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Sapp SGH, Low R, Nine G, Nascimento FS, Qvarnstrom Y, Barratt JLN. Genetic characterization and description of Leishmania (Leishmania) ellisi sp. nov.: a new human-infecting species from the USA. Parasitol Res 2023; 123:52. [PMID: 38099974 PMCID: PMC10724317 DOI: 10.1007/s00436-023-08034-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Accepted: 11/09/2023] [Indexed: 12/18/2023]
Abstract
In a 2018 report, an unusual case of cutaneous leishmaniasis was described in a 72-year-old female patient residing in Arizona, United States of America (USA). Preliminary analysis of the 18S rDNA and glyceraldehyde-3-phosphate dehydrogenase genes supported the conclusion that the Leishmania strain (strain 218-L139) isolated from this case was a novel species, though a complete taxonomic description was not provided. Identification of Leishmania at the species level is critical for clinical management and epidemiologic investigations so it is important that novel human-infecting species are characterized taxonomically and assigned a unique scientific name compliant with the ICZN code. Therefore, we sought to provide a complete taxonomic description of Leishmania strain 218-L139. Phylogenetic analysis of several nuclear loci and partial maxicircle genome sequences supported its position within the subgenus Leishmania and further clarified the distinctness of this new species. Morphological characterization of cultured promastigotes and amastigotes from the original case material is also provided. Thus, we conclude that Leishmania (Leishmania) ellisi is a new cause of autochthonous cutaneous leishmaniasis in the USA.
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Affiliation(s)
- Sarah G H Sapp
- Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Ross Low
- Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, GA, USA
- Oak Ridge Institute of Science and Education, Oak Ridge, TN, USA
| | - Gabriela Nine
- Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, GA, USA
- Association of Public Health Laboratories, Silver Spring, MD, USA
| | - Fernanda S Nascimento
- Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Yvonne Qvarnstrom
- Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Joel L N Barratt
- Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, GA, USA.
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Montes de Oca-Aguilar AC, Pavón-Mendez MI, López-Ávila KB, Sosa-Bibiano EI, Rebollar-Téllez EA, Palacio-Vargas JA, Fernández-Figueroa EA, Loría-Cervera EN. Biting rhythms and infection rates of anthropophilic sand fly species (Diptera: Phlebotominae) in sites with different land use in southern Mexico. Acta Trop 2023; 248:107014. [PMID: 37696485 DOI: 10.1016/j.actatropica.2023.107014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Revised: 08/28/2023] [Accepted: 08/30/2023] [Indexed: 09/13/2023]
Abstract
Could tropical forest conversion shape sand fly (Diptera: Phlebotominae) biting rhythms and Leishmania infection rates? Using a Shannon trap, we estimated the bite rate and infection prevalence among anthropophilic sand flies at sites with different land use in southern Mexico. We estimated the expected monthly infection rate of the Leishmania parasite along the gradient and generated information on the biting rhythm of sand flies in a poorly characterized cutaneous leishmaniasis endemic region. We used generalized mixed linear and mixed additives models to evaluate differences in the biting rate, nocturnal activity, and inoculation rate of female sand flies, as well as their relationship with the loss of forest cover and environmental disparities recorded throughout the study area. Our results show that the loss of forest cover influences the biting rhythm of sand fly species and the potential number of infectious bites with Leishmania, but the greatest entomological and potential epidemiological risk continues to be associated with sylvatic areas (amplification events). Despite this, we detected that the effect of forest cover (%) on the entomological exposure seems to be also dependent on the sand fly species, and that, albeit to a lesser extent, Leishmania parasite is circulating in disturbed landscapes through generalist and competent sand fly vector species. We also found that land use change did not affect the nocturnal activity, however we detected that important vector species were active most of the time. Contrary to our expectation, temperature and humidity did not shape the biting rhythm of sand fly species. We discuss the limitations and epidemiological implications of our findings regarding the risk of contracting leishmaniasis in southern Mexico.
