[leish-l] Leishmaniasis in Afghanistan 2

[R.W. Ashford]

Re the Leishmaniasis in Afghanistan mailing:

1. Cutaneous leish in Afghanistan is of two sorts, caused 
by L. major in the northern border area, and by L. tropica 
in cities throughout the country.

2. L. tropica does not have reservoir host other than Man.

3. L. tropica is transmitted by  P. sergenti, not P. 
papatasi.

4. In Kabul at least, the increasing number of cases is 
almost certainly due to increasing movement of people into 
a 'dependent focus' (ecological 'sink')

5. Psammomys (a gerbil, not a mouse, that lives in humid 
salt-flats not dry river valleys) does not occur in 
Afghanistan, where the reservoir host of L. major is 
Rhombomys opimus, as it is throughout central Asia.

6. Astonishing that such a short article should contain so 
many inaccuracies.

P.s. there have been a handful of reports of infantile 
visceral leishmaniasis, presumably due to L. infantum, from 
Afghanistan.

Transmission should be starting about now, and will peak in 
September, when large numbers of any international troops 
there will become infected. They need information, not 
nonsense.

Regards to all,

Dick Ashford

On Sat, 11 May 2002 19:38:46 +0200 "Fred R. Opperdoes" 
<opperdoes at trop.ucl.ac.be> wrote:

> At 8:04 -0400 11/05/02, ProMED Digest wrote:
> >Date: Sat, 11 May 2002 07:49:56 -0400 (EDT)
> >From: ProMED-mail <promed at promed.isid.harvard.edu>
> >Subject: PRO/AH> Leishmaniasis - Afghanistan (02)
> >
> >LEISHMANIASIS - AFGHANISTAN (02)
> >*******************************
> >A ProMED-mail post
> ><http://www.promedmail.org>;
> >ProMED-mail, a program of the
> >International Society for Infectious Diseases
> ><http://www.isid.org>
> >
> >Date: Fri, 10 May 2002 11:05:48 +0200
> >From: Dan Michaeli, MD <michaeli at netvision.net.il>
> >
> >
> >Background information on leishmaniasis in Afghanistan
> >- -----------------------------------------
> >Cutaneous leishmaniasis is a very old endemic disease. The Afghanistan form
> >is most probably an example of "Leishmaniasis of the Old World" that is
> >common in the Mediterranean area and along the "Silk Route" between the
> >Middle East and the Far East. It is hosted mainly by animals. Unlike
> >_L.donovani_ (the agent for kala azar), the cutaneous form (primarily
> >caused by _L.tropica_) is harboured in smaller animals.
> >
> >The cycle is very interesting because the transmitting vector, _Phlebotomus
> >papatasii_, protects itself from the heat in arid areas in the burrows of
> >_Psammomys_ mice, which [are found] along dry river beds that still have
> >some
> >humidity in their soil. In the evening and at night the flies leave the
> >burrows and may fly as far as a kilometer, and that's when they bite
> >exposed areas of the body. Because of the heat people may sleep half naked,
> >and we have seen people who were bitten so many times that they had a few
> >dozen ulcers.
> >
> >It is intriguing to observe such a widespread epidemic as the
> >current one, and I wonder whether the people involved migrated only
> >recently to these areas. In Jericho we found at the time that most children
> >over the age of 6 were already protected, having probably been infected
> >before.
> >
> >- --
> >Dan Michaeli MD
> >Chairman, Clalit Health Services, Israel
> ><michaeli at netvision.net.il>
> >
> >[Thank you very much for the interesting background information. We have no
> >information as to whether the increase in cutaneous leishmaniasis is due to
> >an increase of the vector or migration of non-immune humans into endemic
> >areas. - Mod.EP]
> >
> >[see also:
> >2002
> >- --
> >Leishmaniasis - Afghanistan (Kabul): alert  20020508.4134
> >Leishmania, Pakistan ex Afghanistan      20020213.3556
> >2001
> >- --
> >Leishmaniasis - India (Calcutta)         20001022.1830
> >Leishmaniasis - India (Calcutta) (02) 20001026.1858
> >Leishmaniasis - Nepal         20000729.1257
> >Leishmaniasis - Nepal (02) 20000731.1266]
> >.....................................ep/pg/jw
> >
> >------------------------------
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----------------------
ashford at liverpool.ac.uk