title: Outbreak of Cutaneous Leishmaniasis in Peruvian Military Personnel Undertaking Training Activities in the Amazon Basin, 2010.
abstract: Military personnel deployed to the Amazon Basin are at high risk for cutaneous leishmaniasis (CL). We responded to an outbreak among Peruvian Army personnel returning from short-term training in the Amazon, conducting active case detection, lesion sample collection, and risk factor assessment. The attack rate was 25% (76/303); the incubation period was 2-36 weeks (median = 8). Most cases had one lesion (66%), primarily ulcerative (49%), and in the legs (57%). Real-time polymerase chain reaction (PCR) identified Leishmania (Viannia) braziliensis (59/61 = 97%) and L. (V.) guyanensis (2/61 = 3%). Being male (risk ratio [RR] = 4.01; P = 0.034), not wearing long-sleeve clothes (RR = 1.71; P = 0.005), and sleeping in open rooms (RR = 1.80; P = 0.009) were associated with CL. Sodium stibogluconate therapy had a 41% cure rate, less than previously reported in Peru (~70%; P < 0.001). After emphasizing pre-deployment education and other basic prevention measures, trainees in the following year had lower incidence (1/278 = 0.4%; P < 0.001). Basic prevention can reduce CL risk in deployed militaries.
authors.forename: Marianela
authors.initials: M
authors.lastname: Oré
authors.forename: Eliana
authors.initials: E
authors.lastname: Sáenz
authors.forename: Rufino
authors.initials: R
authors.lastname: Cabrera
authors.forename: Juan F
authors.initials: JF
authors.lastname: Sanchez
authors.forename: Maxy B
authors.initials: MB
authors.lastname: De Los Santos
authors.forename: Carmen M
authors.initials: CM
authors.lastname: Lucas
authors.forename: Jorge H
authors.initials: JH
authors.lastname: Núñez
authors.forename: Kimberly A
authors.initials: KA
authors.lastname: Edgel
authors.forename: Justino
authors.initials: J
authors.lastname: Sopan
authors.forename: Jorge
authors.initials: J
authors.lastname: Fernández
authors.forename: Andres M
authors.initials: AM
authors.lastname: Carnero
authors.forename: G Christian
authors.initials: GC
authors.lastname: Baldeviano
authors.forename: Juan C
authors.initials: JC
authors.lastname: Arrasco
authors.forename: Paul C F
authors.initials: PCF
authors.lastname: Graf
authors.forename: Andres G
authors.initials: AG
authors.lastname: Lescano
mesh_terms: D000293:Adolescent; D000967:Antimony Sodium Gluconate / Q000627:therapeutic use; D004196:Disease Outbreaks; D005260:Female; D006801:Humans; D007892:Leishmania braziliensis / Q000302:isolation & purification*; D018334:Leishmania guyanensis / Q000302:isolation & purification; D016773:Leishmaniasis, Cutaneous / Q000188:drug therapy / Q000453:epidemiology*; D008297:Male; D008889:Military Personnel; D010568:Peru / Q000453:epidemiology; D060888:Real-Time Polymerase Chain Reaction; D011795:Surveys and Questionnaires; D055815:Young Adult
chemical_list: D000967:Antimony Sodium Gluconate