Thursday, September 30, 2010

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DAY OF PERUVIAN



OCTOBER 5th, DAY OF PERUVIAN MEDICINE
Named in Daniel Alcides Carrión honour, a Peruvian medical student, (August 13th, 1857 - October 5th, 1885).



Daniel Alcides Carrión was born in Cerro de Pasco (4330 meters) and began the study of medicine in 1879 at San Marcos University in Lima. Some years earlier there had been a severe outbreak of an epidemic on the railroad construction between Lima's seaport town Callao and La Oroya (3730 metres). The disease, characterised by fever, quickly progressing anaemia and a high rate of mortality, killed thousands, chiefly among the workers recruited from outside. The physicians were at a loss, never having seen anything like it before.



Railroad construction 1885


As a new factor of the problem was a noticeable increase in Peruvian Verruca or ("Verruga Peruana") . This disease, which manifests with wart-like skin eruptions of various shapes and sizes, it had been present in Peru already in pre-Columbian times, and which had been described in some writings from the English time.

In his journeys from Cerro de Pasco to Lima and vice versa Carrion had met people with verrucous skin eruptions people with fever and caught an interest in the disease. From 1881 he conducted extensive research on "Verruga Peruana", including clinical studies at the " Dos de Mayo hospital " in Lima.

Carrion recognised that the disease was endemic, but not contagious, and that it was caused by an "verrucous agent", possibly by a parasite attacking the blood and destroying red cells. In order to find out whether the disease could be inoculated and to study its clinical course, Carrión decided to conduct an experiment in himself.

On August 27th, 1885, Carrion took blood from a red coloured verruca in the area of the eyebrows from a 14 year old boy about to be released from the hospital. As Carrion had trouble inoculating himself, friends took the lancet and made four inoculations, two in each of Carrión's arms. In accordance with his plans Carrion made detailed notes on the inoculation and the course of the disease. His notes have later been published.

Carrion experienced the first symptoms of the disease on September 17th, and from September 26th he was too feeble to make his own notes, which were continued by his friends attending him at the bedside. Carrion's condition now rapidly deteriorated and on October 5th he succumbed to the disease.

Through his experiment Carrion had proved that Oroya fever and verruca are two phases of the same, inoculant disease. In 1909 Alberto Barton reported patients whose erythrocytes had been attacked by microorganisms which he considered to be agents of the disease. The microorganism was named " Bartonella bacilliformis ".



Bartonella Baciliformes


By cultivating " Bartonella bacilliformis " from Oroya fever and verruca-patients in the years 1926-1927, the Japanese bacteriologist Hideyo Noguchi (1876-1928) was able to demonstrate scientifically that Oroya Fever and Peruvian Verruca are two manifestations of the same infection.

Carrion´s disease
Also know as:
• "Verruga Peruana" = Peruvian Verruca
• Oroya´s fever
• Bartonellosis
• Bartoneliasis.

A disease occurring in the valleys in the Andes Mountains in Peru and Ecuador at altitudes of 600 to 3000 meters. It is a generalized, acute, febrile, endemic, and systemic form of bartonellosis that appears in an acute febrile anaemic stage followed in several weeks by a nodular skin eruption.

Two forms are recognized: the mild form "Verruga Peruana" and the severe form Oroya fever. The mild form is characterized by mild anaemia and either miliary or nodular eruptions resembling Kaposi's sarcoma. The severe form is characterized by acute fever, pernicious anaemia, and muscular pain and weakness.



Wart-like skin eruptions


Alberto Leopoldo Barton (1871-1950) identified the parasite which causes Oroya fever and "Peruvian wart" in 1909. The disease is Caused by Bartonella bacilliformis and Transmitted by the sandfly Phlebotomus verrucarum.



Phletomus verrucarum

On October 7th, 1991, the Peruvian Government Announced a law (Law N º 25,342), Declaring Daniel Alcides Carrión to Be A "National Hero"






In 2010, October 5, we also perform a tribute to Daniel Alcides Carrión presenting to our readers who have problems with the English language a summary of his life (in English); Carrión, sixth grader Faculty of Medicine "San Fernando " of the Universidad Nacional Mayor de San Marcos de Lima - Peru, in year 1885 was inoculated verrucoma blood of a patient and then developed severe anemia fever, which led to the death on October 5, 1885. Demonstrating that the two conditions were separately described in different clinical forms of a single disease.

disease caused by the bacterium Bartonella bacilliformes , now called Bartonellosis or Carrion's disease. Also known as Oroya fever, "not because the disease is present in the city of La Oroya (3730 meters), but because in 1885, the stage acute febrile and fatal, appeared in the workers who built the railroad Lima - La Oroya . Most people bought it in the valley Matucana, when bitten by mosquitoes Phlebotomus verrucarum (agent vector), resulting in thousands dead.

In Peru, October 5th Physicians celebrate "Day of Peruvian Medicine" in honor Carrion physicians traditionally being San Marcos de La Oroya and Cerro de Pasco those who feel more identification with this event.

View: Biography unpublished Daniel Alcides Carrión in this blog



Dr. Achilles
Monroy

DAY OF MEDICINE IN THE OROYA


Hospital Medical Alberto Hurtado, Essalud and Medical Center Chulec

On 5 October 2010, Day Ceremony for Medicine

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