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An epidemic of Oroya fever in the Peruvian Andes
G C Gray1, A A Johnson, S A Thornton
1Walter Reed Army Institute of Research, Washington, DC.
Abstract:
Between February and October 1987, a febrile illness killed 14 persons and seriously affected at least 14 others in Shumpillan, a remote Peruvian mountain village of 353 people. The illness was characterized by fever, headache, chills, and pallor. The fatality rate of untreated cases was 88%. The patients, 71% of whom were male, were 1-75 years of age. Fatal illnesses progressed from lethargy to coma to death in 3-60 days. Patients treated empirically with chloramphenicol survived. Bartonella bacilliformis was isolated from the whole blood of 3 patients. A serologic study revealed a high prevalence of antibodies to B. bacilliformis in the villagers. It is concluded that the villagers suffered from an epidemic of Oroya fever.
Insights
An epidemic of Oroya fever caused by Bartonella bacilliformis in a Peruvian village resulted in a high fatality rate. Early chloramphenicol treatment proved effective, saving lives in this severe febrile illness outbreak.
Area of Science:
- Infectious Diseases
- Epidemiology
- Bacteriology
Background:
- A remote Peruvian village experienced a severe outbreak of a febrile illness between February and October 1987.
- The illness presented with fever, headache, chills, and pallor, leading to a high fatality rate of 88% in untreated cases.
Purpose of the Study:
- To investigate the cause and characteristics of a deadly febrile illness outbreak in Shumpillan, Peru.
- To determine the etiological agent and assess the effectiveness of empirical treatment.
Main Methods:
- Clinical observation of affected individuals, including symptom progression and outcomes.
- Isolation of Bartonella bacilliformis from patient blood samples.
- Serological testing to detect antibodies against Bartonella bacilliformis in the village population.
Main Results:
- The outbreak affected at least 28 individuals in a village of 353 people, with 14 fatalities.
- Fatal cases progressed from lethargy to coma and death within 3-60 days.
- Bartonella bacilliformis was identified in patients, and a high prevalence of antibodies to this bacterium was found in villagers. Empirical chloramphenicol treatment led to patient survival.
Conclusions:
- The outbreak was diagnosed as an epidemic of Oroya fever, caused by Bartonella bacilliformis.
- Prompt empirical treatment with chloramphenicol is crucial for survival during Oroya fever epidemics.