genus in Africa and Eurasia: what does MLSA tell us.</article-title><source>PLoS Negl Trop Dis</source>. <year>2013</year>;<volume>7</volume>:<fpage>e2255</fpage>. <pub-id pub-id-type="doi">10.1371/journal.pntd.0002255</pub-id><pub-id pub-id-type="pmid">23785530</pub-id></mixed-citation></ref><ref id="R4"><label>4. </label><mixed-citation publication-type="journal"><string-name><surname>Huson</surname><given-names>DH</given-names></string-name>, <string-name><surname>Bryant</surname><given-names>D</given-names></string-name>. <article-title>Application of phylogenetic networks in evolutionary studies.</article-title><source>Mol Biol Evol</source>. <year>2006</year>;<volume>23</volume>:<fpage>254</fpage>–<lpage>67</lpage>. <pub-id pub-id-type="doi">10.1093/molbev/msj030</pub-id><pub-id pub-id-type="pmid">16221896</pub-id></mixed-citation></ref><ref id="R5"><label>5. </label><mixed-citation publication-type="journal"><string-name><surname>Krolewiecki</surname><given-names>AJ</given-names></string-name>, <string-name><surname>Gil</surname><given-names>JF</given-names></string-name>, <string-name><surname>Quipildor</surname><given-names>M</given-names></string-name>, <string-name><surname>Cajal</surname><given-names>SP</given-names></string-name>, <string-name><surname>Pravia</surname><given-names>C</given-names></string-name>, <string-name><surname>Juarez</surname><given-names>M</given-names></string-name>, <etal></etal><article-title>Restricted outbreak of American tegumentary leishmaniasis with high microfocal transmission.</article-title><source>Am J Trop Med Hyg</source>. <year>2013</year>;<volume>88</volume>:<fpage>578</fpage>–<lpage>82</lpage>. <pub-id pub-id-type="doi">10.4269/ajtmh.12-0475</pub-id><pub-id pub-id-type="pmid">23339200</pub-id></mixed-citation></ref><ref id="R6"><label>6. </label><mixed-citation publication-type="journal"><string-name><surname>Andrade</surname><given-names>MS</given-names></string-name>, <string-name><surname>Brito</surname><given-names>ME</given-names></string-name>, <string-name><surname>Silva</surname><given-names>ST</given-names></string-name>, <string-name><surname>Ishikawa</surname><given-names>E</given-names></string-name>, <string-name><surname>Carvalho</surname><given-names>SM</given-names></string-name>, <string-name><surname>Brandao-Filho</surname><given-names>SP</given-names></string-name>. <article-title>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</article-title><comment>[in Portuguese]</comment>. <source>Rev Soc Bras Med Trop</source>. <year>2009</year>;<volume>42</volume>:<fpage>594</fpage>–<lpage>6</lpage>. <pub-id pub-id-type="doi">10.1590/S0037-86822009000500022</pub-id><pub-id pub-id-type="pmid">19967247</pub-id></mixed-citation></ref><ref id="R7"><label>7. </label><mixed-citation publication-type="journal"><string-name><surname>Sanchez</surname><given-names>JL</given-names></string-name>, <string-name><surname>Diniega</surname><given-names>BM</given-names></string-name>, <string-name><surname>Small</surname><given-names>JW</given-names></string-name>, <string-name><surname>Miller</surname><given-names>RN</given-names></string-name>, <string-name><surname>Andujar</surname><given-names>JM</given-names></string-name>, <string-name><surname>Weina</surname><given-names>PJ</given-names></string-name>, <etal></etal><article-title>Epidemiologic investigation of an outbreak of cutaneous leishmaniasis in a defined geographic focus of transmission.</article-title><source>Am J Trop Med Hyg</source>. <year>1992</year>;<volume>47</volume>:<fpage>47</fpage>–<lpage>54</lpage> .<pub-id pub-id-type="pmid">1636883</pub-id></mixed-citation></ref><ref id="R8"><label>8. </label><mixed-citation publication-type="confproc"><string-name><surname>Carme</surname><given-names>B</given-names></string-name>, <string-name><surname>Simon</surname><given-names>S</given-names></string-name>, <string-name><surname>Couppie</surname><given-names>P</given-names></string-name>. Epidemiological survey of leishmaniasis in French Guiana. In: Proceedings of the 3rd French Indies and Guiana Interregional Meeting; 2012 Oct 26–27. Saint-Maurice (France): Institut National de Veille Sanitaire; <year>2012</year>.</mixed-citation></ref><ref id="R9"><label>9. </label><mixed-citation publication-type="journal"><string-name><surname>Lavergne</surname><given-names>RA</given-names></string-name>, <string-name><surname>Iriart</surname><given-names>X</given-names></string-name>, <string-name><surname>Martin-Blondel</surname><given-names>G</given-names></string-name>, <string-name><surname>Chauvin</surname><given-names>P</given-names></string-name>, <string-name><surname>Menard</surname><given-names>S</given-names></string-name>, <string-name><surname>Fillaux</surname><given-names>J</given-names></string-name>, <etal></etal><article-title>Contribution of molecular diagnosis to the management of cutaneous leishmaniasis in travellers.</article-title><source>Clin Microbiol Infect</source>. <year>2014</year>;<volume>20</volume>:<fpage>O528</fpage>–<lpage>30</lpage> . <pub-id pub-id-type="doi">10.1111/1469-0691.12487</pub-id><pub-id pub-id-type="pmid">24279601</pub-id></mixed-citation></ref><ref id="R10"><label>10. </label><mixed-citation publication-type="journal"><string-name><surname>Hodiamont</surname><given-names>CJ</given-names></string-name>, <string-name><surname>Kager</surname><given-names>PA</given-names></string-name>, <string-name><surname>Bart</surname><given-names>A</given-names></string-name>, <string-name><surname>de Vries</surname><given-names>HJ</given-names></string-name>, <string-name><surname>van Thiel</surname><given-names>PP</given-names></string-name>, <string-name><surname>Leenstra</surname><given-names>T</given-names></string-name>, <etal></etal><article-title>Species-directed therapy for leishmaniasis in returning travellers: a comprehensive guide.</article-title><source>PLoS Negl Trop Dis</source>. <year>2014</year>;<volume>8</volume>:<fpage>e2832</fpage> . <pub-id pub-id-type="doi">10.1371/journal.pntd.0002832</pub-id><pub-id pub-id-type="pmid">24787001</pub-id></mixed-citation></ref></ref-list></back></pmc></record>Pour manipuler ce document sous Unix (Dilib)
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