Dramatic increase in laboratory-diagnosed human cutaneous leishmaniasis cases in southern Israel, 2007–2013

Ben‐Shimol, Shalom; Sagi, Orli; Codish, Shlomi; Novack, Victor; Barrett, C.B.; Fruchtman, Yariv; Berkowitz, Anat; Shemer‐Avni, Yonat; Greenberg, David

doi:10.3109/00365548.2014.977342

Cited by 15 publications

(22 citation statements)

References 11 publications

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“…A resurgence of human cutaneous leishmaniasis has been reported in Israel during 2001–2012, with increased infection of both L. major and L. tropica with an annual incidence of 4.4 cases per 100,000 inhabitants in 2012 [ 9 ]. A sevenfold increase in the laboratory-confirmed cutaneous leishmaniasis cases was observed from 2007 to 2013 in southern Israel where L. major is the main cause of this disease [ 10 ].…”

Section: Discussionmentioning

confidence: 99%

Leishmania major infection in a dog with cutaneous manifestations

et al. 2016

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BackgroundLeishmania major is a main cause of cutaneous leishmaniasis in humans in an area that stretches from India through Central Asia, the Middle East, to North and West Africa. In Israel, it is a common infection of humans with rodents as the reservoir hosts and Phlebotomus papatasi as its sand fly vector.FindingsA 6 months old spayed female mixed breed dog was referred to the Hebrew University Veterinary Teaching Hospital with a large ulcerative dermal lesion on the muzzle, and lesions in the foot pads and left hind leg. Histopathology of a skin biopsy found chronic lymphohistiocytic dermatitis with the presence of Leishmania spp. amastigotes in the muzzle. Physical examination indicated that the dog was overall in a good clinical condition and the main findings were the skin lesions and enlarged prescapular lymph nodes. Complete blood count and serum biochemistry profile were within reference ranges. Serology by ELISA was positive for Leishmania spp. and PCR of the prescapular lymph node was positive by an ITS1 region PCR-high resolution melt analysis. However, the melt curve and subsequent DNA sequencing indicated that infection was caused by L. major and not L. infantum, which is the main causative agent of canine leishmaniosis in the Mediterranean region. DNA was extracted from the paraffin embedded muzzle biopsy and PCR with sequencing also indicated L. major. The dog’s young age and the absence of hyperglobulinemia and anemia were not typical of L. infantum infection. The dog was treated with allopurinol and the skin lesions improved and later disappeared when the dog was re-evaluated.ConclusionsThis is the first molecularly-confirmed case of L. major infection in a dog. Two previous reports of L. major in dogs originated from Saudi-Arabia and Egypt in 1985 and 1987 were confirmed by enzymatic biochemical techniques. Serology for L. infantum was positive probably due to the well documented serological cross-reactivity between Leishmania spp. Although dogs and wild carnivores are not considered main reservoirs for L. major, the possibility of clinical canine disease and their potential as secondary hosts should be investigated in areas endemic for human L. major infection.

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Section: Discussionmentioning

confidence: 99%

Leishmania major infection in a dog with cutaneous manifestations

et al. 2016

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“…In recent years, the disease has spread to new areas previously considered to be free of infection. In addition, more cases resistant to available treatment have been demonstrated, probably due to LT in this region [ 3 , 18 ]. In the past, no parasite characterization was performed, because it was assumed that leishmaniasis cases in the Negev in Southern Israel are limited to LM infection.…”

Section: Discussionmentioning

confidence: 99%

“…Cutaneous leishmaniasis incidence in Israel increased dramatically in recent years. After a 15-year period of moderate illness rates, reported incidence increased from 0.4 cases per 100 000 population in 2001 to 4.4 cases per 100 000 population in 2012 [ 2 , 3 ]. In Israel, CL is mainly caused by Leishmania major (LM) and Leishmania tropica (LT) species.…”

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“…In the Negev Desert, CL is mainly caused by LM and, until recently, was restricted to geographically defined areas [ 4 , 5 ]. However, the incidence and geography of Leishmania infection (LM and LT) is changing, and the disease has spread to areas previously naive, including Northern Israel, the area surrounding Jerusalem, and also the Negev area in Southern Israel [ 2 , 3 ]. It should be noted that CL lesions caused by LT last much longer and are more resistant to available drugs than those caused by LM.…”

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Sensitive Molecular Diagnostics for Cutaneous Leishmaniasis

Sagi¹,

Berkowitz²,

Codish

et al. 2017

Open Forum Infectious Diseases

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Background.Rapid diagnosis of cutaneous leishmaniasis (CL) and identification of Leishmania species is highly important for the disease management. In Israel, CL is caused mainly by Leishmania major and Leishmania tropica species.Methods.We established an easy to handle point of care lesion-swabbing, combined with a highly sensitive multiplex real time PCR (multiplex qPCR) for accurate and rapid diagnosis of Leishmania species.Results.Using three probes: one general for: Leishmania species, and two specific for L major, and L tropica, we screened 1783 clinical samples collected during two years. Leishmania species was found in 1086 individuals, 1008 L major, and 70 L tropica. Eight samples positive for Leishmania species only, were further tested using a second set of multiplex qPCR developed, and were found positive for Leishmania braziliensis and Leishmania infantum/donovani (2 and 6 samples, concomitantly).Conclusions.Taken together, the test enabled diagnostics and better treatment of Leishmania infections from the Old World (1078 samples) and the New World (8 samples), and the subtyping of the dominant strains in the region, as well as in returning travelers’.

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“…Recent reports have described a 7-fold increase in L. major CL cases among inhabitants of the Negev Desert ( 6 ), with urban expansion into CL-endemic foci and changes in land use currently regarded as the most probable causes for this increase in incidence ( 6 , 7 ). A concurrent increase among travelers has not occurred so far, although the aforementioned cases might indicate that the increasing risk of contracting CL in the Negev Desert is not only restricted to its inhabitants but may also pose a risk to short-term travelers.…”

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