title: Natural history of infection with Bartonella bacilliformis in a nonendemic population.
abstract: An investigation was performed after an outbreak of bartonellosis in a region of Peru nonendemic for this disorder. Symptoms of acute and chronic bartonellosis were recorded. Serological analysis was performed on 55% of the affected population (554 individuals), 77.5% of whom demonstrated previous infection with Bartonella bacilliformis. The attack rate of Oroya fever was 13.8% (123 cases); the case-fatality rate was 0.7%. The attack rate of verruga peruana was 17.6%. A new specific immunostain was developed and used to confirm the presence of B. bacilliformis in the biopsied skin lesions. Most seropositive individuals (56%) were asymptomatic. The symptoms that were associated with prior infection, as determined by Western blot, included fever (37.2% of the seropositive vs. 17.2% of the seronegative population; P<.001), bone and joint pain (27% vs. 9%; P<.001), headache (27% vs. 12.3%; P <.001), and skin lesions described as verruga peruana (26.8% vs. 4.9%; P<.001). Our findings suggest that infection with B. bacilliformis causes a broad spectrum of disease that is significantly milder in severity than that frequently reported.
authors.affiliation: Department of Internal Medicine, Harbor-University of California Los Angeles Medical Center, Torrance, California, USA.
authors.forename: M
authors.initials: M
authors.lastname: Kosek
authors.forename: R
authors.initials: R
authors.lastname: Lavarello
authors.forename: R H
authors.initials: RH
authors.lastname: Gilman
authors.forename: J
authors.initials: J
authors.lastname: Delgado
authors.forename: C
authors.initials: C
authors.lastname: Maguiña
authors.forename: M
authors.initials: M
authors.lastname: Verástegui
authors.forename: A G
authors.initials: AG
authors.lastname: Lescano
authors.forename: V
authors.initials: V
authors.lastname: Mallqui
authors.forename: J C
authors.initials: JC
authors.lastname: Kosek
authors.forename: S
authors.initials: S
authors.lastname: Recavarren
authors.forename: L
authors.initials: L
authors.lastname: Cabrera
mesh_terms: D000293:Adolescent; D000328:Adult; D000818:Animals; D001473:Bartonella; D001474:Bartonella Infections / Q000453:epidemiology* / Q000473:pathology; D002648:Child; D004522:Educational Status; D005260:Female; D006801:Humans; D006813:Humidity; D008297:Male; D010568:Peru / Q000453:epidemiology; D011817:Rabbits; D012867:Skin / Q000473:pathology; D013696:Temperature