By the bacterium “Bartonella bacilliformis” the disease “Oroya fever” is caused. The infection occurs through the transmission of the pathogen by the sand fly. Since the sand fly occurs exclusively in mountain valleys above 800m to 3000m in Peru, Ecuador and Colombia, the disease is also only widespread there. Primarily the bacterium lives in erythrocytes (red blood cells), secondarily it can also occur in internal organs.
The incubation period is two to three weeks, and occasionally it can be as long as four months.
Course
The pathogens can cause two different clinical pictures: the acute form (Oroya fever) and a chronic course with skin symptoms. Basically, the course of the disease can be divided into three phases:
- Oroya fever begins with increasing fever, which is accompanied by lymphadenopathy (disease of the lymph nodes), hepatosplenomegaly (simultaneous enlargement of the spleen and liver), and a marked feeling of illness. It eventually comes to hemolytic anemia (anemia) due to destruction of erythrocytes.
- After this phase of the disease begins the phase of pronounced immunosuppression (this phase was usually fatal in the past, because no antibiotic was available).
- Two to four months later follows the main phase of the disease, in which the so-called “Verruca peruana” (Peru wart) develops. This phase can last for several months.
Origin of the name
Between 1870 and 1890, an unknown epidemic occurred in Peru, affecting mainly railroad workers. They suffered from high fever, weakness and anemia. The disease spread mainly along the new railroad line between the capital Lima and the town of La Oroya, and this is where it got its name.
Discovery of the Oroya fever
In 1881, a young Peruvian medical student died of Oroya fever. He was suffering from wart-like skin rashes at the same time. A student friend named Alcides Carrion suspected a connection between the fever and the warts. Spurred on by his friend’s fate, Carrion had himself inoculated with the blood of a woman who was suffering from the rashes. 22 days later, he discovered the first symptoms (pain, nausea, fever).
A short time later, the pain became so bad that Carrion could no longer move. Some time later, he died from the disease. To this day, he is celebrated as a national hero of Peru for his courage. The causative agent of “Carrion’s disease,” henceforth named after him, was not discovered until 1909 by Alberto Barton and named after him as “Bartonella bacilliformis.”
