Disease Information Sheets

Leishmaniasis
Introduction

Leishmaniasis is a parasitic infection spread by sandflies. There are three forms of the disease - cutaneous (most common), mucocutaneous and visceral (most severe) - with a wide range of symptoms. There are over twenty different species of leishmania causing different forms of disease in different parts of the world. Leishmaniasis is a disease of poverty, and is also linked to environmental changes such as deforestation, new dams, new irrigation schemes and urbanisation, with the accompanying migration of non-immune people to endemic areas.

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How common is it?

350 million people around the world are at risk, living in 88 countries. About 12 million people are currently infected, with about 1-2 million new cases each year. There are 20-30 000 deaths each year. 90% of all visceral leishmaniasis cases occur in Bangladesh, Brazil, India, Nepal and Sudan; 90% of mucocutaneous leishmaniasis occurs in Bolivia, Brazil and Peru; 90% of cutaneous leishmaniasis cases occur in Afghanistan, Brazil, Iran, Peru, Saudi Arabia and Syria.

Countries with highest risk of leishmaniasis

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