Leishmaniasis in travelers: A literature review

Abstract

Summary Leishmaniasis is a vector-borne protozoan infection whose clinical spectrum ranges from asymptomatic infection to fatal visceral leishmaniasis. Over the last decades, an increase in imported leishmaniasis cases in developed, non-endemic countries, have been pointed-out from a review of the international literature. Among the possible causes are increasing international tourism, influx of immigrants from endemic regions and military operations. The main area for the acquisition of cutaneous leishmaniasis, especially for adventure travelers on long-term trips in highly-endemic forested areas, is represented from South America, whereas popular Mediterranean destinations are emerging as the main areas to acquire visceral variant. Leishmaniasis should be considered in the diagnostic assessment of patients presenting with a compatible clinical syndrome and a history of travel to an endemic area, even if this occurred several months or years before. Adventure travelers, researchers, military personnel, and other groups of travelers likely to be exposed to sand flies in endemic areas, should receive counseling regarding leishmaniasis and appropriate protective measures. ª

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

“…Leishmaniasis yüküne ilişkin son tahminlerde, 101 endemik ülkede, yıllık insidansın 0,2-0,4 milyon VL ve 0,7-1,2 milyon KL vakası düzeyin-de olduğu tahmin edilmektedir (25). Ayrıca uluslararası seyahat ve ekoturizm gibi nedenlerden dolayı son yıllarda gelişmiş ve endemik olmayan bölgelerde de importe leishmaniasis vakalarının sayısında artış gözlenmektedir (25,26). Özellikle son on yıl-da leishmaniasis, endemik bölgelere seyahat edenler için tehdit oluşturmakta ve enfekte kişiler seyahat sırasında Leishmania spp.…”

“…Uluslararası literatürde son 25 yılda importe leishmaniasis vakalarının %80'inin KL olduğu bildirilmiştir (26). Ayrıca dünya genelinde farklı 4 yıllık aralıklarda bildirilmiş 214,080 KL vakasının, 61,335 inin Asya kıtasından olup en çok vaka en çok vaka Sri Lanka ve Hindistan'dan bildirilmiştir (29).…”

Got the Travel Bug? A Review of Common Infections, Infestations, Bites, and Stings Among Returning Travelers

“…Caused by a protozoan parasite of the genus Leishmania, leishmaniasis is broadly classified into 'Old World' and 'New World' disease. Old World leishmaniasis originates from Africa, Asia, the Middle East, and Southern Europe; New World disease originates in Central and South America, occasionally as far north as Texas [33][34][35]. Leishmaniasis in returning travelers to the USA has increased in recent years, owing to increased travel abroad and to the activities of the US military and contractors in the Middle East.…”

“…Old and New World leishmaniasis can be classified into four forms: localized cutaneous, diffuse cutaneous (or diffuse anergic cutaneous), mucocutaneous, and visceral. The progression from one stage to another largely depends on the Leishmania species and host response to the infection [33].…”

“…Leishmania mexicana usually causes an ulcer. Primarily a New World disease, diffuse cutaneous leishmaniasis is caused by L. mexicana, L. amazonensis, and L. venezuelensis species [33,41]. Mucocutaneous leishmaniasis is a rare form, almost exclusively in New World disease, and can occur 1-2 years after the onset of primary cutaneous disease.…”