Leishmaniasis

Leishmaniasis is a parasitic vector-borne disease transmitted to humans by sandflies.

Leishmaniasis is found in many parts of the world and can manifest in the skin (cutaneous leishmaniasis) or in various internal organs (visceral leishmanisis). It is hard to estimate the annual number of cases globally, but it is likely to exceed 1 million for both types combined. The annual number of cases has certainly decreased over the last few years. Visceral Leishmaniasis is found in 60 countries, but 90% of cases occur in 6 countries only. These include India, Bangladesh, Nepal, Brazil, Ethiopia and Sudan. Cutaneous Leishmaniasis is found in more than 70 countries with Afghanistan, Syria and Brazil of most concern.

The disease is spoken about in terms of Old World Leishmaniasis and New World Leishmaniasis. In the former case it is found in the Middle East, North Africa, Central Asia and Southern Europe. In the latter, Mexico, Central America and South America (apart from Uruguay and Chile). It is not found in the Pacific or Australia.

People become infected when a female sandfly sucks their blood. The bite is often unnoticed at the time as sandflies are quiet and very small. Sandflies are most active between dusk and dawn, particularly around twilight. You are more likely to be exposed in rural areas.

Leishmaniasis is not a common disease, but cases have been associated with travel. Twenty imported cases were reported in Australia for the period 2005-2007. All were migrants or tourists.

An increased number has been seen in areas where there has been an influx of international refugees from endemic countries. Cases have also been identified in members of the military based in the Middle East.

Primary prevention rests with sandfly avoidance measures, which are similar to measures adopted for mosquitoes.