title: An Outbreak of Bartonella bacilliformis in an Endemic Andean Community.
abstract: BACKGROUND
  Bartonellosis affects small Andean communities in Peru, Colombia and Ecuador. Research in this area has been limited.
  
  
  METHODS
  Retrospective review of 191 cases of bartonellosis managed in Caraz District Hospital, Peru, during the last outbreak (2003).
  
  
  RESULTS
  The majority of cases (65%) were 14 years old and younger. There was a peak in acute cases after the rainy season; chronic cases presented more constantly throughout the year. The sensitivity of blood smear against blood culture in acute disease was 25%. The most commonly used treatment for chronic disease was rifampicin; chloramphenicol was used to treat most acute cases. Complications arose in 6.8% and there were no deaths.
  
  
  CONCLUSIONS
  Diagnostic and treatment algorithms for acute and chronic bartonellosis have been developed without a strong evidence base. Preparation of ready-to-go operational research protocols for future outbreaks would strengthen the evidence base for diagnostic and treatment strategies and enhance opportunities for control.
authors.affiliation: London School of Hygiene and Tropical Medicine, London, United Kingdom.
authors.forename: Nuria
authors.initials: N
authors.lastname: Sanchez Clemente
authors.affiliation: Instituto de Medicina Tropical Alexander von Humboldt, Universidad Peruana Cayetano, Heredia, Lima, Peru.
authors.forename: Cesar
authors.initials: C
authors.lastname: Ugarte-Gil
authors.affiliation: Hospital San Juan de Dios, Caraz, Peru.
authors.forename: Nelson
authors.initials: N
authors.lastname: Solorzano
authors.affiliation: Instituto de Medicina Tropical Alexander von Humboldt, Universidad Peruana Cayetano, Heredia, Lima, Peru.
authors.forename: Ciro
authors.initials: C
authors.lastname: Maguiña
authors.affiliation: London School of Hygiene and Tropical Medicine, London, United Kingdom.
authors.forename: David
authors.initials: D
authors.lastname: Moore
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000465:Algorithms; D001474:Bartonella Infections / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology / Q000473:pathology; D045503:Bartonella bacilliformis; D002648:Child; D002675:Child, Preschool; D002701:Chloramphenicol / Q000008:administration & dosage*; D002908:Chronic Disease; D004196:Disease Outbreaks; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D010568:Peru / Q000453:epidemiology; D012293:Rifampin / Q000008:administration & dosage*
chemical_list: D002701:Chloramphenicol; D012293:Rifampin