BARTONELLOSIS

also called Carrin's Disease, rickettsial infection limited to South America, caused by the bacterium Bartonella bacilliformis of the order Rickettsiales. Bartonellosis is characterized by two distinctive clinical stages: Oroya fever, an acute febrile anemia of rapid onset, bone and joint pains, and a high mortality if untreated, and verruga peruana, a more benign skin eruption characterized by reddish papules and nodules, which usually follows the Oroya fever but may also occur in individuals who have not exhibited previous symptoms. The skin lesions are thought to be an expression of developing immunity in the affected persons; reinfection is extremely rare. The disease is transmitted to humans by the night-biting sand fly of the genus Phlebotomus, which propagates in the Andes Mountains in parts of Peru, Ecuador, and Colombia. The disease responds well to certain antibiotics. Control measures are directed principally at the insect carrier, with the use of insecticides and insect repellents.