[Leish-l] FW: Fwd:Leishmaniasis, human - Spain

[jeffrey shaw]

From: fred.opperdoes at uclouvain.be
Date: Sun, 13 Jun 2010 18:31:49 +0200
To: Leish-l at lineu.icb.usp.br
Subject: [Leish-l] Fwd:Leishmaniasis, human - Spain



Date: Sat, 12 Jun 2010 13:37:18 -0400 (EDT)
From: ProMED-mail <promed-ahead-edr at promed.isid.harvard.edu>
Subject: PRO/AH/EDR> Leishmaniasis, human - Spain

LEISHMANIASIS, HUMAN - SPAIN
****************************
A statement by ProMED-mail
<http://www.promedmail.org>
ProMED-mail is a program
International Society for Infectious Diseases
<http://www.isid.org>

Date: 10 Jun 2010
Source: Lukoran, Spain [in Spanish, trans. Corr.SB, edited]
<http://www.lukor.com/ciencia/noticias/1006/09162234.htm>


Leishmaniasis is increasing in Spain
- ------------------------------------
Between 20 and 80 people each year suffer from a severe infection of  
leishmaniasis, a disease that is transmitted from animal -- mostly  
dogs -- to humans, causing fever and swollen liver and spleen and is  
fatal in up to 5 percent of cases experts said this Wednesday at the  
Infectopatología Course II, held this week in Madrid.

As explained by the representative of the Center for Infectious  
Diseases and International Health in Malaga and co-coordinator of the  
conference, Dr. Fernando Farinas, this disease has become in recent  
years on a "forgotten disease" despite the sandfly which transmits it  
being endemic in Spain and infecting 5 of every hundred dogs per year  
(possibly more).

Leishmaniasis is a zoonotic disease -- a condition shared by dogs and  
humans, not transmitted by direct contact between man and animal but  
through insect vectors which become infected after biting the main  
reservoir of the parasite, the dog.

On the human side, leishmaniasis is particularly virulent in  
immunocompromised patients (HIV, cancer or malnutrition mainly) and  
may occur in 2 forms: the visceral, more serious and the cutaneous,  
more benign and prevalent, that manifests itself through skin ulcers,  
which are often confused with psoriasis.

The latter option is worryingly under-diagnosed in Spain, says Dr  
Farinas, something that is making it easier for parasites to develop  
"hyper-resistance" to the drugs most commonly used against them.  
However, Spain has effective new medicines to eliminate these  
pathogens [but see comment below].

This infectious disease specialist has said you cannot neglect the  
research side of this disease, "it has been detected in patients with  
HIV [infection] when the human is both reservoir and victim, without  
the dog."

An extended illness all over Spain
- ----------------------------------
Regarding the incidence of canine leishmaniasis, regions in Spain most  
affected so far are Andalusia, Palme Mallorca, Valencia and Catalonia.  
However, in recent years it has been shown that not only the typical  
Mediterranean climate zones are prone to the disease. According to the  
latest data, areas of northern Spain are registering more and more  
cases of dogs affected by leishmaniasis. In the Basque Country,  
Galicia and Madrid, infections in dogs have increased 50 percent in  
the last 15 years.

The head of the Department of Parasitology and Parasitic Diseases of  
the Universidad Complutense de Madrid, Guadalupe Miro, stressed that  
"only 5 percent of dogs are diagnosed with this disease, when in fact  
about 60 percent are infected.

- --
Communicated by:
ProMED-mail
<promed at promedmail.org>

[Leishmaniasis is endemic in Spain with dogs as the main reservoir, as  
is also the case in Portugal, southern France, Italy, Malta and  
Greece. A special concern is the association between clinical  
leishmaniasis and immunosuppression e.g. HIV-infection or organ  
transplants. A recent review reported more than 2000 such cases from  
southern Europe over the past 10 years (Alvar J et al. The  
relationship between leishmaniasis and AIDS: the second 10 years. Clin  
Microbiol Rev. 2008;21:334-59). The role of dogs as reservoir in Spain  
has also recently been reviewed (Miro G et al. Canine  
leishmaniasis--new concepts and insights on an expanding zoonosis:  
part two. Trends Parasitol. 2008;24:371-7).

Clearly, leishmaniasis is a increasing zoonotic infection in southern  
Europe, which must be considered in cases with unexplained cutaneous  
symptoms, long term low grade fever, weight loss and splenomegaly. -  
Mod.EP]

["[The disease is] under-diagnosed in Spain ... something that is  
making it easier for parasites to develop "hyper-resistance" to the  
drugs most commonly used against them" seems to be a non sequitur. If  
the disease is not being diagnosed, it is not being treated with  
specific drugs (pentavalent antimonials, pentamidine) therefore cannot  
develop resistance to them. - Mod.JW]

[see also:
2009
- ----
Leishmaniasis - UK: imported 20091125.4049
2004
- ----
Leishmaniasis, dog reservoir - Spain 20040524.1388
2000
- ----
Leishmaniasis - Germany ex Spain 20000725.1236
1999
- ----
Leishmaniasis, visceral & HIV - Europe (SW) 19991106095248
Leishmaniasis, visceral & HIV - Europe (SW) (03) 19991118221651
1997
- ----
Leishmaniasis, canine - Italy (02) 970411151032]
...................sb/ep/ejp/jw

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