Leishmaniasis is a parasitic infection that gets transmitted via the bite of sand flies that are infected. This infectious disease is common in countries like Bangladesh, India, Nepal, Sudan, and Ethiopia and in some parts of Saudi Arabia. This causes painful sores on the skin that takes many months or even years to heal completely. This kind of sores may leave a scar permanently on the skin. Two types of leishmaniasis are available and this disease can be managed by effective medications.
Leishmaniasis is caused by parasite by Leishmania genus protozoan. When the female sand fly that carries the parasite of Leishmania bites any person the infection gets transmitted. Often the infection spreads through travelers or tourists who after getting infected travels to other countries. The primary host of the parasite is humans and sometimes it also affects rodents and canids.
Each year around 1 million fresh cases of leishmaniasis are reported to occur in many countries like India, Bangladesh, Brazil, Sudan and Ethiopia. Several deaths are reported in these cases every year due to visceral leishmaniasis. This disease often affects the economically weaker section of the society who does not have even basic amenities like housing and water facility.
- Two major types of leishmaniasis are known to occur. One is visceral leishmaniasis in which the parasite affects the internal organs of the body like liver, kidney and intestine. Such cases are reported from India, Bangladesh, Sudan, Nepal and Brazil.
- The other type is known by name cutaneous leishmaniasis in which the parasite affects only the skin sparing other parts of the body. Such cases are seen in countries like Saudi Arabia, Algeria, Afghanistan, Syria and Peru. Military troops of the USA force residing in these places for longer duration are prone to develop this infection.
Mode of Transmission :
Parasites belonging to Leishmania species cause this infection. More than 21 species are known to cause infection in humans. The sand flies often carry this protozoan and when it bites the humans, it injects some parasites into the body that are absorbed by blood cells. Once inside the body, the parasite multiples and produces more numbers thereby infecting other tissues and organs. Sand fly can get this parasite while biting the infected people and animals.
Who are at risk?
- People who live in the rural areas are more prone to get bitten by sand flies than others. Exposure to sand flies increases the risk of developing leishmaniasis infection.
- Sand flies become very active after dusk and infect the residents and new travelers who visit rural areas.
- People with weakened immunity have increased risk of getting infected. Patients with immune related diseases like HIV or AIDS or cancer are at high risk of getting this infection.
- Once the parasite enters the body, it can live for many years without producing any symptoms.
For most of the cases, visceral leishmaniasis will not show any symptoms. Such infected people will carry the parasite without their knowledge. When the immunity of such person gets weak symptoms would appear. In mild to moderate cases of infection there may not be any visible symptoms. But in severe cases, it can cause loss of weight, reduced blood count, fever and enlargement of liver. The person may develop fever now and then causing extreme tiredness. The levels of immune globulin may increase considerably. Internal organs like liver and kidney may also get affected.
For some people, the skin would become dark causing black sickness. Some others may develop persistent rashes on the skin. In the case of cutaneous leishmania the person may develop ulcer or lesions on the skin with a raised border. Such lesions may remain on the body for several weeks. It can be in the shape of ulcerated plaque or as scaly patches.
It might take several months or years for these lesions to heal completely but even then it leaves a scar permanently. Another type called mucocutaneous leishmaniasis affects the oral cavity and the nose. Such people may develop lesions on their nose which would subsequently penetrate the nasal septum. In case the larynx gets affected the person may develop hoarse voice.
Based on the symptoms and health condition of the patient, the doctor may opt for testing the tissue sample collected from the skin. Testing would be done by a microscope to diagnose the parasite. He may order for complete blood profile to check the presence of antibodies. It is difficult to diagnose visceral leishmaniasis with the symptoms of fever, fatigue and weight loss since the same signs are present for other infectious diseases like TB, syphilis and malaria also.
Medications are given either orally (as tablet) or in the form of intravenous injection, based on the health of the patient. Amphotericin B is the drug prescribed for leishmaniasis. Medications like Miltex or Humatin are also given. For patients affected with cutaneous infection topical creams can be applied on the skin for treating lesions. Ointments that contain ketoconazole is effective in reducing the lesions.
Images, Pics, Photos and Pictures of Leishmaniasis :
In most of the cases cutaneous leishmaniasis is not harmful excepting in leaving the scars on the body. Severe form of visceral type of leishmaniasis can become fatal if not treated immediately. The patient may collapse and die due to vital organ failure.
Tips for Prevention :
- It is necessary to wear protective clothing for the people who live in the rural areas prone to sand fly bite. Keeping the body fully covered can prevent the bite of sand fly.
- Fine nets can be used on the houses to prevent entry of sand flies.
- Insecticides like permethrin or deltamethrin can be used to protect the family from insect bites.