title: A cluster of human T-cell lymphotropic virus type I-associated myelopathy/tropical spastic paraparesis in Jujuy, Argentina.
abstract: 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.
authors.affiliation: National Reference Center of AIDS, Buenos Aires, Argentina. mbiglione@fmed.uba.ar
authors.forename: Mirna M
authors.initials: MM
authors.lastname: Biglione
authors.forename: Manuel
authors.initials: M
authors.lastname: Pizarro
authors.forename: Alberto
authors.initials: A
authors.lastname: Puca
authors.forename: Horacio E
authors.initials: HE
authors.lastname: Salomón
authors.forename: Maria I
authors.initials: MI
authors.lastname: Berría
mesh_terms: 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