What is already known about this topic? Visceral leishmaniasis (VL) is an important vectorborne disease in rural areas of western China. The spreading of VL made its prevention and control become more complicated. What is added by this report?The number of VL cases decreased from 2015 (n=498) to 2019 (n=166). However, the mountain-type zoonotic visceral leishmaniasis (MT-ZVL) cases increased from 2015 (n=82, 16.5%) to 2019 (n=122, 73.5%). In addition, both number and proportion of imported cases increased from 2015 (n=18, 3.6%) to 2019 (n=41, 24.7%). The re-emergence of MT-ZVL was considerable; 13 historically-endemic counties reported 48 indigenous cases. Infants and young children were the high risk population of VL (848, 62.4%) followed by farmers (303, 22.3%). What are the implications for public health practice?Both MT-ZVL and imported cases showed an increasing trend in China. Therefore, two actions are needed to control VL: 1) to prevent re-emergence and spreading of MT-ZVL; and 2) to ensure timely diagnosis and appropriate treatment to avoid fatal VL cases, especially in non-endemic areas.

* Data include results of serological and fecal tests of local and floating populations in all surveillance sites throughout the country from 2015 to 2018 and all tests are standardized according to the requirements of the surveillance scheme.SLL: sero-prevalence of the local population in lake and marsh regions; SLW: sero-prevalence of the local population in water-network regions; SLM: sero-prevalence of the local population in mountainous regions; SPL: sero-prevalence of the local population; SPF: sero-prevalence of the floating population; EPL: estimated prevalence of the local population; EPF: estimated prevalence of the floating population.The estimated prevalence is equal to the fecal positive rate, which is the infection rate of Schistosoma in the population.

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