What is leishmaniasis?
There are two main types of leishmaniasis, both of which are very rare in travelers. Cutaneous leishmaniasis causes disfiguring facial lesions and is especially prevalent in the Middle East and Afghanistan. Visceral leishmaniasis (kala-azar) affects the spleen, liver and bone marrow, causing fever, weight loss, and anemia. Sufferers can be misdiagnosed as having lymphoma or leukemia. This form is widespread in Asia, parts of South America, and East Africa.
How do you contract leishmaniasis? The leishmania organism is spread by the bite of an infected sandfly. Many animals, especially dogs, can be infected with certain forms of the disease. Contact with pets does not spread leishmaniasis; a sandfly is still required to act as a vector of the disease. The incubation period is at least a week and can be up to many months. The parasites that cause visceral leishmaniasis can remain dormant for many years and become “reactivated” when a person’s immune system becomes suppressed (such as with HIV or steroid treatment).
How is leishmaniasis treated and prevented?
Anyone thought to be infected should seek treatment with a specialist in tropical medicine or an infectious disease expert. Amphotericin B (Ambisome, Abelcet, Amphotec) may be prescribed.
There are no vaccines to prevent leishmaniasis, and travelers should take steps to avoid sandfly bites. As sandflies are extremely small and can pass through the holes in standard mosquito nets, it is important that all nets are treated with an insecticide. Insect repellents are advised for exposed skin, especially at night, as sandflies generally bite in darkness.
MASTA Travel Health: www.masta-travel-health.com
Centers for Disease Control and Prevention: www.cdc.gov/parasites/leishmaniasis/
Last Reviewed: June 2013