Objective: To report an outbreak of ZIKV infection among asymptomatic pregnant women during 2016 in the city of Jaen, Cajamarca. Results: Zika virus RNA was detected in 3.2% (n = 36) of cases by RT-PCR. The mean age of patients positive for ZIKV infection was 29.6 years. 7 patients (19.4%) infected with ZIKV were in their first-trimester of gestation, 13 (36.1%) were in their second-trimester, and 16 (44%) were in their third-trimester. All of the infected pregnant women were asymptomatic. ZIKV infection remains a major public health issue that calls for constant epidemiological surveillance. It can cause the congenital Zika virus syndrome in the newborns of infected mothers. The lack of molecular diagnostic methods in isolated localities and the similarity of symptoms to other arboviral infections, lead to an under-diagnosis of this disease in endemic areas. / Revisión por pares

CoordenaÃÃo de AperfeiÃoamento de Pessoal de NÃvel Superior / Pesquisas cientÃficas buscando a utilizaÃÃo de antÃgenos de Coccidioides posadasii sÃo comuns na literatura especializada, uma vez que, sÃo instrumentos relevantes para diagnÃstico e possÃvel efeito imunoprotetor em humanos. Diante do exposto, foi realizada caracterizaÃÃo bioquÃmica de antÃgeno protÃico oriundo de C. posadasii. busca ativa de casos humanos de coccidioidomicose no Estado do CearÃ, bem como, avaliaÃÃo da resposta imunolÃgica in vivo. Para concretizar tais objetivos, a caracterizaÃÃo bioquÃmica do antÃgeno foi realizada por meio de eletroforese (SDS-PAGE e 2D-PAGE), detecÃÃo de proteases, glicoproteÃnas e sequenciamento N-terminal e foram buscados, ativamente, quadros de coccidiodiomicose em trÃs caÃadores de tatu com a respectiva descriÃÃo clÃnica e avaliaÃÃo laboratorial. Ademais, foi descrito modelo murino de coccidioidomicose com testagem de possÃvel efeito imunoprotetor do antÃgeno in-house. Quanto a anÃlise bioquÃmica, observou-se delimitaÃÃo de bandas nas faixas de 45-67 kDa e 67-97 kDa (SDS-PAGE), detecÃÃo de glicoproteÃnas, proteases e sequenciamento N-terminal demonstrando serem as bandas uma β-glucosidase e uma glutamina sintetase. Nos casos clÃnicos, foram encontrados queixas pneumÃnicas, exame micolÃgico direto, cultivo de escarro, imunodifusÃo radial dupla (com antÃgeno in-house) e PCR positivos para C. posadasii. No modelo murino, o grupo infectado, na presenÃa de antÃgeno e adjuvante, apresentou, na anÃlise histopatolÃgica, menores alteraÃÃes pulmonares que os demais grupos, alÃm de maior estÃmulo linfÃide esplÃnico. No que concerne a dosagem de citocinas (IL-6, IL-12 e TNFα), nÃo se observou diferenÃa significativa entre os grupos, mas uma tendÃncia à resposta imunoprotetora. O grupo infectado, sem imunoproteÃÃo, apresentou maior perda ponderal. Na anÃlise macroscÃpica, o mÃximo comprometimento foi a presenÃa de 2 granulomas, neste Ãltimo grupo. Na anÃlise dos hemogramas, a sÃrie branca demonstrou maiores diferenÃas entre os grupos. Em conclusÃo, o antÃgeno in-house se mostrou tratar-se de uma β-glicosidase e uma glutamina sintetase que tenderam a estimular a imunidade celular em modelo murino. AlÃm disso, a descriÃÃo de casos humanos contribui para a difusÃo do diagnÃstico precoce da coccidioidomicose e requer investigaÃÃes laboratoriais complementares. / Scientific researches seeking to use Coccidioides posadasii antigens are common in the literature, as relevant instruments to diagnosis and possible immunoprotector effect in humans. Thus, we performed biochemical characterization of protein antigen derived from C. posadasii, an active search for human cases of coccidioidomycosis in CearÃ, as well as evaluation of immune response in vivo. To achieve these goals, the biochemical characterization of the antigen was performed by electrophoresis (SDS-PAGE and 2D-PAGE), detection of proteases, glycoproteins and N-terminal sequencing and we reported three human cases of coccidiodiomycosis in armadillo hunters with its clinical description and laboratory evaluation. Further, a murine model was described