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Affiliation(s)
- A C Montes de Oca-Aguilar
- Laboratorio de Inmunología, Centro de Investigaciones Regionales "Dr. Hideyo Noguchi", Universidad Autónoma de Yucatán, Mexico.
| | - M I Pavón-Mendez
- Laboratorio de Inmunología, Centro de Investigaciones Regionales "Dr. Hideyo Noguchi", Universidad Autónoma de Yucatán, Mexico
| | - K B López-Ávila
- Laboratorio de Inmunología, Centro de Investigaciones Regionales "Dr. Hideyo Noguchi", Universidad Autónoma de Yucatán, Mexico
| | - E I Sosa-Bibiano
- Laboratorio de Inmunología, Centro de Investigaciones Regionales "Dr. Hideyo Noguchi", Universidad Autónoma de Yucatán, Mexico
| | - E A Rebollar-Téllez
- Laboratorio de Entomología Médica, Departamento de Zoología de Invertebrados, Facultad de Ciencias Biológicas, Universidad Autónoma de Nuevo León, San Nicolás de los Garza, Mexico
| | - J A Palacio-Vargas
- Dirección de Prevención y Protección de la Salud de los Servicios de Salud del Estado de Yucatán, Mexico
| | - E A Fernández-Figueroa
- Núcleo B de Innovación en Medicina de Precisión, Instituto Nacional de Medicina Genómica, Mexico
| | - E N Loría-Cervera
- Laboratorio de Inmunología, Centro de Investigaciones Regionales "Dr. Hideyo Noguchi", Universidad Autónoma de Yucatán, Mexico
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Cañeda-Guzmán IC, de Oca-Aguilar ACM, Miranda-Caballero CI, Grostieta E, Correa-Morales F, Romero-Pérez R, Romero-Contreras FE, Rodríguez-Atanacio JA, Ruiz-Tovar K, Huerta H, Mis-Avila PC, Quintanilla-Cedillo MR, Lammoglia-Villagómez MA, Blum-Domínguez S, Tamay-Segovia P, Rojas-Ronquillo R, Sánchez-Montes S, Becker I. Entomological Survey and Leishmania ( Leishmania) mexicana Prevalence in Sand Fly Species during an Outbreak of Cutaneous Leishmaniasis in Quintana Roo State, Mexico. Trop Med Infect Dis 2023; 8:465. [PMID: 37888593 PMCID: PMC10610947 DOI: 10.3390/tropicalmed8100465] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Revised: 09/28/2023] [Accepted: 10/02/2023] [Indexed: 10/28/2023] Open
Abstract
(1) Background: Localized cutaneous leishmaniasis is a neglected vector-borne disease that has become a serious public health problem in the Yucatan Peninsula. Although more than 60% of cases originate from the state of Quintana Roo, it is one of the least explored areas in terms of incriminating vectors of the Leishmania parasite. Additionally, cases of leishmaniasis have increased substantially in that region in recent years. For this reason, we explored and provided primary evidence of Leishmania DNA in sand fly species from four localities during outbreaks of leishmaniasis in Quintana Roo. We also contributed information on the regional genetic diversity of Leishmania parasites. (2) Methods: Sand flies were collected during several periods from November 2022 to April 2023 using Mosquito Light Circle and Shannon traps, as well as an active entomological search in refuges. For Leishmania detection, we amplified a fragment of 300-350 bp of the internal transcribed spacer subunit 1 (ITS-1). (3) Results: Of the 242 females collected, we detected Leishmania DNA in 25 specimens represented by Bichromomyia olmeca (1), Psathyromyia shannoni (17), Lutzomyia cruciata (4), Psathyromyia undulata (2), and Dampfomyia deleoni (1). The detection of Leishmania in these last two species represents new records for the Yucatan Peninsula and for Mexico. Leishmania (Leishmania) mexicana was the only species detected in the Phlebotominae species, with prevalence values that ranked between 7.41% and 33.33% from specimens collected in the sylvatic areas of Cozumel Island and Petcacab. (4) Conclusions: This study provides the first evidence of infection of Da. deleoni and Pa. undulata by L. (L.) Mexicana. In addition, the presence of three dominant haplotypes in all the evaluated localities was evidenced using the analysis of genetic diversity, and the locality of Petcacab was the one with the circulation of two new haplotypes not previously described in Mexico or neighboring countries. These results highlight the importance of intensive epidemiological surveillance due to the dynamics of transmission of Leishmania between different species.
