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<br><div><div class="ecxgmail_quote">From: <b class="ecxgmail_sendername">ProMED-mail</b> <span dir="ltr"><<a href="mailto:promed@promed.isid.harvard.edu">promed@promed.isid.harvard.edu</a>></span><br>
Date: 2012/1/13<br>Subject: PRO/AH/EDR> Leishmaniasis - Europe: imported<br>To: <a href="mailto:promed-ahead-edr@promedmail.org">promed-ahead-edr@promedmail.org</a><br><br><br>LEISHMANIASIS - EUROPE: IMPORTED<br>
********************************<br>
A ProMED-mail post<br>
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ProMED-mail is a program of the<br>
International Society for Infectious Diseases<br>
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<br>
Date: Thu 12 Jan 2012<br>
Source: TropNet [edited]<br>
<<a href="http://www.tropnet.net/index.php?id=103" target="_blank">http://www.tropnet.net/index.php?id=103</a>><br>
<br>
<br>
Imported cases of leishmaniasis have become more frequent in Europe<br>
over the past years due to increased travel to risk areas.<br>
Standardized species identification and treatment protocols are<br>
warranted to provide patients with the best possible treatment.<br>
<br>
The broad availability of PCR allows a rapid determination of species.<br>
Each species has a different sensibility to the different<br>
anti-leishmanial drugs. Therefore, a species-specific treatment<br>
approach has been evaluated for many species and has been widely<br>
applied in many centres recently.<br>
<br>
As the leishmania species influences the outcome of systemic<br>
treatment, parasite species identification is of high clinical<br>
relevance. In particular, in the setting of travel clinics, where the<br>
origin of an infection often cannot be assigned to a specific<br>
location, more sophisticated species identification than just a<br>
geographical one is required.<br>
<br>
Currently, treatment recommendations are usually based on data from<br>
endemic regions, but travelers could have different treatment<br>
responses to anti-leishmanial drugs than the endemic population with<br>
repeated contact to leishmania parasites. Moreover, more treatment<br>
options are available to western travelers as compared to endemic<br>
settings, where high cost and inadequate logistics can be a major<br>
problem. Therefore, data on the efficacy of specific treatment<br>
approaches in travellers are needed.<br>
<br>
Little is known on the frequency and treatment of cutaneous and<br>
mucosal leishmaniasis in Switzerland and Europe. Lack of efficacy to<br>
one or the other drug may arise. Therefore, an international<br>
surveillance is necessary to monitor the efficacy of a<br>
species-specific treatment. Since the number of patients in<br>
Switzerland of each species of cutaneous leishmaniasis is too small,<br>
an international surveillance system is necessary.<br>
<br>
Project Goal:<br>
Improving treatment of leishmaniasis based on clinical presentation<br>
and molecular species differentiation<br>
<br>
Objectives:<br>
1. Exchange between specialist and harmonisation of treatment<br>
recommendations in Europe<br>
2. Surveillance of treatment of cutaneous and mucosal leishmaniasis in<br>
Europe<br>
<br>
The consortium so far consists of 17 participants from 12 institutions<br>
from 7 European countries (UK: 3 partner institutions; France: 3<br>
partner institutions; Belgium: one partner institution; Germany: 2<br>
partner institutions; Netherlands: one partner institution;<br>
Switzerland: one partner institution; Spain: one partner<br>
institution).<br>
<br>
--<br>
Communicated by:<br>
ProMED-mail <<a href="mailto:promed@promedmail.org">promed@promedmail.org</a>><br>
<br>
[Leishmania is endemic in southern Europe. A recent study from Spain<br>
found that 2028 patients were diagnosed in the 12-year period from<br>
1997 to 2008, of which 1/3rd were co-infected with human<br>
immunodeficiency virus. (Gil-Prieto R et al. Epidemiology of<br>
leishmaniasis in Spain based on hospitalization records (1997-2008).<br>
Am J Trop Med Hyg. 2011;85:820-5).<br>
<br>
In the southern Mediterranean region, the disease is most frequent in<br>
children, whereas in Europe, and particularly in France, it is mostly<br>
an opportunistic infection associated with immunosuppression (Marty P<br>
et al. Mediterranean visceral leishmaniasis. Bull Acad Natl Med.<br>
(Paris) 2011;195:181-8).<br>
<br>
In most countries, neither visceral nor cutaneous leishmaniasis is a<br>
notifiable disease, and, therefore, data on the number of imported<br>
cases are lacking. The TropNet project will provide new data and help<br>
to determine whether leishmaniasis should be made a notifiable disease<br>
in Europe. - Mod.EP<br>
<br>
A HealthMap/ProMED-mail map can be accessed at:<br>
<<a href="http://healthmap.org/r/1wZE" target="_blank">http://healthmap.org/r/1wZE</a>>.]<br>
<br>
[see also:<br>
Leishmaniasis - UK ex Afghanistan: military: 20120108.1003634<br>
2010<br>
----<br>
Leishmaniasis, human - Spain: 20100612.1969<br>
2009<br>
----<br>
Leishmaniasis - UK: imported 20091125.4049<br>
2004<br>
----<br>
Leishmaniasis, dog reservoir - Spain 20040524.1388<br>
2003<br>
----<br>
Leishmaniasis - Iraq, Kuwait, Afghanistan: military 20031024.2669<br>
2000<br>
----<br>
Leishmaniasis - Germany ex Spain 20000725.1236<br>
1999<br>
----<br>
Leishmaniasis, visceral & HIV - Europe (SW) 19991106095248<br>
Leishmaniasis, visceral & HIV - Europe (SW) (03) 19991118221651<br>
1997<br>
----<br>
Leishmaniasis, canine - Italy (02) 19970411151032]<br>
.................................................sb/ep/msp/dk<br>
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