Are travellers and/or expat workers at risk?

Yes. People travelling to tropical and subtropical endemic regions who are staying in rural and some urban areas are at risk. People who are outdoors at night may have an increased risk. Leishmania may live quietly for years before reactivating if the immune system becomes suppressed, for example through HIV infection, chemotherapy or use of steroids.

 

What is the illness?

Cutaneous leishmaniasis involves the development of skin ulcers on exposed parts of the body, for example the face and legs. Unless treated, these lesions can leave the patient seriously disabled and prone to infection and scarring. Lesions can heal spontaneously after a month or so or last for up to a year. The stigma caused by the lesions can lead to social exclusion and prejudice particularly for women.

 

Visceral leishmaniasis is a chronic disease characterised by irregular bouts of fever, substantial weight loss, swelling of the spleen and liver, and anaemia (occasionally serious).

 

Mucocutaneous leishmaniasis is a rarer form, and leads to partial or total disfigurement of the mucous membranes of the nose, mouth and throat cavities and surrounding tissues. Uncommonly, people who have had cutaneous leishmaniasis can subsequently develop mucocutaneous leishmaniasis, even years after the original illness resolved.

 

How is it treated?

The treatment depends on the species of leishmania, where it was acquired and the illness.

 

How can it be prevented?

There is no vaccine or protective medication available. Prevention relies on avoiding sandfly bites. Sandflies bite mainly in the evening and at night, but are very small - even smaller than mosquitoes. 

• Wear long-sleeved clothing, trousers, socks

• Use insect repellents containing DEET

• Sleep under a fine-mesh bed net impregnated with permethrin which is well tucked-in

• Treat clothing with permethrin