Abstract. In Brazil, programs based on elimination of infected dogs have not curtailed the spread of visceral leishmaniasis (VL), suggesting that other reservoirs of infection exist. Persons with active VL can infect the sand fly vector, but in endemic areas, persons with asymptomatic infections, whose infectivity to sand flies is unknown, are far more numerous. In this study, a polymerase chain reaction-based assay detected kinetoplast DNA of Leishmania chagasi in the blood of eight of 108 asymptomatic persons living with patients with recently diagnosed VL. These eight persons had low or unmeasurable levels of IgG antibodies to Leishmania, demonstrating the insensitivity of serology for subclinical infection. All eight persons had positive leishmanin skin test results, as did 70% of persons living in households of persons with active VL. Even if a small proportion of such asymptomatic persons are infective to sand flies, they represent a formidable reservoir of infection in endemic areas.

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A monoclonal antibody designated Gib 13-5-2 (Gib 13) and directed against the cattle parasite Onchocerca gibsoni was used in a two-site immunoradiometric assay (IRMA) for detection of circulating antigen in the sera of Wuchereria bancrofti-infected individuals from Sri Lanka and Papua New Guinea. The microfilaremic patients were, in general, serum antigen positive by the Gib 13 IRMA. Among the amicrofilaremic patients, 47% of those with lymphedema, lymphangitis, hydrocele, etc., and 25% of those with elephantiasis had circulating antigen. Correlation of the presence of serum antigen with clinical status indicated that the Gib 13 target antigen in serum is probably an indicator of either active or early infection, or of both. The antigen was also detected in the urine of some patients. By sodium dodecyl sulphate polyacrylamide gel electrophoresis immunoblotting, Gib 13 target antigens of molecular weights 67,000 and 52,000 were identified.

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