testing a possible imunoprotector effect with an in-house antigen. For biochemical analysis, it was observed delimitation bands in ranges 45-67 kDa and 67-97 kDa (SDS-PAGE), detection of glycoproteins, proteases and N-terminal sequencing demonstrating the bands being a β-glucosidase and a glutamine synthetase. In clinical cases, it was found pneumonic disease, direct mycological examination, sputum culture, double radial immunodiffusion (antigen in-house) and PCR positive for C. posadasii. In the murine model, the infected group, in the presence of antigen and adjuvant, showed, histologically, lung disorders smaller than the other groups, and increased splenic lymphoid stimulus. Regarding the cytokines (IL-6, IL-12 and TNF), there was no significant difference between groups, but a trend toward immunoprotective response. The infected group, without immunoprotection, showed greater weight loss. In the macroscopic analysis, the maximum commitment was the presence of 2 granulomas in the latter group. In the analysis of blood counts, the white run showed major differences between groups. In conclusion, the in-house antigen showed that it was a β-glucosidase and a glutamine synthetase which tended to stimulate cellular immunity in a murine model. Moreover, the description of human cases contributes to the spread of early diagnosis of coccidioidomycosis and requires additional laboratory investigations.

Tornado outbreaks (TO) occur every year across the continental United States and are a result of various synoptic scale, mesoscale, and climatological patterns. This study looks to find what patterns exist among the various scales and how that relates to the climatology of the TOs. In order to find these patterns, principal component analysis (PCA) and a cluster analysis were conducted to differentiate the patterns of data. Four distinct clusters of TOs were found with varying synoptic and mesoscale patterns as well as distinct climatological patterns. An interesting result from this study includes the shifting of TO characteristics over time to a more synoptically forced pattern that has becoming stronger and shifted eastward from the Great Plains.

In an infectious animal disease outbreak, effective management of the event requires timely and accurate information collection, processing, storage and distribution. This thesis focuses on the tools to assist information collection and management. The first study describes the comparison of questionnaire methodology for the information collection in the initial epidemiologic investigation of a Canadian federally reportable disease. The second study defines attributes of an animal disease outbreak information management system (IMS). The studies were performed within a one-year period (July 2013-July 2014). The first study performed two comparisons to determine differences in the information quality (completeness and accuracy) between differing questionnaire methodology and modes of completion (hard copy and electronic). The study was conducted with 24 Canadian Food Inspection Agency (CFIA) inspectors and veterinarians using a fictitious Canadian reportable disease scenario. The first comparison used a hard copy of a Canadian Food Inspection Agency (CFIA) questionnaire designed to be applicable (or generic) for all highly infectious reportable disease investigations with a supplementary disease specific section compared to an electronic disease specific reportable disease questionnaire. There was no significant difference in the information quality (N = 22; P = 0.09). The mean difference in completeness and accuracy scores was 3.5% (95% CI -0.6, 7.6). The second comparison focused on the hard copy disease questionnaire and assessed differences in information quality between using only the generic sections of the questionnaire compared to the supplementation of a disease specific section. A difference in information quality was determined (N = 24; P < 0.0001). The mean completeness and accuracy score for the generic only