TY - JOUR AU - Sousa, Anastácio AU - Pearson, Richard T1 - Drought, Smallpox, and Emergence of Leishmania braziliensis in Northeastern Brazil T2 - Emerging Infectious Disease journal PY - 2009 VL - 15 IS - 6 SP - 916 SN - 1080-6059 AB - Cutaneous leishmaniasis caused by Leishmania (Vianna) braziliensis is a major health problem in the state of Ceará in northeastern Brazil. We propose that the disease emerged as a consequence of the displacement of persons from Ceará to the Amazon region following the Great Drought and smallpox epidemic of 1877–1879. As the economic and social situation in Ceará deteriorated, ≈55,000 residents migrated to the Amazon region to find work, many on rubber plantations. Those that returned likely introduced L. (V.) brazilensis into Ceará, where the first cases of cutaneous leishmaniasis were reported early in the 20th century. The absence of an animal reservoir in Ceará, apart from dogs, supports the hypothesis. The spread of HIV/AIDS into the region and the possibility of concurrent cutaneous leishmaniasis raise the possibility of future problems. KW - Drought KW - smallpox KW - cutaneous leishmaniasis KW - Leishmania braziliensis KW - Brazil KW - viruses KW - parasites KW - historical review DO - 10.3201/eid1506.071331 UR - https://wwwnc.cdc.gov/eid/article/15/6/07-1331_article ER - End of Reference