CDC warns of spreading parasitic disease through local sand flies, potentially causing disfigurement.
A Potentially Disfiguring Skin Disease Spreading Among Americans
A skin disease that was once exclusive to international travelers returning to the United States has now been found among Americans with no travel history, according to a study by the U.S. Centers for Disease Control and Prevention (CDC).
The disease, known as leishmaniasis, is caused by a parasitic infection transmitted through the bite of sand flies. Previously, it was only detected in travelers from tropical and subtropical regions. However, recent research by the CDC has identified infections among Americans who have not traveled internationally.
The CDC discovered that the leishmania parasites causing these infections were different from the imported cases.
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A study presented at an annual meeting of the American Society of Tropical Medicine and Hygiene (ASTMH) revealed a concerning rise in cutaneous leishmaniasis infections in the United States over the past decade.
Cutaneous leishmaniasis is the most common form of the disease, causing persistent skin lesions that can last for months or even years.
While most cases involved individuals who had traveled to countries where leishmaniasis is prevalent, the CDC found 86 patients with no travel history.
An analysis of tissue samples from these cases showed that the Leishmania strain infecting them had a slightly different genetic fingerprint, suggesting an American variant spread by local sand fly populations.
Although most infections among nontravelers were found in Texas, sand flies capable of transmitting leishmaniasis are present across the United States, particularly in the southern regions.
Fatal Version of Infection
The increasing number of cutaneous leishmaniasis cases in the United States raises concerns about the potential spread of the fatal form of the infection, visceral leishmaniasis. This could occur through imported dogs carrying the pathogen.
Visceral leishmaniasis is the most deadly form of the infection, with a mortality rate of over 95%. It affects internal organs and causes 20,000 to 30,000 deaths worldwide each year.
While there are no drugs to prevent the disease, treatments for human infections can have serious side effects. Vaccines for dogs are available in Brazil and Europe.
Another study presented at the ASTMH annual meeting highlighted the risks of visceral leishmaniasis spreading in the United States through imported dogs.
According to Christine Petersen, director of the Center for Emerging Infectious Diseases at the University of Iowa, a significant number of dogs entering the U.S. have lived in areas where Leishmania parasites are known to circulate among people and animals.
Infected dogs can be treated to reduce the number of parasites they carry, but regular screening and treatment are necessary due to the high relapse rate.
The Infection
According to the CDC, individuals infected with cutaneous leishmaniasis may develop lesions within weeks or months, but they often appear several years later. These lesions can become ulcerative and painful if infected with bacteria or located near a joint.
The skin sores usually heal on their own, but it may take months or years and leave unsightly scars. In some cases, the parasites can cause lesions in the nose, mouth, or throat.
Visceral leishmaniasis manifests as fever, weight loss, enlarged liver and spleen, and low levels of blood cells. In certain regions, infected humans are necessary for the transmission of the disease, while in others, animal hosts can sustain the parasite’s transmission.
As there are no drugs or vaccines to prevent infection, the CDC advises travelers to protect themselves from sand fly bites by minimizing outdoor activities at night, wearing protective clothing, and applying insect repellent.
“Both forms of leishmaniasis cause tremendous suffering around the world, and the fact that they now pose risks in the United States shows why we need to work together as a global community to fight infectious diseases wherever they exist,” said ASTMH President Daniel Bausch.
How can healthcare providers raise awareness and improve surveillance of leishmaniasis in order to diagnose and treat cases more effectively?
E effects and are not always effective. Prevention of the disease relies mainly on vector control, such as the use of insecticide-treated bed nets and indoor residual spraying.
The recent discovery of leishmaniasis cases among Americans without travel history highlights the need for increased awareness and surveillance of the disease within the country. Healthcare providers should consider leishmaniasis as a possible diagnosis in patients with persistent skin lesions, especially if they have spent time in areas where the disease is endemic or have come into contact with sand flies.
Furthermore, efforts should be made to control the local sand fly populations to prevent the spread of the disease. This may include measures such as eliminating breeding sites, using insecticides, and implementing educational campaigns to raise awareness about the disease and its transmission.
In addition to the potential spread of the fatal form of the infection through imported dogs, there is also a concern about the impact on the economy. The presence of leishmaniasis in the United States could deter tourists from visiting areas where sand flies are prevalent, leading to a decrease in tourism revenue.
In conclusion, the emergence of leishmaniasis among Americans with no travel history is a concerning development. Increased surveillance, awareness, and control measures are necessary to prevent further spread of the disease and protect public health. Further research is also needed to understand the genetic variations of the parasite and the factors contributing to its transmission within the United States. By taking proactive measures, we can mitigate the impact of this potentially disfiguring skin disease and safeguard the well-being of the population.
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