sections was 50.2% (95% CI 43.6, 57.2) compared to 80.2% (95% CI 76.2, 84.5) with the inclusion of the disease-specific section. The greatest difference in information quality occurred in the tracing specific information categories (P < 0.0001) with a mean difference of completeness and accuracy scores of 67.7% (95% CI 52.0, 83.4) for the trace-in (exposure history) category and 38.3% (95% CI 28.3, 48.3) for the trace-out (potential spread of disease) category. The absence of disease-specific questions were determined to be the primary factor in the difference in information quality. The second study determined a comprehensive list of user-defined attributes of an animal disease outbreak IMS and further identified the most important (key) attributes. A list of 34 attributes and associated definitions were determined through a series of focus group sessions and two surveys of Canadian animal health stakeholders. The animal health stakeholders included federal and provincial governments, veterinary academia and animal production industry representatives. The key attributes of an animal disease outbreak IMS identified were: ‘user friendly’, ‘effectiveness’, ‘accessibility’, ‘data accuracy’, ‘reliability’ and ‘timeliness’. ‘User friendly’ received the highest frequency of ranking as the most important attribute, followed by ‘effectiveness’. Information management was identified as the main purpose of an animal disease outbreak IMS with a median rating of 10 (rating scale of 0-10 with 10 = strongly agree). The occurrence of a federally reportable disease or a large-scale animal disease outbreak can have a great impact on the animal agriculture sector, regulatory government agencies and the economy. Information collection and management are essential to assist with the epidemiologic investigation and disease control measures. The study provided a novel opportunity to study information management for an animal disease outbreak from a Canadian perspective. The knowledge obtained will add value to the future development of tools and systems designed for information collection and management involving an animal disease outbreak.

Background. Foodborne disease is estimated to cause 48 million illnesses annually in the US resulting in 3000 deaths [1]. Although most infections occur as sporadic cases, outbreak surveillance offers valuable insight about the foods and pathogens responsible for illnesses [2]. A total of 1632 foodborne disease outbreaks were reported during 2011-2012 [3] and recent data indicates an overall decrease in the number of outbreaks reported each year [4]. Understanding which factors contribute to the successful identification of a food vehicle in a foodborne outbreak investigation is crucial for improving outbreak response [5-10]. The purpose of this study was to describe outbreak characteristics and to determine which may be associated with the success of a foodborne outbreak investigation (i.e. one in which a food vehicle has been reported). Methods. A foodborne disease outbreak was defined as the event in which two or more people acquired similar illnesses from consuming the same food or beverage. Outbreaks occurring in FoodNet sites during 2003 through 2010 were included in the analysis. Results. Data were available for 1441 (87%) of the 1655 foodborne disease outbreaks documented in FoodNet Outbreak Supplement forms from 2003 through 2010. A food vehicle was identified in 692 of the 1441 (48%) outbreaks. Six outbreak characteristics remained statistically significant in both univariate and multivariate analyses: environmental and/or food culture collection, FDA or state agriculture involvement, outbreak size, case-control studies, and number of fecal specimens tested for norovirus. Conclusions. Less than half of foodborne outbreaks examined here resulted in a food vehicle being identified. Having more robust resources available for outbreak detection and investigation may improve likelihood of a food vehicle being identified.

No description available.

