Leishmaniasis
Leishmaniasis is a
parasitic disease spread from rodents by the bite of infected sand flies.
Sand flies become infected by biting an infected animal (for example, a
rodent or dog) or person. Since sand flies do not make noise when they fly,
people may not realise they are present. Sand flies are very small and may
be hard to see; they are only about one-third the size of typical mosquitoes.
Sand flies usually are most active in twilight, evening, and nighttime hours
(from dusk to dawn).
Manifestations:
There is three different expression of the disease. These are characterised
by their geographic occurrence and symptoms:
Leishmania cutanea
is a benign disease. This which causes skin sores. The sores need up to
several years to heal. This disease occurs in:
- India
- Western Asia
- Africa
Leishmaniasis braziliensis
is more serious. This form spreads to bones. This form occurs in:
- South America
- Central America
Leishmaniasis viscerale
(kala azar) is a serious disease, which untreated, will cause death in about
70% of infected people. The symptoms are
- Fever
- weight loss
- enlarged spleen
- enlarged liver (usually
the spleen is bigger than the liver)
- swollen glands
- Diarrhoea
Diagnose and
treatment: The parasite
is demonstrated in the sore or in blood. Treatment is available.
Prevent Leismaniasis
by:
- Stay in well-screened
or air-conditioned areas as much as possible.
- Avoid outdoor activities,
especially from dusk to dawn, when sand flies are the most active.
- When outside, wear
long-sleeved shirts, long pants, and socks. Tuck your shirt into your
pants.
- Apply insect repellent
on uncovered skin and under the ends of sleeves and pant legs. Follow
the instructions on the label of the repellent. The most effective repellents
are those that contain the chemical DEET (N,N-diethylmetatoluamide). The
concentration of DEET varies among repellents. Repellents with DEET concentrations
of 30-35% are quite effective, and the effect should last about 4 hours.
Lower concentrations should be used for children (no more than 10% DEET).
Repellents with DEET should be used sparingly on children from 2 to 6
years old and not at all on children less than 2 years old.
- Spray clothing with
permethrin-containing insecticides. The insecticide should be reapplied
after every five washings.
- Spray living and
sleeping areas with an insecticide to kill insects.
- If you are not sleeping
in an area that is well screened or air-conditioned, use a bed net and
tuck it under your mattress. If possible, use a bed net that has been
soaked in or sprayed with permethrin. The permethrin will be effective
for several months if the bed net is not washed. Keep in mind that sand
flies are much smaller than mosquitoes and therefore can get through smaller
holes. Fine-mesh netting (at least 18 holes to the inch, some sources
say even finer) is needed for an effective barrier against sand flies.
This is particularly important if the bed net has not been treated with
permethrin. However, it may be uncomfortable to sleep under such a closely
woven bed net when it is hot.
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20-Feb-2003 • İtraveldoctorOnline 2001 •
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