[leish-l] Leishmaniasis in Afghanistan 2

dan and micky michaeli michaeli at netvision.net.il
Mon May 13 12:24:46 BRT 2002


Sorry, but my note is based on well established facts that were published in
the Journal of Infectious Diseases in 1969 or about it ( I shall send the
references tomorrow). I am sorry that the editor changed a little my
original text concerning the vector. I wrote that the vectors in Israel are
"gerbils and psammomys, both wild rodents" this is of course more accurate.
The psammomys in the Jericho area lives in dry river beds, and it is
relatively close to the Dead Sea and it is true that the soil there is salty
and I agree with this comment ,but the jerbils were found by another group
in the Jordan Valley and I don't have first hand information about the soil
there. I don't know of P. sergenti in Israel but P. papatasii is very common
and was always considered the agent here. It could be different in other
areas of the world.

It is disappointing that before cricising so vehemently my notes Dr Ashford
did not ask at least for the references. At least I am pleased to know that
my guess there is a connection between population movements and the present
outbreak.

Sincerely,

Dan Michaeli

----- Original Message -----
From: "R.W. Ashford" <ashford at liverpool.ac.uk>
To: "Fred R. Opperdoes" <opperdoes at trop.ucl.ac.be>
Cc: <leish-l at bdt.org.br>; <michaeli at netvision.net.il>
Sent: Monday, May 13, 2002 12:25 PM
Subject: Re: [leish-l] Leishmaniasis in Afghanistan 2


> 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
> > >
> > >------------------------------
> > _______________________________________________
> > leish-l mailing list
> > leish-l at bdt.org.br
> > http://panda.fat.org.br/mailman/listinfo/leish-l
>
> ----------------------
> ashford at liverpool.ac.uk
>





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