[Leish-l] [Possivel Spam] Fwd: Fw: PRO/AH/EDR> Leishmaniasis - USA: new guidelines, IDSA

[spider at icbusp.org]

Dear all: I suggest the authors specify (in the title) what  
leishmaniasis it is: kalazar or tegumentary leishmaniasis. Sincerely,  
L Marcelo


Citando Jeffrey Shaw <jayusp at gmail.com>:

> ------------------------------
> *Subject:* Fwd: PRO/AH/EDR> Leishmaniasis - USA: new guidelines, IDSA
>  ubject: PRO/AH/EDR> Leishmaniasis - USA: new guidelines, IDSA
> To: promed-post at promedmail.org, promed-edr-post at promedmail.org,
> promed-ahead-post at promedmail.org
>
>
> LEISHMANIASIS - USA: NEW GUIDELINES, INFECTIOUS DISEASES SOCIETY OF
> AMERICA
> ***************************************************************************
> A ProMED-mail post
> <http://www.promedmail.org>
> ProMED-mail is a program of the
> International Society for Infectious Diseases
> <http://www.isid.org>
>
> Date: Tue 15 Nov 2016
> Source: Infectious Diseases Society of America (IDSA) press release
> [edited]
> <http://www.idsociety.org/Press_Release_11_15_2016/>
>
>
> Driven by burgeoning ecotourism and military campaigns in Iraq and
> Afghanistan, a parasitic infection called leishmaniasis is showing up
> in more US patients, often stumping doctors. Rapid diagnostic tests
> and innovative treatments are among the strategies to address
> leishmaniasis highlighted in new guidelines released by the Infectious
> Diseases Society of America (IDSA) and the American Society of
> Tropical Medicine and Hygiene (ASTMH) and published in the journal
> Clinical Infectious Diseases [see reference below].
>
> The bite of the nearly invisible sand fly ­- 1/3 the size of a
> mosquito -­ transmits the leishmania parasite. The parasite is found
> in more than 90 countries around the world ­- including Mexico and
> those in Central and South America, Asia, Africa, the Middle East, and
> southern Europe.
>
> The infection rarely occurs in the United States, although a few cases
> have been reported to have been acquired in Texas and Oklahoma. The
> growth of travelers, soldiers, and immigrants with leishmaniasis being
> seen by US doctors and the complicated diagnosis and management of the
> disease drove the creation of these guidelines, the 1st in the United
> States.
>
> "Leishmaniasis is an increasingly common infection in ecotourists
> traveling to Central and South America. Travelers visiting the jungle
> in the Amazon basin have a high likelihood of being exposed," said
> Naomi E Aronson, MD, lead author of the guidelines. "The cutaneous and
> mucosal forms of the infection cause serious scarring and visceral
> leishmaniasis can be deadly, so timely diagnosis and treatment managed
> by an infectious diseases physician is vital. Because it's still
> relatively uncommon in the United States, many doctors are unfamiliar
> with leishmaniasis and don't suspect it when diagnosing patients.
>
> The sore at the site of an infected sand fly bite often is painless
> and symptoms of the infection may not show up for a month or longer,
> further complicating the diagnosis. More than 20 types of leishmania
> parasites cause human infection.
>
> The 3 main clinical syndromes, often determined by the specific
> parasite, are:
> - cutaneous leishmaniasis (CL): CL causes skin sores, such as bumps or
> lumps that may turn into ulcers with a central crater or scab over.
> This is the commonest type of leishmaniasis, with an estimated 700 000
> to 1.2 million cases worldwide every year, according to the Centers
> for Disease Control and Prevention (CDC).
> - mucosal leishmaniasis (ML): CL can metastasize, or spread, to mucous
> membranes, especially the mouth and nose, resulting in ML. ML most
> often occurs when the patient is infected by leishmania parasites from
> Central or South America. Untreated, ML can cause serious scarring and
> deformity.
> - visceral leishmaniasis (VL): the most serious form, active VL is a
> systemic infection that is almost always fatal if not treated.
> Symptoms include weeks to months of high fevers, significant weight
> loss, an enlarged spleen and low blood counts. CDC estimates there are
> 200 000 to 400 000 new cases of VL a year.
>
> When doctors see infections with these symptoms, they should ask if
> the patient has traveled outside of North America, Dr Aronson notes.
>
> CL can be tested by polymerase chain reaction (PCR) or by doing a
> culture to identify the type of leishmania and determine how
> aggressively it should be treated. A blood test called rK39 provides a
