Rising Concern: The Emergence of Leishmaniasis in the United States

 

Rising Concern: The Emergence of Leishmaniasis in the United States

Leishmaniasis, a little-known parasitic skin infection with monikers like Baghdad boil, Calcutta ulcer, and Jericho button, has been making its presence felt in the United States. What was once primarily associated with international travelers is now taking root as an endemic disease in certain U.S. regions.

The infection has been quietly advancing, particularly among non-travelers in Texas, where healthcare providers are now mandated to report cases to health authorities. Moreover, it has been observed spreading in parts of southeast Oklahoma and Arizona.

This concerning trend is attributed to a significant population of disease-carrying vectors and the influence of climate change, facilitating the disease's reach.

Genetic analysis of 86 locally acquired cases revealed that the majority were infected by a variant of the Leishmania mexicana parasite believed to have originated within the U.S. Mary Kamb, a medical epidemiologist with the Centers for Disease Control and Prevention, expressed, "Now, for the first time, we have a distinct genetic fingerprint from a relatively large cluster, providing further evidence that leishmaniasis may be well-established in some parts of the US." These findings were unveiled at a recent scientific meeting held in Chicago.

Leishmaniasis is transmitted by around 70 species of sand flies, with Lutzomyia insects, known for their blood-feeding habits, being the primary culprits in the Western Hemisphere. These insects are prevalent in various regions of the United States, especially in the southern states.

The parasite has found a "reservoir" in animals, predominantly opossums, armadillos, and rodents, which female sand flies feed on. The virus has also infected American cats and dogs, raising concerns about imported dogs potentially carrying a life-threatening visceral form of the disease.

In humans, cutaneous leishmaniasis manifests as hard-to-heal, ulcerating sores, often larger than a half-dollar, which can persist for six to twelve months. While treatment options exist, untreated sores can result in disfiguring scars.

In Texas, dermatologists are familiar with spotting the infection, but its recognition is limited in other states, hindering efforts to gauge the extent of parasite spread.

As this concerning health issue continues to evolve, understanding its dynamics and raising awareness becomes paramount in safeguarding public health in the United States.