The burden of visceral leishmaniasis in Italy from 1982 to 2012: a retrospective analysis of the multi-annual epidemic that occurred from 1989 to 2009

Abstract

Starting from 1989 Italy experienced an increase of visceral leishmaniasis (VL) cases over a baseline of 10 to 30 cases reported annually. The number of cases peaked in 2000 and 2004 with more than 200 cases/ year, and subsequently declined to reach on average one third of the 2000 peak value in the period after 2010. A retrospective analysis from 1982 to 2012 showed that the multi-annual epidemic consisted of major components including (i) an outbreak involving infants and immunocompetent adults in parts of the Campania region (southern peninsular Italy) and that appears to have declined naturally, (ii) a second outbreak affecting human immunodeficiency virus (HIV)-infected individuals throughout the country, that declined owing to the use of highly active antiretroviral therapies (HAART), (iii) a generalised increase of VL cases in immunocompetent individuals and patients affected by associated conditions other than HIV from endemic regions of peninsular and insular Italy (other than Campania), which was due to a geographical spreading of VL foci, with no major case-clusters or outbreak features. A minor component consisted in the appearance of a few autochthonous cases in formerly non-endemic areas, starting from the early 1990s. Epidemic determinants and reasons for VL decline in the Campania region remain largely unexplained, despite the information available on canine reservoir and phlebotomine vectors in Italy.

Prevalence of Leishmania infantum and co-infections in stray cats in northern Italy

“…Phlebotomus perniciosus is the most widespread sandfly plebotomine in Italy [1,2]. Although domestic dogs (Canis familiaris) are the main reservoirs of infection, the Leishmania parasite is the causative agent of both visceral and cutaneous leishmaniosis in humans [3]. Both in dogs Abbreviations: BCS, body condition score; ELISA, enzyme-linked immunosorbent assay; FCoV, feline coronavirus; FeLV, feline leukemia virus; FIV, feline immunodeficiency virus; IFAT, indirect fluorescent antibody test; rPCR, real-time polymerase chain reaction; TNR, trap neuter release.…”

Living on the Edge: Border Countries Should Have Strict Veterinary and Health Policy on Leishmaniasis

“…Seroprevalence in people and dogs in Slovenia has not been estimated yet. High seroprevalence ratios in dogs were recently found in neighboring countries such as Italy and Croatian region of Dalmatia (21% and 42.85%, respectively) [32,33]. Unfortunately, no information on the prevalence of healthy human inhabitants from Dalmatia is available.…”

Chronic amastigote‐negative cutaneous leishmaniasis: A clinical, histopathologic and molecular study of 27 cases with emphasis on atypical and pseudolymphomatous presentations

“…The disease usually runs a self‐healing course and is caused mainly by Leishmania major , Leishmania tropica , Leishmania infantum and Leishmania Aethiopica . However, as demonstrated by the recent outbreaks in Italy and Spain, leishmaniasis has the potential to further emerge, or re‐emerge within Europe, through the spreading of the current species because of the climate change, the introduction of exotic Leishmania species due to international traveling, ecotourism activities, military operations, immigration and an increase in the number of immunosuppressed subjects . There is also a rise in atypical presentations with polymorphous and/or disseminated cutaneous lesions and a chronic and/or recurrent course, especially in immunodepressed and/or debilitated subjects .…”