> rapid result if VL is suspected, which would be confirmed with PCR or
> culture.
>
> Oral miltefosine was approved by the Food and Drug Administration
> (FDA) in 2014 for specific cases of cutaneous, mucosal, and visceral
> leishmaniasis. "It may become a game-changer for treating
> leishmaniasis as it is a pill that can be used for all 3 leishmaniasis
> syndromes, depending on the parasite species responsible for the
> infection," said Dr Aronson.
>
> In addition, the ThermoMed(TM) [heat therapy] device can be used to
> heat treat CL. FDA-approved liposomal amphotericin B is given
> intravenously (IV) for VL. While more than 80 per cent effective,
> these therapies don't always eradicate the parasite, and sometimes
> additional treatment is necessary.
>
> Despite the name, the fly that transmits the parasite also lives in
> rotting vegetation in jungle areas. The sand fly most often bites
> exposed skin at night, transmitting the parasite. While there are no
> vaccines or preventive medications for leishmaniasis, people traveling
> to areas where the parasite exists should use protective measures to
> avoid infection. That includes wearing protective clothing (long
> sleeves and pants), applying insect repellents containing DEET, and
> using insecticide-impregnated bed nets.
>
> [Reference
> Aronson N, Herwaldt BL, Libman M, et al. Diagnosis and treatment of
> leishmaniasis: clinical practice guidelines by the Infectious Diseases
> Society of America (IDSA) and the American Society of Tropical
> Medicine and Hygiene (ASTMH). Clin Infect Dis. 2016; doi:
> 10.1093/cid/ciw670. First published online 14 Nov 2016; available at
> <http://cid.oxfordjournals.org/content/early/2016/11/03/cid.ciw670.full>]
>
> --
> communicated by:
> ProMED-mail
> <promed at promedmail.org>
>
> [ProMED-mail posts extensively on leishmaniasis worldwide (see
> postings in 2016 listed below). It is also important to inform
> physicians that immunocompromised patients, for instance those
> receiving TNF-inhibitors or being HIV positive, do often not respond
> to standard treatment.
>
> A country specific recent review of leishmaniasis was published by J
> Alvar and colleagues in 2012 (Alvar J, Vélez ID, Bern C, et al. WHO
> Leishmaniasis Control Team: Leishmaniasis worldwide and global
> estimates of its incidence. PLoS One. 2012; 7(5): e35671. doi:
> 10.1371/journal.pone.0035671;
> <http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0035671>).
> - Mod.EP
>
> A HealthMap/ProMED-mail map can be accessed at:
> <http://healthmap.org/promed/p/106>.]
>
> [See Also:
> Leishmaniasis - Brazil (02): new sandfly vect susp, Psathyromyia
> elizabethdorvalae http://promedmail.org/post/20161101.4600154
> Leishmaniasis, visceral - Brazil: (MG) children
> http://promedmail.org/post/20161029.4593491
> Leishmaniasis, visceral - Nepal: (MO)
> http://promedmail.org/post/20161002.4531103
> Leishmaniasis, visceral - South Sudan: (UN)
> http://promedmail.org/post/20160910.4479134
> Leishmaniasis, cutaneous - Syria (03): (HL)
> http://promedmail.org/post/20160821.4430681
> Leishmaniasis, cutaneous - Pakistan (05): (TA)
> http://promedmail.org/post/20160717.4350532
> Leishmaniasis, cutaneous - Syria (02)
> http://promedmail.org/post/20160630.4319680
> Leishmaniasis, cutaneous - Syria: refugees
> http://promedmail.org/post/20160529.4252805
> Leishmaniasis, cutaneous - Palestinian Auth: (WE)
> http://promedmail.org/post/20160528.4250881
> Leishmaniasis, cutaneous - Pakistan (04): (NW) EpiCore responses
> http://promedmail.org/post/20160521.4236192
> Leishmaniasis, cutaneous - Pakistan (03): (NW)
> http://promedmail.org/post/20160518.4230112
> Leishmaniasis, cutaneous - Colombia: (NS) alert
> http://promedmail.org/post/20160429.4192208
> Leishmaniasis, cutaneous - Pakistan: (02): (NW)
> http://promedmail.org/post/20160418.4167556
> Leishmaniasis, cutaneous - Iraq: (DA) Yazidi refugees
> http://promedmail.org/post/20160415.4161067
> Leishmaniasis, cutaneous - Libya: (TR)
> http://promedmail.org/post/20160414.4160311
> Leishmaniasis - Colombia: (TO) RFI
> http://promedmail.org/post/20160403.4136205
> Leishmaniasis, canine - France
> http://promedmail.org/post/20160220.4033101
> Leishmaniasis, cutaneous - Pakistan: (TA)
> http://promedmail.org/post/20160217.4027519
> Leishmaniasis - Albania, Jordan, Pakistan: surveillance 2015
> http://promedmail.org/post/20160210.4009452
> Leishmaniasis - Uruguay: (SA) canine, alert
> http://promedmail.org/post/20160122.3952222]
> .................................................sb/ep/mj/sh
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