title: An outbreak of acute bartonellosis (Oroya fever) in the Urubamba region of Peru, 1998.
abstract: During May 1998, we conducted a case-control study of 357 participants from 60 households during an outbreak of acute bartonellosis in the Urubamba Valley, Peru, a region not previously considered endemic for this disease. Blood and insect specimens were collected and environmental assessments were done. Case-patients (n = 22) were defined by fever, anemia, and intra-erythrocytic coccobacilli seen in thin smears. Most case-patients were children (median age = 6.5 years). Case-patients more frequently reported sand fly bites than individuals of neighboring households (odds ratio [OR] = 5.8, 95% confidence interval [CI] = 1.2-39.2), or members from randomly selected households > or = 5 km away (OR = 8.5, 95% CI = 1.7-57.9). Bartonella bacilliformis isolated from blood was confirmed by nucleotide sequencing (citrate synthase [g/tA], 338 basepairs). Using bacterial isolation (n = 141) as the standard, sensitivity, specificity, and positive predictive value of thin smears were 36%, 96%, and 44%, respectively. Patients with clinical syndromes compatible with bartonellosis should be treated with appropriate antibiotics regardless of thin-smear results.
authors.affiliation: Viral and Rickettsial Zoonoses Branch, Division of Viral and Rickettsial Diseases, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia 30333, USA.
authors.forename: B A
authors.initials: BA
authors.lastname: Ellis
authors.forename: L D
authors.initials: LD
authors.lastname: Rotz
authors.forename: J A
authors.initials: JA
authors.lastname: Leake
authors.forename: F
authors.initials: F
authors.lastname: Samalvides
authors.forename: J
authors.initials: J
authors.lastname: Bernable
authors.forename: G
authors.initials: G
authors.lastname: Ventura
authors.forename: C
authors.initials: C
authors.lastname: Padilla
authors.forename: P
authors.initials: P
authors.lastname: Villaseca
authors.forename: L
authors.initials: L
authors.lastname: Beati
authors.forename: R
authors.initials: R
authors.lastname: Regnery
authors.forename: J E
authors.initials: JE
authors.lastname: Childs
authors.forename: J G
authors.initials: JG
authors.lastname: Olson
authors.forename: C P
authors.initials: CP
authors.lastname: Carrillo
mesh_terms: D000293:Adolescent; D000328:Adult; D001473:Bartonella / Q000302:isolation & purification*; D001474:Bartonella Infections / Q000175:diagnosis / Q000453:epidemiology* / Q000503:physiopathology; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D004196:Disease Outbreaks; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D010568:Peru / Q000453:epidemiology; D012307:Risk Factors