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Affiliation(s)
- Isabel C. Cañeda-Guzmán
- Centro de Medicina Tropical, División de Investigación, Facultad de Medicina, Universidad Nacional Autónoma de México, Mexico City 06720, Mexico; (I.C.C.-G.); (C.I.M.-C.); (E.G.)
| | - Ana C. Montes de Oca-Aguilar
- Laboratorio de Inmunología, Centro de Investigaciones Regionales “Dr. Hideyo Noguchi”, Universidad Autónoma de Yucatán, Mérida, Yucatán 97000, Yucatán, Mexico;
| | - Carlos I. Miranda-Caballero
- Centro de Medicina Tropical, División de Investigación, Facultad de Medicina, Universidad Nacional Autónoma de México, Mexico City 06720, Mexico; (I.C.C.-G.); (C.I.M.-C.); (E.G.)
| | - Estefania Grostieta
- Centro de Medicina Tropical, División de Investigación, Facultad de Medicina, Universidad Nacional Autónoma de México, Mexico City 06720, Mexico; (I.C.C.-G.); (C.I.M.-C.); (E.G.)
| | - Fabián Correa-Morales
- Programa de Enfermedades Transmitidas Por Vectores, Centro Nacional de Programas Preventivos y Control de Enfermedades, Secretaría de Salud, Mexico City 11800, Mexico; (F.C.-M.); (R.R.-P.); (F.E.R.-C.); (J.A.R.-A.)
| | - Raquel Romero-Pérez
- Programa de Enfermedades Transmitidas Por Vectores, Centro Nacional de Programas Preventivos y Control de Enfermedades, Secretaría de Salud, Mexico City 11800, Mexico; (F.C.-M.); (R.R.-P.); (F.E.R.-C.); (J.A.R.-A.)
| | - Francisco E. Romero-Contreras
- Programa de Enfermedades Transmitidas Por Vectores, Centro Nacional de Programas Preventivos y Control de Enfermedades, Secretaría de Salud, Mexico City 11800, Mexico; (F.C.-M.); (R.R.-P.); (F.E.R.-C.); (J.A.R.-A.)
| | - José A. Rodríguez-Atanacio
- Programa de Enfermedades Transmitidas Por Vectores, Centro Nacional de Programas Preventivos y Control de Enfermedades, Secretaría de Salud, Mexico City 11800, Mexico; (F.C.-M.); (R.R.-P.); (F.E.R.-C.); (J.A.R.-A.)
| | - Karina Ruiz-Tovar
- Laboratorio de Entomología, Instituto de Diagnóstico y Referencia Epidemiológicos ‘Dr, Manuel Martínez Báez’, Secretaría de Salud, Mexico City 01480, Mexico; (K.R.-T.); (H.H.)
| | - Herón Huerta
- Laboratorio de Entomología, Instituto de Diagnóstico y Referencia Epidemiológicos ‘Dr, Manuel Martínez Báez’, Secretaría de Salud, Mexico City 01480, Mexico; (K.R.-T.); (H.H.)
| | - Pedro. C Mis-Avila
- Departamento de Enfermedades Transmitidas por Vector y Zoonosis, Servicios Estatales de Salud de Quintana Roo, Chetumal Quintana Roo 77000, Mexico
| | | | - Miguel A. Lammoglia-Villagómez
- Facultad de Ciencias Biológicas y Agropecuarias, Región Tuxpan, Universidad Veracruzana, Tuxpan de Rodríguez Cano, Veracruz 92870, Mexico; (M.A.L.-V.); (R.R.-R.)
| | - Selene Blum-Domínguez
- Laboratorio de Enfermedades Tropicales, Centro de Investigaciones Biomédicas de la Universidad Autónoma de Campeche, Campeche 24039, Mexico;
| | - Paulino Tamay-Segovia
- Laboratorio de Enfermedades Transmitidas por Vectores y Zoonosis, Centro de Investigaciones Biomédicas de la Universidad Autónoma de Campeche, Campeche 24039, Mexico;
| | - Rebeca Rojas-Ronquillo
- Facultad de Ciencias Biológicas y Agropecuarias, Región Tuxpan, Universidad Veracruzana, Tuxpan de Rodríguez Cano, Veracruz 92870, Mexico; (M.A.L.-V.); (R.R.-R.)
| | - Sokani Sánchez-Montes
- Centro de Medicina Tropical, División de Investigación, Facultad de Medicina, Universidad Nacional Autónoma de México, Mexico City 06720, Mexico; (I.C.C.-G.); (C.I.M.-C.); (E.G.)
