Phlebotomine sandflies and leishmaniasis in British Honduras (Belize)

Sugar feeding in triatomines: a new perspective for controlling the transmission of Chagas disease

Introduction: Triatomines are vectors of Trypanosoma cruzi, the etiological agent of Chagas disease. Currently, there is no vaccine against this disease. Thus, control of the insect vector population is the main strategy available to reduce the number of cases. Triatomines are considered obligate hematophagous, but different alternative feeding behaviors were described, such as haemolymphagy or plant feeding. Methods: To determine the preference for sugar feeding in nymphs and adults of Rhodnius prolixus, the insects were exposed a piece of cotton containing bromophenol blue plus sucrose. In addition, we offered several sugars for different species of triatomines, and tested sugar meals as a route of delivery of insecticides in first-instar nymphs of R. prolixus. The effect of sugar feeding on the physiology of these different species of triatomines was recorded. Results: First instar nymphs ingested sucrose more strongly than other stages, and showed high mortality rates. In different species of triatomines, sucrose induced an ingestion, but engorgement varied according to the species. R. prolixus nymphs showed an indiscriminate intake of various sugars, with very different physiological effects. Furthermore, ingesting different combinations of insecticides + sugar significantly reduced insect survival. Discussion: In summary, we described for the first-time sugar feeding as a widespread behavior in several species of triatomines, and the possibility of the use of toxic sugar baits for the control of these vectors. The knowledge of feeding behavior in these insects can be fundamental for the development of new strategies to control Chagas disease.

Revisiting the cave-dwelling sand flies (Diptera, Psychodidae, Phlebotominae) from Brazil: Diversity and potential role in the transmission of Leishmania Ross, 1903 (Kinetoplastida: Trypanosomatidae)

Brazilian caves, one of the many tourist attractions of the country, may act as a shelter for insects, such as sand flies (Diptera: Psychodidae), natural hosts of various microorganisms including parasites of the genus Leishmania Ross, 1903. In the last decades, with the increasing global need for sustainable development, ecotourism has emerged as one of the major activities in Brazil. However, the constant monitoring in environmentally protected areas is not often carried out, endangering visitors and professionals, especially due to the occurrence of zoonoses. Several sand fly species have already been recorded in Brazilian caves, drawing attention to the possibility of Leishmania transmission at this ecotope. Indeed, this current systematic review summarizes the fauna of cave-dwelling sand flies in Brazil, focusing on their biological behaviour and the occurrence of potential vectors of Leishmania parasites.

Effect of land use change on the phlebotomine sand fly assemblages in an emergent focus of cutaneous leishmaniasis in Yucatan, Mexico

As land use intensifies in tropical forests, it is expected that species assemblages will be modified and that key functions of these ecosystems will be affected. The latter scenario is important from a public health perspective, because the land use change has been linked the outbreaks of vector-borne diseases. In this study, we evaluated the response of Phlebotominae (Diptera: Psychodidae) assemblages and their pattern of co-occurrence in four sites with different land use in an emerging cutaneous leishmaniasis focus in Yucatan, Mexico. Our hypothesis is that the conservation status (as forest cover) will positively influence the structure and composition of sand flies' assemblages. Using three different traps over a period of five months, a sampling effort of 1, 440 night-traps was performed. A total of 7, 897 sand fly specimens belonging to six genera and 10 species were collected. Our hypothesis was partially achieved since sand fly diversity increased as forest cover increased and vice versa, however random patterns of co-occurrence in assemblages were detected among sites. Even though the high abundance of sand flies in the forest fragment suggests an amplification effect, our results show that different vector species directly dominate in each site. We discuss the potential implications of the nestedness of species dominance. We suggest that in this emerging focus and under the land use gradient, Lutzomyia cruciata and Psathyromyia cratifer could play a pivotal role in maintaining the transmission cycles of Leishmania. The apparent generalist or colonialist profile of Lu. cruciata in disturbed areas deserves attention, due to the potential risk of leishmaniasis "domiciliation". This information is essential to understand the eco-epidemiology of leishmaniasis and the factors associated with its emergence in Yucatan, Mexico.

