A cluster of human T-cell lymphotropic virus type I-associated myelopathy/tropical spastic paraparesis in Jujuy, Argentina.
Compared with other regions in Argentina, greater human T-cell lymphotropic virus type I (HTLV-I) seroprevalence has been reported in Jujuy Province, where it reaches 2.32% in the general population, so that a search for HTLV-I-associated myelopathy/tropical spastic paraparesis (HAM/TSP) cases deserved to be carried out. Accordingly, a clinically diagnosed and serologically confirmed cluster of cases in 1 man and 10 women, including 2 sisters, is described here. Most patients (9/11) were born in Cochinoca Department, located in an Andes highland area called Puna Jujeña, situated at more that 3400 m above sea level. No history of risk factors was disclosed, except for a single transfusion in 1 patient. In contrast to the Andean region of Bolivia, where high HTLV-I seroprevalence is in part attributable to Japanese immigrants, the Jujuy population mainly consists of aborigines, mestizos, and European descendants. Therefore, the long-term presence of virus in Jujuy natives may be taken for granted. Considering the HAM/TSP cluster described here plus previously reported isolated cases in neighboring Salta Province, we speculate that the Puna Jujeña region and regions in that vicinity would be a microepidemic focus of disease. To determine the role of possible pathogenic cofactors such as geographic, ethnic, genetic, and cultural features, further pertinent surveys are required in subtropical northwestern Argentina.
Biglione
Mirna M
MM
National Reference Center of AIDS, Buenos Aires, Argentina. mbiglione@fmed.uba.ar
Pizarro
Manuel
M
Puca
Alberto
A
Salomón
Horacio E
HE
Berría
Maria I
MI
D001118:Argentina / Q000453:epidemiology; D016000:Cluster Analysis; D004196:Disease Outbreaks; D005260:Female; D005843:Geography; D006801:Humans; D015994:Incidence; D008297:Male; D015493:Paraparesis, Tropical Spastic / Q000150:complications / Q000453:epidemiology*; D035781:Siblings; D011795:Surveys and Questionnaires