- Facultad de Ciencias Biológicas y Agropecuarias, Región Tuxpan, Universidad Veracruzana, Tuxpan de Rodríguez Cano, Veracruz 92870, Mexico; (M.A.L.-V.); (R.R.-R.)
| | - Ingeborg Becker
- Centro de Medicina Tropical, División de Investigación, Facultad de Medicina, Universidad Nacional Autónoma de México, Mexico City 06720, Mexico; (I.C.C.-G.); (C.I.M.-C.); (E.G.)
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Oca-Aguilar ACMD, Fernández-Figueroa EA, Pavón-Méndez MI, López-Ávila K, Sosa-Bibiano EI, Rebollar-Téllez EA, Palacio-Vargas JA, Miranda-Ortíz H, Loría-Cervera EN. First detection of Leishmania DNA in Lutzomyia longipalpis sensu lato (Diptera: Phlebotominae) in southem Mexico. J Vector Borne Dis 2023; 60:453-456. [PMID: 38174527 DOI: 10.4103/0972-9062.391880] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2024] Open
Abstract
Background & objectives Lutzomyia longipalpis sensu lato is an important vector of Leishmania infantum, the causative agent of visceral leishmaniasis (VL) in Latin America. In Mexico, this species has been recorded in endemic areas of leishmaniasis transmission, but it has never been detected as infected with Leishmania sp. This study aimed to explore the presence of Leishmania DNA in Lutzomyia longipalpis s.l. from samples collected with a human baited trap from an endemic region of leishmaniasis in southeastern Mexico. Methods This is a prospective study where a total of 45 specimens of Lu. longipalpis s.l. collected in two sites of Yucatan state with records of leishmaniasis were tested. The nuclear ribosomal Internal Transcribed Spacer was amplified for the detection of Leishmania DNA. Results Two females were positive for Leishmania DNA. None of the specimens positive for parasite DNA were found fed or gravid. Our finding represents the first record of infection by Leishmania in Lu. longipalpis s.l. for the country. Interpretation & conclusion More studies are necessary to understand the potential role of this vector species in the transmission cycle of the causative agent of leishmaniasis in the southeastern and other regions of Mexico.
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Affiliation(s)
- Ana C Montes de Oca-Aguilar
- Laboratorio de Inmunología, Centro de Investigaciones Regionales "Dr. Hideyo Noguchi", Universidad Autónoma de Yucatán, México, Mexico
| | | | - Mariela I Pavón-Méndez
- Laboratorio de Inmunología, Centro de Investigaciones Regionales "Dr. Hideyo Noguchi", Universidad Autónoma de Yucatán, México, Mexico
| | - Karina López-Ávila
- Laboratorio de Inmunología, Centro de Investigaciones Regionales "Dr. Hideyo Noguchi", Universidad Autónoma de Yucatán, México, Mexico
| | - Erika I Sosa-Bibiano
- Laboratorio de Inmunología, Centro de Investigaciones Regionales "Dr. Hideyo Noguchi", Universidad Autónoma de Yucatán, México, Mexico
| | - Eduardo A Rebollar-Téllez
- Laboratorio de Entomología Médica, Departamento de Zoología de Invertebrados, Facultad de Ciencias Biológicas, Universidad Autónoma de Nuevo León, San Nicolás de los Garza, Mexico
| | - Jorge A Palacio-Vargas
- Dirección de Prevención y protección de la Salud de los Servicios del Estado de Yucatán, Mexico
| | | | - Elsy N Loría-Cervera
- Laboratorio de Inmunología, Centro de Investigaciones Regionales "Dr. Hideyo Noguchi", Universidad Autónoma de Yucatán, México
