[Leish-l] FW: PRO/AH/EDR> Leishmaniasis - Europe: imported

Tue Apr 10 17:47:23 BRT 2012

From: ProMED-mail <promed at promed.isid.harvard.edu>

Date: 2012/1/13
Subject: PRO/AH/EDR> Leishmaniasis - Europe: imported
To: promed-ahead-edr at promedmail.org

LEISHMANIASIS - EUROPE: IMPORTED

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A ProMED-mail post

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International Society for Infectious Diseases

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Date: Thu 12 Jan 2012

Source: TropNet [edited]

<http://www.tropnet.net/index.php?id=103>

Imported cases of leishmaniasis have become more frequent in Europe

over the past years due to increased travel to risk areas.

Standardized species identification and treatment protocols are

warranted to provide patients with the best possible treatment.

The broad availability of PCR allows a rapid determination of species.

Each species has a different sensibility to the different

anti-leishmanial drugs. Therefore, a species-specific treatment

approach has been evaluated for many species and has been widely

applied in many centres recently.

As the leishmania species influences the outcome of systemic

treatment, parasite species identification is of high clinical

relevance. In particular, in the setting of travel clinics, where the

origin of an infection often cannot be assigned to a specific

location, more sophisticated species identification than just a

geographical one is required.

Currently, treatment recommendations are usually based on data from

endemic regions, but travelers could have different treatment

responses to anti-leishmanial drugs than the endemic population with

repeated contact to leishmania parasites. Moreover, more treatment

options are available to western travelers as compared to endemic

settings, where high cost and inadequate logistics can be a major

problem. Therefore, data on the efficacy of specific treatment

approaches in travellers are needed.

Little is known on the frequency and treatment of cutaneous and

mucosal leishmaniasis in Switzerland and Europe. Lack of efficacy to

one or the other drug may arise. Therefore, an international

surveillance is necessary to monitor the efficacy of a

species-specific treatment. Since the number of patients in

Switzerland of each species of cutaneous leishmaniasis is too small,

an international surveillance system is necessary.

Project Goal:

Improving treatment of leishmaniasis based on clinical presentation

and molecular species differentiation

Objectives:

1. Exchange between specialist and harmonisation of treatment

recommendations in Europe

2. Surveillance of treatment of cutaneous and mucosal leishmaniasis in

Europe

The consortium so far consists of 17 participants from 12 institutions

from 7 European countries (UK: 3 partner institutions; France: 3

partner institutions; Belgium: one partner institution; Germany: 2

partner institutions; Netherlands: one partner institution;

Switzerland: one partner institution; Spain: one partner

institution).

--

Communicated by:

ProMED-mail <promed at promedmail.org>

[Leishmania is endemic in southern Europe. A recent study from Spain

found that 2028 patients were diagnosed in the 12-year period from

1997 to 2008, of which 1/3rd were co-infected with human

immunodeficiency virus. (Gil-Prieto R et al. Epidemiology of

leishmaniasis in Spain based on hospitalization records (1997-2008).

Am J Trop Med Hyg. 2011;85:820-5).

In the southern Mediterranean region, the disease is most frequent in

children, whereas in Europe, and particularly in France, it is mostly

an opportunistic infection associated with immunosuppression (Marty P

et al. Mediterranean visceral leishmaniasis. Bull Acad Natl Med.

(Paris) 2011;195:181-8).

In most countries, neither visceral nor cutaneous leishmaniasis is a

notifiable disease, and, therefore, data on the number of imported

cases are lacking. The TropNet project will provide new data and help

to determine whether leishmaniasis should be made a notifiable disease

in Europe. - Mod.EP

A HealthMap/ProMED-mail map can be accessed at:

<http://healthmap.org/r/1wZE>.]

[see also:

Leishmaniasis - UK ex Afghanistan: military: 20120108.1003634

2010

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Leishmaniasis, human - Spain: 20100612.1969

2009

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Leishmaniasis - UK: imported 20091125.4049

2004

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Leishmaniasis, dog reservoir - Spain 20040524.1388

2003

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Leishmaniasis - Iraq, Kuwait, Afghanistan: military 20031024.2669

2000

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Leishmaniasis - Germany ex Spain 20000725.1236

1999

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Leishmaniasis, visceral & HIV - Europe (SW) 19991106095248

Leishmaniasis, visceral & HIV - Europe (SW) (03) 19991118221651

1997

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Leishmaniasis, canine - Italy (02) 19970411151032]

.................................................sb/ep/msp/dk

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