Bakgrund: Enterohemorragisk Escherichia coli (EHEC) är en toxinproducerande bakterie somkan orsaka sporadiska fall av infektion men även ge upphov till allvarliga utbrott. Sjukdomen kan ge symtom alltifrån okomplicerad diarré, blodig diarrétill mycket allvarliga symtomsom hemolytiskt uremiskt syndrom (HUS). De flesta EHEC-falli Sverige förekommer i åldersgruppen ett till fyra år. Syfte: Studienssyfte var att undersöka värdet av en EHEC-screening hos barn under tio år genom att kartlägga förekomst av EHEC och distribution av serotypoch stx-typer. Ytterligare ett syfte var att undersöka om den kliniska bilden är beroende av serotyp och stx-typ. Därutöver undersöktes hur länge man utsöndrars tx i avföringen. Metod: I studien ingick alla barn under tio års ålder, som lämnat avföringsprov under perioden 1 maj 2003 till 30 april 2013i Jönköpingslän. Barnen delades in i de med klinisk EHEC frågeställning och de resterande som ingick i screeningen. Barnen följdes med upprepad provtagning varje vecka efter första positiva provet. Kliniska data samlades in via ett frågeformulär samt via granskning av journaler. Resultat: Totalt diagnostiserades 191 barn (87 flickor och 104 pojkar) med EHEC, av dessa var 162 indexfall och 29 hittades vid smittspårning. Prevalensen av EHEC var 1,8% i gruppen med klinisk frågeställning och 1,5% ingick i screening (p=0,5). Mediantiden för utsöndringav stx i avföringen var 20 dagar (1-256 dagar). Barnmed Stx2 producerande EHEC hade allvarligare symtom. Sju barn insjuknade i HUS, alla var smittade i Sverige. Det var vanligare med Stx2 hos barn smittade i Sverige. I fem av fallen kunde smittkällan fastställas. Konklusion: Studienvisar en lika högprevalens av EHEC i den screenade gruppen som i gruppen där EHEC var efterfrågat. Även svårighetsgraden av symtom var lika i båda grupperna.EHEC-förekomstenvar hög och de flestavarejav serotyp O157. Serotypoberoende metoder vid diagnostikär därför viktiga. Den långa utsöndringstiden utgör en risk för smittspridning. De flesta barnen med Stx2 var smittade i Sverige, vilket medför ökad risk för svår sjukdom. Studiens resultatbekräftar värdet av EHEC-screening hos barn. / Background:Enterohemorrhagic Escherichia coli(EHEC) is a toxin-producing bacterium responsible for sporadic cases of infection as well as serious outbreaks. Symptoms rangefrom uncomplicated or bloody diarrhea to hemolytic uremic syndrome (HUS). In Sweden, most EHEC casesoccurin 1-4-year-old children. Aims:This study aimed at investigate the value of EHEC screening in children younger than 10 years of age by evaluatingthe prevalence of EHEC and the distribution of serotypes and stxtypes. We also aimed t ocorrelate clinical symptoms with EHEC serotypes and stxtypes. Furthermore the duration of faecal shedding of stxwas investigated. Methods: The study examined stool samples collected fromall children younger than 10 years of age between1 May 2003 and April 2013 in the County of Jönköping. We divided the children into a physician-requested EHEC analysis group and ascreening group. Children who tested positive for stxwere sampled weekly after initial EHEC diagnosis. We used a questionnaire and reviewed medical records to collect clinical data. Results: Among 191 children (87 girls and 104 boys) with confirmed EHEC, 162 specimens were index cases and 29 were found by contact tracing. The EHEC prevalence was 1.8 % in the EHEC requested group and 1.5 % in the screening group (p=0.5). The median duration of stxdetection in faeces was 20 days (1-256 days). Symptoms were more severe in children with Stx2-producing EHEC, and seven children developed HUS, all infected in Sweden. We were able to determine the source of infection in five cases. Conclusions: This study showed that the EHEC prevalence and severity of symptoms where equal between the requested and screening group. HighEHEC prevalence and a high proportion of non-O157 isolates were found. Our results emphasize the need for serotype-independent methods for EHEC detection. The long duration of stxdetection in stools indicates a risk for transmission. Most children with Stx2 were infected in Sweden, suggesting a higher risk forsevere symptoms. Our results confirm the value of EHEC screening in children. / <p>ISBN 978-94-86739-92-8</p>

