Leishmaniasis

Leishmaniasis is a disease caused by protozoan parasites, and is also known as Leichmaniosis and Leishmaniose, and was formerly called various other names including Baghdad Boils, Black Fever, Dum-Dum Fever, Espundia, Kala Azar, Orient Boils, and Sandfly Disease.

There are four main forms of Leishmaniasis:

  • Cutaneous Leishmaniasis: the most common form of the disease, and where a skin ulcer forms at the bite site, which heals in a few months to a year, leaving an ugly scar. This form of the disease can progress to any of the other three forms, if left untreated.
  • Diffuse Cutaneous Leishmaniasis: this form of the disease produces widespread skin ulcers which resemble leprosy and is particularly difficult to treat.
  • Mucocutaneous Leishmaniasis: commences with skin ulcers which spread causing widespread tissue damage, especially to the mouth and nose.
  • Visceral Leishmaniasis: the most serious form of the disease in which the parasites have migrated to and are attacking the bodys vital organs. This form of the disease can be potentially fatal if left untreated.

Symptoms

The main symptoms of Leishmaniasis include:

  • Anemia
  • Damage to the liver
  • Damage to the spleen / enlarged spleen
  • Fever
  • Skin sores which erupt weeks to months after infection

These symptoms of Leishmaniasis may manifest themselves anywhere from a few months to years after infection.

The disease can be potentially fatal if left untreated.

Causes of Leishmaniasis

Leishmaniasis is caused by protozoan parasites that belong to the genus Leishmania that are transmitted to humans by the bite of certain species of sand fly.

This parasite is a member of the same genus as the parasites that cause African Trypanosomiasis (Sleeping Sickness) and also a member of the same order as the parasites that cause Chagas Disease (American Trypanosomiasis). However, its clinical manifestations, geographical distribution, life cycle, and insect vectors are quite different to these other parasites.

Transmission

Leishmaniasis may be transmitted to humans, and between humans, in the following ways:

  • Insect Bite: specifically, when the person is bitten by sand flies of the genus Lutzomyia or Phlebotomus.
  • Blood Transfusion: If infected people donate blood, then the recipients of the blood can become infected. Only some forms of the disease can be spread in this way.

Treatment

The main medication treatments for sufferers of Leishmaniasis include:

AmBisom

Amphotericin

Medications containing antimony, which are known as pentavalent antimonials. Examples include meglumine antimoniate (Glucantim) and sodium stibogluconate (Pentostam).

Miltefosine (Impavido), which has lesser side effects than other medications, the main one being gastrointestinal disturbances in the days following treatment. This medication is also available as an oral formulation, so no hospitalization is needed, making it convenient and cheap.

Paromomycin

It is not completely understood how some of these medications act against the parasite that causes the disease.

One ongoing problem is that the parasite that causes the disease has been becoming more resistant to some of these medications.

Further research is constantly being conducted into a range of other treatment options, such as immunotherapy treatments and vaccines, and this research provides hope for better treatments in the future.

Prevention and Control

The following techniques are used to attempt to prevent and control Leishmaniasis:

Personal Protection: however, sand flies are extremely small insects that can slip through all but the finest fly screens and mosquito nets. However, covering exposed skin, using insect repellents, and avoiding areas where sand flies are common can help reduce a persons chances of becoming infected.

Further research is constantly being conducted into a range of antiviral approaches to attack the Dengue virus directly, and this research may deliver better treatments or even eradication of the viruses in the future.