History and Geography

Carrión's disease was probably depicted thousands of years ago in the pottery of the ancient Peruvian civilization. The disease flourished jointly with malaria and cutaneous leishmaniasis in the inter-Andean valleys of western South America. The focus of the endemic transmission is in Peru, although some cases exist in Colombia and Ecuador. The endemic areas of the disease are confined to rural areas in narrow valleys where the elevation is 2,100 to 7,500 feet.

The disease in both its forms was probably noticed and described during the Spanish Conquest. It attracted worldwide attention only in 1870, when an epidemic of the acute febrile form of the disease killed thousands of workers during the construction of a railroad from Lima to Oroya. In 1885, Daniel Carrión, a Peruvian medical student, contracted the disease by self-inoculation with verruga and died of Oroya fever, thus establishing the connection between the two conditions. In 1909 Alberto Barton, a Peruvian physician, described the presence of live organisms in the red blood corpuscles of victims of Oroya fever, and a decade later these findings were confirmed by R. P. Strong and his colleagues (1913). They, however, felt that despite the work of Carrión, Oroya fever and verruga peruana were caused by two distinct agents. The controversy was resolved by H. Noguchi and T. Battistine (1926), who reported the pair to be different manifestations of the same disease. M. Hertig in 1942 definitively described both the disease and its vector.

Oscar Urteaga-Ballón

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