[leish-l] Leishmaniasis - Iraq

Tue Jun 10 15:50:00 BRT 2003

Dear Philippe

I was away, in Israel, so missed the nonsense about Iraq till now. 
Congratulations on the moderateness of your response.  It's probably just 
as well I missed it, as my response would have been 'a l'ashfordienne', and 
people would have been upset by straight talk.

By the way, I have been thoroughly through all the reports I can find, and 
can find absolutely NO reliable evidence of L. tropica causing VL.  Every 
report is flawed one way or another and, before postulating such an 
unlikely event, the evidence would have to be very convincing a) that the 
parasite really is tropica and b) that the infection really is 
leishmaniasis!

Best wishes,

Dick

--On 02 June 2003 09:53 +0200 desjeuxp at who.int wrote:

> This report on leishmaniasis in Iraq is full of mistakes and confusing.
> There is no real outbreak of visceral leishmaniasis but accumulated non
> treated cases. The transmission season is from May to October with a major
> risk of transmission in September/October and, due to the incubation time,
> cases are mainly detected from November to April. Due to the pre-war
> situation and the lack of drugs during this period, accumulated cases of
> last year transmission are seen now. UNICEF and WHO have recently sent a
> large quantity of drugs.
>
> L major and L.tropica are at the origin of zoonotic and anthroponotic
> cutaneous leishmaniasis specially in central and Northern but CERTAINLY
> not at the origin of leishmaniasis visceral in Iraq.
>
> Regards
>
> P. Desjeux
>
> 	_______________________________
> 		 Dr Philippe Desjeux
> 		     Medical Officer
> 	Department of Communicable Disease
> 	        Surveillance and Response
> 		      (CDS/CSR)
> World Health Organization 		Direct Tel. (+41 22) 791 38 70
> 20, Avenue Appia		 	Operator    (+41 22) 791 21 11
> CH-1211 Geneva 27		Fax:          (+41 22) 791 48 78
> Switzerland			Email.        <desjeuxp at who.int>
>
>
> -----Original Message-----
> From: Fred R. Opperdoes [mailto:opperdoes at trop.ucl.ac.be]
> Sent: Sunday, 1 June 2003 08:13
> To: leish-l at fat.org.br
> Subject: [leish-l] Leishmaniasis - Iraq
>
>
> At 22:46 -0400 5/31/03, ProMED Digest wrote:
>> Date: Sat, 31 May 2003 20:08:31 -0400 (EDT)
>> From: ProMED-mail <promed at promed.isid.harvard.edu>
>> Subject: PRO/EDR> Leishmaniasis - Iraq: RFI
>>
>> LEISHMANIASIS - IRAQ: REQUEST FOR INFORMATION
>> **********************
>> 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, 31 May 2003
>> From: Pablo Nart <p.nart at vet.gla.ac.uk>
>> Source: NDTV Thu 29 May 2003
>> <http://www.ndtv.com/template/template.asp?template=Usiraqconfrontation&
>> slu
> g=%3CI%3EKalaAzar%3C%2FI%3E+outbreak+in+Iraq%3A+UNICEF&id=38619&callid=1>
>>
>>
>> Outbreak of Kala-Azar (visceral leishmaniasis) in Iraq
>> - --------------------------------------------------
>> UNICEF has announced an outbreak of Kala-Azar (Visceral Leishmaniasis) in
>> Iraq. Though there have been outbreaks of the disease in Iraq in the past
>> around this time of year, it is particularly severe this time.
>>
>> There are now more than 200 cases of Kala-Azar reported in Iraq. The
>> country does see regular outbreaks of the disease.
>> UNICEF has warned that this time the outbreak could be severe.
>>
>> Kala-Azar is spread mainly by sand flies and causes malnutrition and
>> anaemia. When left untreated, the disease is fatal within 4 to 6 weeks.
>>
>> [Byline: Kamini Sawhney (Baghdad)]
>>
>> - --
>> ProMED-mail
>> <promed at promedmail.org>
>>
>> [Leishmaniasis is endemic in Iraq and is caused by _L. major_ and _L.
>> tropica_, which can cause both visceral leishmaniasis (VL) and cutaneous
>> leishmaniasis (CL). Leishmaniasis from these 2 species are predominantly
>> CL, and an increase in CL will most probably be found if looked for. It
>> is possible that malnutrition and other infections may have caused more
>> cases to manifest as VL. Leishmania is transmitted from animal
>> reservoirs and human hosts by sandflies. There are no annual statistics
>> on VL in Iraq, but Gideon (<www.gideononline.com>) reports 8500 cases
>> from 1971 to 1980, with the highest prevalence in the central areas and
>> greater Baghdad. Cases have not been reported since then, but there is
>> no reason to believe that there have been fewer cases. More information
>> on this outbreak would be appreciated. - Mods.EP/MPP]
>>
>> [see also:
>> 2001
>> - ----
>> Leishmaniasis, suspected - Iraq      20010917.2245]
>> ...................mpp/ep/pg/mpp
>>
>> ------------------------------
>
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Please note new status and phone number:
R.W. Ashford
Professor (Retired) of Parasite and Vector Biology
Liverpool School of Tropical Medicine
Liverpool L3 5QA
Tel: +44 151 632 2714
Fax: +44 151 705 3371
e-mail: ashford at liv.ac.uk