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      Bartonellosis in Ecuador: serosurvey and current status of cutaneous verrucous disease.

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          Abstract

          Human bartonellosis is a classically biphasic disease caused by infection with the alpha-2 Proteobacteria Bartonella bacilliformis, which is phylogenetically related to the etiologic agents of cat scratch disease, bacillary angiomatosis, and trench fever. In Ecuador, typical bartonellosis has remained endemic for the past century in highland provinces near the Peruvian border. During the past six years, public health officials have noted an increasing number of atypical cases in which monophasic verrucous cutaneous disease is the only clinical manifestation. Epidemiologic, immunologic, histopathologic, and molecular biological studies have confirmed the presence of sporadic, atypical bartonellosis in residents of the lowland province of Manabi, where archeologic evidence exists of bartonellosis in pre-Colombian times. Between 1987 and 1995, 11 cases of cutaneous bartonellosis were investigated and serologic studies were done on 224 persons from five villages, two lowland and three highland. In the lowland village of Pajan in the province of Manabi, there was a 21% seropositivity proportion in contacts of index cases. These combined data suggest that bartonellosis is significantly under-reported due to the existence of mild clinical disease, possibly associated with less virulent bacterial strains, which are now disseminating or re-emerging in previously disease-free areas.

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          Author and article information

          Journal
          Am. J. Trop. Med. Hyg.
          The American journal of tropical medicine and hygiene
          0002-9637
          0002-9637
          Aug 1997
          : 57
          : 2
          Affiliations
          [1 ] National Institute of Hygiene and Tropical Medicine, Leopoldo Izquieta Perez, Guayaquil, Ecuador.
          Article
          9288812
          f270e1fb-d68d-400e-9f9b-cc0836e03b26
          History

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