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<br><br><div><div id="SkyDrivePlaceholder"></div><div class="ecxgmail_quote">---------- Forwarded message ----------<br>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: 2012/12/26<br>Subject: PRO/EDR> Leishmaniasis, tuberculosis - Syria<br>To: <a href="mailto:promed-edr@promedmail.org">promed-edr@promedmail.org</a><br><br><br>LEISHMANIASIS, TUBERCULOSIS - SYRIA<br>
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A ProMED-mail post<br>
<<a href="http://www.promedmail.org" target="_blank">http://www.promedmail.org</a>><br>
ProMED-mail is a program of the<br>
International Society for Infectious Diseases<br>
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<br>
Date: Tue 25 Dec 2012<br>
SOURCE: Washington Post [edited]<br>
<<a href="http://www.washingtonpost.com/world/middle_east/as-fighting-rages-in-aleppo-syrians-face-hunger-disease-and-little-hope-of-aid/2012/12/25/86ab74f0-4d37-11e2-835b-02f92c0daa43_story.html?wpisrc=nl_headlines" target="_blank">http://www.washingtonpost.com/world/middle_east/as-fighting-rages-in-aleppo-syrians-face-hunger-disease-and-little-hope-of-aid/2012/12/25/86ab74f0-4d37-11e2-835b-02f92c0daa43_story.html?wpisrc=nl_headlines</a>><br>
<br>
<br>
Leishmaniasis and tuberculosis increasing in Syria<br>
--------------------------------------------------<br>
Inevitably, disease is spreading among people whose immune systems<br>
have been weakened by hunger, in a city [Aleppo] where sanitation has<br>
broken down. Tuberculosis is ravaging some neighborhoods, and there<br>
have been hundreds of cases of leishmaniasis, a skin disease<br>
transmitted by sand flies, which are multiplying amid the heaps of<br>
uncollected trash, said Saad Wafai, who serves on the crisis committee<br>
of the Aleppo council.<br>
<br>
At a small clinic in an abandoned shopping arcade -- set up by doctors<br>
driven out of a hospital destroyed in an air strike -- the number of<br>
patients has surged recently, to about 150 a day. For the 1st time,<br>
physician Izzat al-Mizyad said, most show up not with injuries from<br>
the war but infectious diseases, including hepatitis, respiratory<br>
infections and scabies.<br>
<br>
--<br>
Communicated by:<br>
ProMED-mail<br>
<<a href="mailto:promed@promedmail.org">promed@promedmail.org</a>><br>
<br>
[Leishmaniasis is transmitted by sand flies (_Phlebotomus_ spp.) and<br>
the incubation period can be weeks to months. Cutaneous leishmaniasis<br>
is caused by _Leishmania tropica_ and 30 000 cases were reported in<br>
2008 (Alvar J et al. and the WHO Leishmaniasis Control Team.<br>
Leishmaniasis Worldwide and Global Estimates of Its Incidence. PLoS<br>
One. 2012; 7(5): e35671). Visceral leishmaniasis is rare but is found<br>
from Aleoppo and towards the Turkish border. The reservoir for<br>
_L.tropica_ is small rodents and for _L.infantium_ it is dogs.<br>
<br>
It is no surprise that the incidence is increasing. Rodent and vector<br>
control activities most probably no longer exist and leishmania<br>
infected dogs are not captured and killed.<br>
<br>
It it no surprise either that tuberculosis in on the increase. Syria<br>
was in 2009 estimated to have 26 (range 22-31) new cases of<br>
tuberculosis per 100 000 population (WHO World Tuberculosis Report<br>
2012;<br>
<<a href="http://www.who.int/tb/publications/global_report/gtbr12_annex4.pdf" target="_blank">http://www.who.int/tb/publications/global_report/gtbr12_annex4.pdf</a>>).<br>
- Mod.EP]<br>
<br>
[[Cutaneous lesions on a leg:<br>
<a href="http://www.leishrisk.net/Leishrisk/UserFiles/Image/cutaneous%20lesion%201%281%29.jpg" target="_blank">http://www.leishrisk.net/Leishrisk/UserFiles/Image/cutaneous%20lesion%201(1).jpg</a><br>
on a dog's ear:<br>
<a href="http://www.vetnext.com/fotos/Lm1.jpg" target="_blank">http://www.vetnext.com/fotos/Lm1.jpg</a><br>
Sandfly biting finger<br>
<<a href="http://upload.wikimedia.org/wikipedia/en/thumb/b/bf/Biting_sandfly.jpg/220px-Biting_sandfly.jpg" target="_blank">http://upload.wikimedia.org/wikipedia/en/thumb/b/bf/Biting_sandfly.jpg/220px-Biting_sandfly.jpg</a>><br>
Life cycle:<br>
<a href="http://www.uni-tuebingen.de/modeling/images/leishmania_cycle.jpg" target="_blank">http://www.uni-tuebingen.de/modeling/images/leishmania_cycle.jpg</a><br>
- Mod.JW]<br>
<br>
A HealthMap/ProMED-mail map can be accessed at:<br>
<<a href="http://healthmap.org/r/3aLZ" target="_blank">http://healthmap.org/r/3aLZ</a>>.]<br>
<br>
.................................................ep/ejp/jw<br>
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