Kongkaew W, Siriarayaporn P, Leelayoova S, Supparatpinyo K, Areechokchai D, Duang-ngern P, Chanachai K, Sukmee T, Samung Y, Sridurongkathum P
Field Epidemiology Training Program, Ministry of Public Health, Nonthaburi, Thailand.
Southeast Asian J Trop Med Public Health. 2007 Jan;38(1):8-12.
Visceral leishmaniasis (VL) is a rare disease in Thailand. Only one previous case has been reported in which transmission was likely autochthonous. We conducted an investigation of a case of VL, which included serological and symptom surveys of people who lived near the case in Nan Province and Bangkok, serological surveys of domestic animals in his home village and sand fly surveys in his home village and in Bangkok. No humans interviewed met our case definition for possible VL. One hundred thirty-one villagers were seronegative for Leishmania antibodies. We found three cows and one cat that had positive direct agglutination tests for Leishmania spp, but we were unable to confirm current infection by PCR. Sand fly surveys showed that most of the flies were of the Sergentomyia genus, which has not previously been reported as a competent vector in Thailand. Nonetheless, we conclude, based on the patient's lack of travel outside Thailand and the presence of seropositive domestic animals in his home village, that he was most likely infected by the bite of a sand fly in Thailand. We believe this is the second case of autochthonously transmitted VL in Thailand.
内脏利什曼病（VL）在泰国是一种罕见疾病。此前仅报告过一例可能为本地传播的病例。我们对一例VL病例进行了调查，包括对难府和曼谷病例居住地附近居民的血清学及症状调查、其家乡家畜的血清学调查以及其家乡和曼谷的白蛉调查。接受访谈的人中无人符合我们关于可能患VL的病例定义。131名村民利什曼原虫抗体血清学检测呈阴性。我们发现三头牛和一只猫利什曼原虫属直接凝集试验呈阳性，但无法通过PCR确认当前感染情况。白蛉调查显示，大多数白蛉属于司蛉属，此前在泰国尚未报道该属为有效传播媒介。尽管如此，基于患者在泰国境外无旅行史且其家乡存在血清学阳性家畜，我们得出结论，他很可能是在泰国被白蛉叮咬感染。我们认为这是泰国第二例本地传播的VL病例。
