Leishmaniasis

Leishmaniasis is a parasitic disease of animals and humans caused by over 20 species in the genus Leishmania. Leishmania parasites are transmitted by the bite of infected female phlebotomine sand flies, which acquired the infection by feeding on a reservoir host including humans. Leishmaniasis is endemic in many tropical, subtropical, and temperate regions around the world. The disease may be asymptomatic or may display a spectrum of symptoms with incubation periods ranging from as short as one to two weeks to more than a year. The three main forms of leishmaniasis are:

  • Cutaneous leishmaniasis (CL), the most common form, which causes open lesions on the skin and may result in permanent scarring;
  • Visceral leishmaniasis (VL), also known as kala-azar, which is a systemic form affecting the liver, spleen, and bone marrow and is usually fatal if not treated; and
  • Mucocutaneous leishmaniasis, also known as espundia, which results in ulceration and destruction of the mucous membranes of the nose, mouth and throat

Epidemiology

Information on the frequency and distribution of leishmaniasis throughout the world can be found in the following resources:

Further information can be found on the Centers for Disease Control and Prevention (CDC) Web page, Leishmaniasis Resources for Health Professionals and the World Health Organization (WHO) Leishmaniasis Fact Sheet.

Military Perspective

Leishmaniasis is a health concern for members of the military. Due to the potential severity of the disease, personnel deploying to areas of the world where leishmaniasis occurs should be informed of the possibility of infection and the need to take precautions to reduce the risk of exposure and should receive appropriate personal protective equipment. During the redeployment process, personnel should be provided information on how to access health care if they develop skin lesions or become ill. Although most deployment-related diseases occur while troops are still in the theater of operations, leishmaniasis may not cause symptoms until after they return home. Therefore, service members should always inform their providers if they have deployed and the location.

The Leishmaniasis Annual Vector-Borne Report, 2005-2014, prepared by the Armed Forces Health Surveillance Branch (AFHSB), provides information on the number of cases of leishmaniasis in U.S. military by service for the active and reserve components, and other beneficiaries.

The following articles describe the effect of leishmaniasis on the U.S. military:

  • Gulf War and Health: Volume 5. Infectious Diseases (2007)
    • Report produced by the National Academy of Medicine of the National Academies of Science, Engineering, and Medicine (formerly the Institute of Medicine of the National Academy of Sciences) which details infectious diseases, including leishmaniasis, in U.S. troops who served in the Gulf War and Operations Enduring Freedom and Iraqi Freedom.
    • Based on this report, the Department of Veterans Affairs (VA) established a presumption of service connection for nine infectious diseases, including visceral leishmaniasis, related to military service in the Southwest Asia theater of operations and Afghanistan that appeared either during a qualifying period of active service or prior to December 31, 2016. Further information can be found on the VA Compensation Gulf War web page