[leish-l] Leishmaniasis in Iraq: comments (02)

[Fred R. Opperdoes]

At 10:39 -0400 6/12/03, ProMED Digest wrote:
>LEISHMANIASIS - IRAQ: COMMENTS (02)
>**********************
>A ProMED-mail post
><http://www.promedmail.org>
>ProMED-mail, a program of the
>   International Society for Infectious Diseases
><http://www.isid.org>
>
>[1]
>Date: 11 Jun 2003
>From: Stanley Deresinski MD <polishmd at earthlink.net>
>Source: Communicable Disease Profile: Iraq.  WHO/CDS/2003.17. 19 Mar 2003
>[edited]
><http://www.who.int/infectious-disease-news/IDdocs/whocds200317/1profile.pdf>
>
>
>Visceral and cutaneous leishmaniasis in Iraq over the past decade
>- --------------------------------------------------
>WHO indicates that 2893 cases of visceral leishmaniasis (VL; kala-azar) were
>reported in Iraq in 2001, producing an incidence that year of 10.9 cases per
>100 000 population.  The major areas of endemicity are central Iraq and the
>greater Baghdad metropolitan area, but over the last decade, VL has extended
>its reach into additional areas, including that around Basra. 
>
>Transmission occurs between May and October, after hatching of sandfly eggs,
>while the peak of identification of new cases occurs between December and
>January. The etiologic agent of VL is generally _L. donovani_. However, after
>Desert Storm in 1991, VL due to _L. tropica_ was detected (often with great
>difficulty) in U.S. military personnel (N Engl J Med 1993;328:1383-1387).
>
>[Byline: Stan Deresinski]
>
>******
>[2]
>Date: 11 Jun 2003
>From: Philippe Desjeux <desjeuxp at who.int>
>
>
>First of all, up until the war, data were available from the Ministry of
>Health, Baghdad. I discount the possibility of a current "epidemic," as the
>transmission season has just begun (the major transmission risk is in
>September and October).  I cannot discuss the possibility of an increased
>number of cases, but the current cases are the last of the 2002 transmission,
>due to the long incubation time.  It is very different in terms of potential
>increasing risk and level of international response. VL is very common in
>Iraq, especially in central plains near Baghdad and in some foci between
>Baghdad and Basra. VL is due to _L. infantum_ (_L.donovani_).
>
>- --
>Dr Philippe Desjeux
>Medical Officer
>Department of Communicable Disease Surveillance and Response (CDS/CSR)
>World Health Organization
>Geneva 27 Switzerland
><desjeuxp at who.int>
>
>[ProMED thanks Dr Deresinski for providing the reference to the very valuable
>WHO assessment of the communicable disease profile of Iraq, which had escaped
>our search for background data. Also thanks to Dr Desjeux for pointing out
>that new patients with visceral leishmaniasis were infected during the last
>transmission season from May to October 2002, and have no relation to the
>present situation.
>
>WHO reports that cutaneous leishmaniasis has decreased over the last 10 years
>in Iraq, from a high in 1992 of 8779 cases (45.5 per 100 000 pop.) to 625
>cases in 2001 (2.3 per 100 000 pop.). Visceral leishmaniasis has fluctuated
>somewhat but seems to be increasing, with 744 cases in 1999 (3.0 per 100 000
>pop.) to 2893 (10.9 per 100 000 pop.) in 2001. - Mod.EP]
>
>[see also:
>Leishmaniasis - Iraq: comments 20030602.1348
>Leishmaniasis - Iraq: RFI      20030531.1331
>2001
>- ----
>Leishmaniasis, suspected - Iraq      20010917.2245]
>..........................ep/pg/jw
>
>------------------------------


-- 
Fred R. Opperdoes,      	      	      	    
Research Unit for Tropical Diseases (TROP) and
Laboratory of Biochemistry (BCHM) 
Christian de Duve Institute of Cellular Pathology (ICP)
and Catholic University of Louvain (UCL)
Avenue Hippocrate 74-75, B-1200 Brussels, Belgium

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