Leishmaniasis is a Neglected Tropical Disease (NTD) that is spread by phlebotomine sand flies. It is a parasitic disease that can be found in southern Europe, the tropics, and the subtropics.
Leishmaniasis is caused by parasitic Leishmania species that are spread through the bite of phlebotomine sand flies. While this NTD is mostly found in the subtropics and tropics, as well as southern Europe, it has also been reported in other parts of the world.
Leishmaniasis is classified into several types:
- Cutaneous, which results in skin sores
- Mucocutaneous leishmaniasis occurs when cutaneous leishmaniasis spreads to the mucous lining of the mouth or nose.
- Visceral cancer affects internal organs like the bone marrow, liver, and spleen.
What Causes Leishmaniasis Infection?
When female phlebotomine sand flies drink the blood of an infected animal, such as a dog or a rodent, they can spread Leishmania parasites. When bitten by an infected sand fly, you will develop a red ring on your skin. Because these bites aren’t always painful, it’s not always obvious that you’ve been bitten.
Visceral leishmaniasis can also be contracted through blood transfusion or needle sharing. It can also be passed from an infected pregnant woman to her unborn child.
Every year, it is estimated that 700,000 to 1.2 million people contract cutaneous leishmaniasis, while less than 100,000 people contract visceral leishmaniasis.
People of all genders and ages are at risk if they go to areas where leishmaniasis has occurred or frequently occurs. Leishmaniasis is more common in rural areas, so be sure to take precautions as needed if you spend a lot of time outdoors in areas where leishmaniasis occurs.
The following people are at a high risk of getting infected:
- Ornithologists (people who study birds)
- Peace Corps volunteers
- People who stay outside at sunrise, sunset, or night
Even if you’ve had cutaneous leishmaniasis before, you can get it again. When visiting a leishmaniasis-infected area, you should always exercise caution.
Symptoms of Leishmaniasis Infections
The symptoms of these infections depend on whether you have cutaneous, mucocutaneous, or visceral leishmaniasis.
Some people with this condition exhibit no symptoms. However, if you do, you may develop sores on your skin that change in appearance and size over time.
These sores can start as bumps (papules) or lumps (nodules) and progress to ulcers covered by crust or scab. These sores are usually painless, but they can be painful if they are accompanied by swollen glands.
Cutaneous leishmaniasis usually manifests itself a few weeks or months after being bitten by an infected sand fly. In some cases, it can also take years.
It may also take months or years for the sores, which can leave scars, to heal.
This type of leishmaniasis usually manifests itself years after your cutaneous leishmaniasis sores have healed.
It is capable of causing the following symptoms:
- Stuffy nose
- Mouth or nose sores
- Frequent nose bleeds
- If you don’t get treated for this condition on time, your face may become severely disfigured.
Visceral leishmaniasis, like cutaneous leishmaniasis, can cause no symptoms in some people. If you have symptoms, they will most likely include:
- Weight loss
- Swelling of the liver and spleen
- Abnormal blood tests
- It can lead to low blood counts, such as a low white blood cell count (leukopenia), low red blood cell count (anemia), and low platelet count (thrombocytopenia)
- If untreated, visceral leishmaniasis can be fatal.
To determine if you have leishmaniasis, consider whether you have visited a region of the world where leishmaniasis occurs and whether you have any of the symptoms listed above.
Contact your doctor right away if you suspect you have leishmaniasis.
During a leishmaniasis test, specimens from your skin sores or bone marrow may be taken and examined for Leishmania parasites. Blood and DNA tests may be used as well.
Treatment depends on the type of leishmaniasis infection you have.
Cutaneous leishmaniasis may resolve on its own, but it should be treated because it can progress to mucocutaneous leishmaniasis.
There are so many ways to treat cutaneous leishmaniasis, including low-dose regimens of pentamidine isethionate. You can also get topical treatments like cauterization, cryotherapy, and local heat application. Because Leishmania is heat sensitive, applying heat to your sores can be an effective way of treating this infection.
Fluconazole is an effective treatment for mucocutaneous leishmaniasis, but it has serious side effects. This condition can also be treated with other medications, such as the antifungal agents itraconazole and ketoconazole.
The drugs made available for treatment of visceral leishmaniasis are the systemic agents like antimony, amphotericin, paromomycin and the oral drug, miltefosine.
Unfortunately, there are currently no drugs or vaccines available to prevent infection. This means that you must take extra precautions when visiting a region of the world where leishmaniasis is prevalent.
- You should take the following precautions to avoid sand fly bites:
- Avoid going outside at sunrise or sunset.
- Sleep in a room with air conditioning and window screens.
- Sleep with an insecticide-treated bed net over your head.
- Avoid camping near animal habitats because some animals carry leishmaniasis.
- Avoid going to places where leishmaniasis can occur.
- Insecticides should also be sprayed in sleeping and living areas to kill any sand flies that may be present.