Forest tent caterpillar (Malacosoma disstria Hübner; FTC), a major defoliator of aspen trees, occupies both aspen and mixedwood forest stands in Alberta’s boreal forest. Forest stand composition could influence the spatial pattern of FTC outbreaks if mortality from natural enemies differs between stand types. I conducted field experiments to determine whether predator- or parasitoid-caused mortality of FTC differed between aspen and mixedwood forest stands and developed a spatial population model to determine the effects of variation in generalist predation on the spread of an FTC outbreak, including the effects of potential predator-caused Allee effects. Generalist predation on FTC was higher in aspen stands than in mixedwood stands, and the spatial model suggests that these observed differences may be sufficiently large to impact FTC outbreak spread rates. Forest stand composition may contribute to the spatial pattern of FTC outbreaks through variation in the impacts of predators on FTC populations. / Ecology

Submitted by Ana Maria Fiscina Sampaio (fiscina@bahia.fiocruz.br) on 2012-07-25T20:57:02Z No. of bitstreams: 1 Luis da Conseiçao Martins Morais Epidemiologia molecular de Streptococcus pneumoniaes... 2012.pdf: 2694690 bytes, checksum: 6a8757e0acddf633d2db80ca6ea13e0c (MD5) / Made available in DSpace on 2012-07-25T20:57:02Z (GMT). No. of bitstreams: 1 Luis da Conseiçao Martins Morais Epidemiologia molecular de Streptococcus pneumoniaes... 2012.pdf: 2694690 bytes, checksum: 6a8757e0acddf633d2db80ca6ea13e0c (MD5) Previous issue date: 2012 / Fundação Oswaldo Cruz. Centro de Pesquisas Gonçalo Moniz. Salvador, Bahia, Brasil / Streptococcus pneumoniae é a principal causa de morbi-mortalidade no mundo. Em Moçambique, os sorotipos 1 e 5 são os mais prevalentes. Este estudo investigou a relação clonal de isolados de pneumococo obtidos de doença invasiva entre o período de 2002-2007, utilizando três procedimentos laboratoriais: Box-PCR, PFGE e MLST. Um total de 105 isolados (sendo 72 do sorotipo 1 e 33 do sorotipo 5), foram submetidos a técnica de Box-PCR. O sorotipo 5 apresentou cinco padrões, sendo um clonal com 20 isolados e quatro padrões não clonais. O padrão A foi o predominante com 61% dos isolados, enquanto que por PFGE, 100% dos isolados foram agrupados em um único clone (clone A), e pela técnica de MLST foi identificado apenas um único ST (ST 289). Por outro lado, o sorotipo 1 apresentou maior diversidade clonal pelos três métodos; por Box-PCR os isolados foram agrupados em 3 clones, sendo predominante o padrão B com 58 isolados, padrão C e N com dois isolados cada. Um total de 12 isolados foram não clonais. O clone B apresentou 20 subtipos, sendo o mais frequente o sub-tipo B1 com 20 amostras idênticas, seguido por B2, B6, B7 com 5 amostras idênticas cada. Por PFGE, 19 amostras confirmaram ser do mesmo perfil clonal (clone B), enquanto que 12 amostras demonstraram ser não clonais. Quando submetidos ao MLST, foram identificados 6 STs; ST 217 (7 isolados), ST 853 (1 isolado), e quatro novos STs, ST 4125, ST 2909, ST 3779 e ST 4166. O ST 217 pertence ao clone Suécia1-27 (ST217), identificados previamente em surtos de meningite na África, enquanto o ST 289 foi identificado como um representante do clone Colômbia5-19 (ST289) que circulam na América Latina desde 1994. A taxa de não susceptibilidade à penicilina foi de 3%, e à cotrimoxazole foi de 39%. A maior taxa de resistência foi encontrada entre os isolados de sorotipo 1. Este trabalho mostra a persistência de dois sorotipos responsáveis por causar doença pneumocócica invasiva graves, bem como seus respectivos clones em uma região do sul de Moçambique. / Streptococcus pneumoniae is the leading cause of morbidity