Phlebotomine sand flies (Diptera: Psychodidae) from an emergent focus of localized cutaneous leishmaniasis in Yucatan, Southeast Mexico

Localized cutaneous leishmaniasis (LCL) is endemic in the Yucatan Peninsula, with historical and contemporary records mainly in the states of Campeche and Quintana Roo. Recently, we reported autochthonous LCL cases and 27.6% of asymptomatic infection in the municipality of Tinum, Yucatan, where no studies of Phlebotominae (Diptera: Psychodidae) sand flies have been carried out. In this work, from November, 2019 to February, 2020, we conducted a field study in three areas of Tinum to document, for the first time, the species of Phlebotominae in areas with records of human leishmaniasis transmission. In order of abundance, the species identified were Pifanomyia serrana, Psathyromyia shannoni, Psathyromyia cratifer, Lutzomyia cruciata, Bichromomyia olmeca olmeca, and Dampfomyia deleoni. Most of the sand flies were captured in a Shannon trap where 77.8% of collected specimens were females. The distribution of sand fly species showed some degree of heterogeneity among sites, and the highest species richness was registered in a site located in Xcalakoop. We also discuss the medical importance of Lu. cruciata, Ps. shannoni, and Pi. serrana as potential vectors of causal agents of LCL in this area.

A review on the occurrence of companion vector-borne diseases in pet animals in Latin America

Companion vector-borne diseases (CVBDs) are an important threat for pet life, but may also have an impact on human health, due to their often zoonotic character. The importance and awareness of CVBDs continuously increased during the last years. However, information on their occurrence is often limited in several parts of the world, which are often especially affected. Latin America (LATAM), a region with large biodiversity, is one of these regions, where information on CVBDs for pet owners, veterinarians, medical doctors and health workers is often obsolete, limited or non-existent. In the present review, a comprehensive literature search for CVBDs in companion animals (dogs and cats) was performed for several countries in Central America (Belize, Caribbean Islands, Costa Rica, Cuba, Dominican Republic, El Salvador, Guatemala, Honduras, Mexico, Nicaragua, Panama, Puerto Rico) as well as in South America (Argentina, Bolivia, Brazil, Chile, Colombia, Ecuador, French Guiana, Guyana (British Guyana), Paraguay, Peru, Suriname, Uruguay, Venezuela) regarding the occurrence of the following parasitic and bacterial diseases: babesiosis, heartworm disease, subcutaneous dirofilariosis, hepatozoonosis, leishmaniosis, trypanosomosis, anaplasmosis, bartonellosis, borreliosis, ehrlichiosis, mycoplasmosis and rickettsiosis. An overview on the specific diseases, followed by a short summary on their occurrence per country is given. Additionally, a tabular listing on positive or non-reported occurrence is presented. None of the countries is completely free from CVBDs. The data presented in the review confirm a wide distribution of the CVBDs in focus in LATAM. This wide occurrence and the fact that most of the CVBDs can have a quite severe clinical outcome and their diagnostic as well as therapeutic options in the region are often difficult to access and to afford, demands a strong call for the prevention of pathogen transmission by the use of ectoparasiticidal and anti-feeding products as well as by performing behavioural changes.

Workshop no. 11. Ecology of Leishmania

The ecology of Leishmania of man is concerned with the circulation of the parasite in nature from one mammal to another by the bite of phlebotomine sandflies. The natural vertebrate hosts are anthropocentrieally referred to as reservoir hosts although in sorac foci of human leishmaniasis (anthroponotic cutaneous leishmaniasis and Indian kala-azar) man himself is thought to be the reservoir.

