International travel and health

Leishmaniasis (cutaneous, mucosal and visceral forms)

Cause

Several species of the protozoan parasite Leishmania.

Transmission

Infection is transmitted by the bite of female phlebotomine sandflies. Dogs, rodents and other mammals, including humans, are reservoir hosts for leishmaniasis. Sandflies acquire the parasites by biting infected reservoirs. Transmission from person to person by injected blood or contaminated syringes and needles is also possible.

Nature of the disease

Leishmaniasis occurs in three main forms:

  • Cutaneous leishmaniasis: causes skin sores and chronic ulcers. It is generally self-limiting but can be a chronic and progressive disease in a proportion of cases.
  • Mucosal leishmaniasis: caused by Leishmania species in Africa and the Americas, which affect the nasal, oral and pharyngeal mucosa, producing a disabling and mutilating disease.
  • Visceral leishmaniasis affects the spleen, liver, bone marrow and lymph nodes, producing fever and anaemia. It is usually fatal if untreated.

Geographical distribution

Many countries in tropical and subtropical regions, including Africa, central and South America, Asia, and the Mediterranean region.

More than 90% of all cases of cutaneous leishmaniasis occur in Afghanistan, Algeria, Brazil, Colombia, the Islamic Republic of Iran, Peru, Saudi Arabia and the Syrian Arab Republic.

More than 90% of all cases of mucosal leishmaniasis occur in Plurinational State of Bolivia, Brazil, Ethiopia and Peru.

More than 90% of all cases of visceral leishmaniasis occur in Bangladesh, Brazil, Ethiopia, India, Nepal and Sudan.

Risk for travellers

Visitors to rural and forested areas in countries or areas at risk.

Prophylaxis

None.

Precautions

Avoid sandfly bites, particularly after sunset, by using insect repellents and insecticide-impregnated bednets. The bite leaves a non-swollen red ring, which can alert the traveller to its origin.

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