and mortality worldwide. In Mozambique, serotypes 1 and 5 are the most prevalent. This study investigated the clonal relationship of isolates obtained from pneumococcal invasive disease during the period of 2002-2007 using three laboratory procedures: Box-PCR, PFGE and MLST. A total of 105 isolates (72 serotype 1 and 33 serotype 5) were submited to Box-PCR technique. The serotype 5 showed five patterns, one clonal with 20 isolates and four non-clonal patterns. The pattern A, covered 61% of all isolates, whereas by PFGE, 100% of the isolates have been grouped into a single clone (clone A), and by MLST was also identified only one ST (ST 289). In another hand, serotype 1 had higher clonal diversity by the three methods; by Box-PCR isolates have been grouped into three clonal patterns, the pattern B being predominantly (58 isolates), C and N with two isolates each. A total of 12 strains were non-clonal. Clone B showed 20 sub-types, the most common subtype B1 with 20 identical samples, followed by B2, B6, B7 with 5 identical samples each. By PFGE, 19 samples confirmed with the same profile clone (clone B), while 12 samples were non-clonal. By MLST, 6 STs were identified, ST 217 (7 isolates), ST 853 (one isolate) and four new STs, ST 4125, ST 2909, ST 3779 and ST 4166. ST 217 belongs to Sweden1-27 clone (ST217), previously identified in outbreaks of meningitis in Africa, while the ST 289 has been identified as a representative clone Colômbia5-19 clone (ST289) that circulate in Latin America since 1994. The rate of non susceptibility to penicilin was 3%, and 39% to cotrimoxazol. The highest resistance rate was found among serotype 1 isolates. This results shows the persistence of two serotypes responsible for cases of severe invasive pneumococcal disease, as well as their respective clones in a region of southern Mozambique.

Submitted by Ana Maria Fiscina Sampaio (fiscina@bahia.fiocruz.br) on 2012-08-02T21:29:09Z No. of bitstreams: 1 Pricila Brito Magalhães. Ocorrencia de Leishmaniose visceral humana num ecossistema de manguezal.pdf: 2019963 bytes, checksum: 4cd382e434745709deb814ea88bad0c0 (MD5) / Made available in DSpace on 2012-08-02T21:29:10Z (GMT). No. of bitstreams: 1 Pricila Brito Magalhães. Ocorrencia de Leishmaniose visceral humana num ecossistema de manguezal.pdf: 2019963 bytes, checksum: 4cd382e434745709deb814ea88bad0c0 (MD5) Previous issue date: 2009 / Fundação Oswaldo Cruz. Centro de Pesquisas Gonçalo Moniz. Salvador, Bahia, Brasil / A leishmaniose visceral humana (LVH) é reconhecida como uma importante doença infecciosa emergente em muitas áreas do mundo. Recentemente, a ocorrência de LVH na periferia de grandes centros urbanos tem causado preocupação à saúde pública. É uma doença insidiosa, com espectro amplo, variando desde a infecção assintomática a casos com doença grave. Já foi descrita em diversos tipos de ambientes e climas, dentre eles não há referências sobre o encontro de casos em manguezal. Assim, o objetivo deste trabalho é Investigar um surto de Leishmaniose Visceral Humana em ecossistema de manguezal, descrevendo as características dos casos confirmados da doença, avaliando a prevalência de infecção por Leishmania em outros moradores dos domicílios com caso, identificando a presença do Lutzomyia longipalpis no domicílio e peridomicílio e, avaliando a prevalência de casos de leishmaniose canina na região. O surto ocorreu no município de Salinas da Margarida, cidade situada no nordeste do Brasil, em 2004. Todos os outros moradores do domicílio (controles) foram avaliados quanto à evidência de infecção prévia por Leishmania sp. usando o teste de Intradermo Reação de Montenegro (IDRM). A presença de pápula/ nódulo, ≥5 mm ou ulceração foi considerada como IDRM positiva. Os fatores de risco foram investigados através de questionário testado e validado. No total, 26 casos foram relatados em 2004. Cerca de 54% eram homens e 46% eram mulheres; 50% tinham menos de 10 anos e a maioria dos casos (69,2%) ocorreram no Distrito de