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Reyes-Novelo E, Sauri-Arceo C, Panti-May A, Marín D, Canché-Pool EB, Chan-Espinoza DE, Marín C, Bolio-González M, Rodríguez-Vivas RI, Torres-Castro M, Escobedo-Ortegón FJ. Exposure to Trypanosoma cruzi and Leishmania parasites in dogs from a rural locality of Yucatan, Mexico. A serological survey. Vet Parasitol Reg Stud Reports 2023; 44:100911. [PMID: 37652628 DOI: 10.1016/j.vprsr.2023.100911] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2023] [Revised: 06/30/2023] [Accepted: 07/11/2023] [Indexed: 09/02/2023]
Abstract
Trypanosoma cruzi, the causal agent of American trypanosomiasis, and Leishmania spp., the causal agents of Leishmaniasis, are prevalent in more than 20 American countries, including Mexico. Dogs have been reported as incidental hosts for both parasites and may be helpful as transmission sentinels. We surveyed the dog population in a rural locality of the Merida municipality in Yucatan, Mexico, to evaluate the seroreactivity against T. cruzi and Leishmania spp. using two antigens, parasite homogenate (H) and iron superoxide dismutase extract (FeSODe), with two serological techniques (ELISA and Western Blot). Our study found that 3.33% of the tested dogs were seroreactive to T. cruzi using ELISA-H, and 29.5% were seroreactive to FeSODe antigen, with a 94.4% consistency between the two tests. Similarly, for L. mexicana, 1.6% were seroreactive using ELISA-H, and 9.8% were seroreactive using ELISA-FeSODe, with an 83.3% consistency between tests. For L. braziliensis, no dogs were seroreactive using ELISA-H, but 16.4% were seroreactive using ELISA-FeSODe, with a 90% consistency between tests. Finally, for L. infantum, 4.9% were seropositive using ELISA-H, and 6.6% were seropositive using ELISA-FeSODe, with a 75% consistency between tests. These results show noticeable evidence of exposure of dogs to trypanosomatid parasites and highlight the potential disease risk for the people and their companion animals in the region.
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Affiliation(s)
- Enrique Reyes-Novelo
- Centro de Investigaciones Regionales "Dr. Hideyo Noguchi", Universidad Autónoma de Yucatán, Av. Itzaes por 49 núm. 490, Centro, Merida CP. 97000, Yucatan, Mexico.
| | - Carlos Sauri-Arceo
- Departamento de Salud Animal y Medicina Preventiva, Facultad de Medicina Veterinaria y Zootecnia, Universidad Autónoma de Yucatán, Merida, Yucatan, Mexico
| | - Alonso Panti-May
- Centro de Investigaciones Regionales "Dr. Hideyo Noguchi", Universidad Autónoma de Yucatán, Av. Itzaes por 49 núm. 490, Centro, Merida CP. 97000, Yucatan, Mexico
| | - Denisse Marín
- Departamento de Salud Animal y Medicina Preventiva, Facultad de Medicina Veterinaria y Zootecnia, Universidad Autónoma de Yucatán, Merida, Yucatan, Mexico
| | - Elsy B Canché-Pool
- Centro de Investigaciones Regionales "Dr. Hideyo Noguchi", Universidad Autónoma de Yucatán, Av. Itzaes por 49 núm. 490, Centro, Merida CP. 97000, Yucatan, Mexico
| | - Daniel E Chan-Espinoza
- Centro de Investigaciones Regionales "Dr. Hideyo Noguchi", Universidad Autónoma de Yucatán, Av. Itzaes por 49 núm. 490, Centro, Merida CP. 97000, Yucatan, Mexico
| | - Clotilde Marín
- Laboratorio de Parasitología Molecular, Facultad de Ciencias, Universidad de Granada, Granada, Spain
| | - Manuel Bolio-González
- Departamento de Salud Animal y Medicina Preventiva, Facultad de Medicina Veterinaria y Zootecnia, Universidad Autónoma de Yucatán, Merida, Yucatan, Mexico
| | - Roger I Rodríguez-Vivas
- Departamento de Salud Animal y Medicina Preventiva, Facultad de Medicina Veterinaria y Zootecnia, Universidad Autónoma de Yucatán, Merida, Yucatan, Mexico
| | - Marco Torres-Castro
- Centro de Investigaciones Regionales "Dr. Hideyo Noguchi", Universidad Autónoma de Yucatán, Av. Itzaes por 49 núm. 490, Centro, Merida CP. 97000, Yucatan, Mexico
