Leishmaniasis, an emerging infection in travelers

Abstract

Leishmaniasis is a vector-borne protozoan infection with a wide clinical spectrum, which ranges from asymptomatic infection to fatal visceral leishmaniasis. A review of the recent literature indicates a sharp increase in imported leishmaniasis cases in developed, non-endemic countries over the last decade, in association with increasing international tourism, military operations, and the influx of immigrants from endemic countries. South America is the main area for the acquisition of cutaneous leishmaniasis, and adventure travelers on long-term trips in highly-endemic forested areas are at particular risk. Popular Mediterranean destinations are emerging as the main areas of acquisition of visceral leishmaniasis for European travelers. Leishmaniasis should be considered in patients presenting with a compatible clinical syndrome and a history of travel to an endemic area, even if this occurred several months or years ago. Appropriate counseling should be provided to adventure travelers, military personnel, researchers, and other groups of travelers likely to be exposed to sandflies in endemic areas.

Leishmaniasis in travelers: A literature review

“…A review of international literature show that in the published cases of imported travel-related leishmaniasis over the past 25 years nearly 80% have concerned CL [9]. According to recent estimates, CL is endemic in 88 different countries, 72 of which are developing nations, placing nearly 350 million people at risk of infection and disease, 1.5 million new cases each year.…”

“…In brief, systemic treatment is indicated in cases of 1) New World CL, in which skin lesions are caused by Viannia complex species (especially L. [V.] braziliensis), 2) multiple or large (>4 cm) lesions, especially when the face or a joint are affected or lesions are present on the hands or feet, or for cosmetic reasons, 3) established metastatic spread to lymph nodes, 4) failure to respond to topical treatment, and 5) immune-suppressed patients. Several studies show how early systemic treatment may prevent mucosal lesions, which are seen more frequently in patients with incomplete or missing specific treatment [9,115,124,125,133,134] (Table 4).…”

An Essential Type I Nitroreductase from Leishmania major Can Be Used to Activate Leishmanicidal Prodrugs

“…These infections are endemic in 88 countries around the world with ϳ350 million people living in "at risk" areas (1). Recently, as a result of military activity, population migration, modern medical practices, intravenous drug usage, and global warming, leishmaniasis has emerged as a problem in nonendemic areas (2)(3)(4).…”

Travel-Related Parasitic Infections in Travellers to Southeast Asia and Western Pacific Countries

“…Cilt lezyonlarına neden olan KL, endemik bölgelere seyahat edenlerde, özellikle açık hava aktivitelerine katılanlarda en sık görülen deri hastalıklarından birisidir (27,28). Uluslararası literatürde son 25 yılda importe leishmaniasis vakalarının %80'inin KL olduğu bildirilmiştir (26).…”