Encarnação, seguido de Pirajuía (11,5%). Todos os pacientes foram diagnosticados pela demonstração parasitológica de Leishmania sp. ou pela apresentação clínica (febre, hepatoesplenomegalia e pancitopenia) com ou sem resposta à terapia antimonial. Foram capturados flebótomos (Lutzomyia longipalpis) em metade das casas (13/26) onde os casos moravam. Foram avaliados 145 moradores (26 casos e 119 controles). Em cerca de 35% dos domicílios 100% dos moradores não-caso apresentavam evidência de infecção. E em 81% das residências (21 de 26) metade ou mais dos moradores nãocaso tinham evidência de infecção. Cerca de 60% dos domicílios tinham cão e em metade das residências foi encontrado flebótomo (Lutzomyia longipalpis) numa única tentativa de captura. Dentre os fatores de risco investigados para LVH, o consumo/ abuso de bebida alcoólica foi significativamente associado à maior chance de desenvolver doença aparente (OR= 10,6). Nosso estudo indica, pela primeira vez, a ocorrência da LVH em um ecossistema de manguezal, inusitado para a adaptação do flebótomo. Os dados indicam também que a maioria dos moradores de domicílios onde ocorreu caso de LVH tem evidência de infecção por Leishmania sp., embora a maioria não desenvolva doença aparente. As implicações destes achados devem ser mais estudadas. / The Human Visceral Leishmaniasis (LVH) is recognized as an important emerging infectious disease in many areas of the world. Recently, the occurrence of LVH in the outskirts of large urban centers have caused concern to public health. It is an insidious disease, with broad spectrum, ranging from asymptomatic infection to cases of serious illness. It has been described in many types of environments and climates, among them there are no references about the meeting where mangroves. The objective of this study is to investigate an outbreak of Kala-azar in mangrove ecosystem, describing the characteristics of confirmed cases of the disease, assessing the prevalence of Leishmania infection in other residents of the homes with the case, identifying the presence of Lutzomyia longipalpis in domiciliary areas and assessing the prevalence of cases of canine leishmaniasis in the region. The outbreak occurred in the city of Salinas da Margarida, a city in northeastern Brazil, in 2004. All other household members (controls) were evaluated for evidence of prior infection with Leishmania sp. using the test “IntradermoReação de Montenegro (IDRM)”. The presence of papule / nodule ≥ 5 mm or ulceration was seen as positive IDRM. The risk factors were investigated through a questionnaire and tested. In total, 26 cases were reported in 2004. About 54% were men and 46% were women, 50% had less than 10 years and most cases (69.2%) occurred in the district of Incarnation, followed by Pirajuía (11.5%). All patients were diagnosed by parasitological demonstration of Leishmania sp. or by clinical presentation (fever, hepatosplenomegaly and pancytopenia) with or without response to antimonial therapy. Were captured sandflies (Lutzomyia longipalpis) in half of the homes (13/26) where the cases lived. We assessed 145 residents (26 cases and 119 controls). In about 35% of households 100% non-residents' case had evidence of infection. And in 81% of households (21 of 26) half or more of non-residents if they had evidence of infection. About 60% of households had dogs and half of the homes was found sandfly (Lutzomyia longipalpis) in a single attempt to capture. Among the investigated risk factors for LVH, the use / abuse of alcohol was significantly associated with greater chance to develop apparent disease (OR = 10.6). Our study indicates for the first time, the occurrence of LVH in a mangrove ecosystem, unusual for the adaptation of the sandfly. The data also indicate that most residents of households where there was case of LVH has evidence of infection by Leishmania sp., Although most do not develop apparent disease. The implications of these findings should be further investigated.