| | - Francisco J Escobedo-Ortegón
- Centro de Investigaciones Regionales "Dr. Hideyo Noguchi", Universidad Autónoma de Yucatán, Av. Itzaes por 49 núm. 490, Centro, Merida CP. 97000, Yucatan, Mexico
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Canché-Pool EB, Panti-May JA, Ruiz-Piña HA, Torres-Castro M, Escobedo-Ortegón FJ, Tamay-Segovia P, Blum-Domínguez S, Torres-Castro JR, Reyes-Novelo E. Cutaneous Leishmaniasis Emergence in Southeastern Mexico: The Case of the State of Yucatan. Trop Med Infect Dis 2022; 7:tropicalmed7120444. [PMID: 36548699 PMCID: PMC9787846 DOI: 10.3390/tropicalmed7120444] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2022] [Revised: 12/12/2022] [Accepted: 12/14/2022] [Indexed: 12/23/2022] Open
Abstract
Environmental changes triggered by deforestation, urban expansion and climate change are present-day drivers of the emergence and reemergence of leishmaniasis. This review describes the current epidemiological scenario and the feasible influence of environmental changes on disease occurrence in the state of Yucatan, Mexico. Relevant literature was accessed through different databases, including PubMed, Scopus, Google, and Mexican official morbidity databases. Recent LCL autochthonous cases, potential vector sandflies and mammal hosts/reservoirs also have been reported in several localities of Yucatan without previous historical records of the disease. The impact of deforestation, urban expansion and projections on climate change have been documented. The current evidence of the relationships between the components of the transmission cycle, the disease occurrence, and the environmental changes on the leishmaniasis emergence in the state shows the need for strength and an update to the intervention and control strategies through a One Health perspective.
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Affiliation(s)
- Elsy B. Canché-Pool
- Centro de Investigaciones Regionales “Dr. Hideyo Noguchi”, Universidad Autónoma de Yucatán, Av. Itzaes No. 490 x 59, Col. Centro, Mérida 97200, Mexico
| | - Jesús A. Panti-May
- Centro de Investigaciones Regionales “Dr. Hideyo Noguchi”, Universidad Autónoma de Yucatán, Av. Itzaes No. 490 x 59, Col. Centro, Mérida 97200, Mexico
| | - Hugo A. Ruiz-Piña
- Centro de Investigaciones Regionales “Dr. Hideyo Noguchi”, Universidad Autónoma de Yucatán, Av. Itzaes No. 490 x 59, Col. Centro, Mérida 97200, Mexico
| | - Marco Torres-Castro
- Centro de Investigaciones Regionales “Dr. Hideyo Noguchi”, Universidad Autónoma de Yucatán, Av. Itzaes No. 490 x 59, Col. Centro, Mérida 97200, Mexico
| | - Francisco J. Escobedo-Ortegón
- Centro de Investigaciones Regionales “Dr. Hideyo Noguchi”, Universidad Autónoma de Yucatán, Av. Itzaes No. 490 x 59, Col. Centro, Mérida 97200, Mexico
| | - Paulino Tamay-Segovia
- Centro de Investigaciones Biomédicas, Universidad Autónoma de Campeche, Av. Agustín Melgar s/n x 20 y Juan de la Barrera, Col. Buenavista, Campeche 24039, Mexico
| | - Selene Blum-Domínguez
- Centro de Investigaciones Biomédicas, Universidad Autónoma de Campeche, Av. Agustín Melgar s/n x 20 y Juan de la Barrera, Col. Buenavista, Campeche 24039, Mexico
| | - Jimmy R. Torres-Castro
- Servicios de Salud de Yucatán, Dirección de Prevención y Protección de la Salud, Calle 72 No. 463 x 53 y 55 Col. Centro, Mérida 97000, Mexico
| | - Enrique Reyes-Novelo
- Centro de Investigaciones Regionales “Dr. Hideyo Noguchi”, Universidad Autónoma de Yucatán, Av. Itzaes No. 490 x 59, Col. Centro, Mérida 97200, Mexico
- Correspondence:
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