The role of Palmyra palm trees (Borassus flabellifer) and sand fly distribution in northeastern India

Visceral leishmaniasis (VL), known as Kala-azar in India, is a parasite transmitted by the bite of the sand fly vector Phlebotomus argentipes. Published information on the species indicates it is a poor flyer, mainly hopping and gliding. This study describes the vector as more arboreal than previously documented. Data collected indicate the ability of P. argentipes and Sergentomyia spp to attain vertical heights in Palmyra palm trees Borassus flabellifer up to 18.4 m above ground level. To determine if sand flies were either climbing the tree trunk to rest in the canopy or flying, sticky traps were set around the tree trunk and checked for captures overnight. CDC traps set in the palm tree canopy resulted in the capture of 5,067 sand flies, 3,990 of which were P. argentipes. Traps were set during daylight hours to determine if sand flies remained and rested in the canopy. A total of 128 sand flies were trapped over 29 trap days in the palm trees. With the CDC traps, 130 P. argentipes and no Sergentomyia spp were captured. The converse was true for the sticky traps set around tree trunks 3 m below the CDC traps. Of the 105 sand flies collected, only one was P. argentipes and 104 were Sergentomyia spp. As reported elsewhere, this indicates Sergentomyia spp tend to climb and hop, wheareas P. argentipes are capable of longer and more sustained flight. Data presented herein suggest that P. argentipes is more exophylic and exophagic than previously reported. These findings have implications for sand fly control.

Investigation of habitat effects on the spatial distribution of Lutzomyia shannoni across heterogeneous environments, with note of respective mosquito species compositions

Sand flies are small blood feeding dipterans that are primary vectors of numerous human and livestock pathogens. Control efforts are often complex and multidimensional. A fundamental step in the development and implementation of any integrated pest management (IPM) program is the refining of effective surveillance and identification techniques. Before this study, the presence of two species, Lutzomyia shannoni (Dyar) and Lutzomyia vexator (Coquillett) became known in Kentucky and surrounding states. To understand the spatial distribution of these species across heterogeneous landscapes in this region, trapping was conducted at random locations in previously designated habitats. Although a lack of clear data prevented any conclusions to be drawn for the preferences of L. vexator, the species of greater medical and veterinary importance, L. shannoni, was documented to show a strong preference for habitats along the wooded edges of pasture lands. In the region of study, these lands are frequently used in the production of beef cattle and other livestock, reinforcing the veterinary significance of the findings. Because of their familiarity to vector control officials and operators, mosquito species compositions were compared with the recorded abundance of L. shannoni across the varied habitats. The linking of this information should prove useful to management plans for the phlebotomine, if warranted in the future.

Current knowledge of Leishmania vectors in Mexico: how geographic distributions of species relate to transmission areas

Leishmaniases are a group of vector-borne diseases with different clinical manifestations caused by parasites transmitted by sand fly vectors. In Mexico, the sand fly Lutzomyia olmeca olmeca is the only vector proven to transmit the parasite Leishmania mexicana to humans, which causes leishmaniasis. Other vector species with potential medical importance have been obtained, but their geographic distributions and relation to transmission areas have never been assessed. We modeled the ecological niches of nine sand fly species and projected niches to estimate potential distributions by using known occurrences, environmental coverages, and the algorithms GARP and Maxent. All vector species were distributed in areas with known recurrent transmission, except for Lu. diabolica, which appeared to be related only to areas of occasional transmission in northern Mexico. The distribution of Lu. o. olmeca does not overlap with all reported cutaneous leishmaniasis cases, suggesting that Lu. cruciata and Lu. shannoni are likely also involved as primary vectors in those areas. Our study provides useful information of potential risk areas of leishmaniasis transmission in Mexico.

The biology and control of leishmaniasis vectors

Vector control remains a key component of many anti-leishmaniasis programs and probably will remain so until an effective vaccine becomes available. Technologies similar to those used for control of adult mosquitoes, specifically interior residual sprays and insecticide-treated nets, are currently at the forefront as disease control measures. This article provides a review of literature on the biology and control of sand fly vectors of leishmaniasis in the context of changing disease risks and the realities of modern vector control. The Literature Retrieval System of the Armed Forces Pest Management Board, Washington, DC, was the primary search engine used to review the literature.

Incrimination of four sandfly species previously unrecognized as vectors of Leishmania parasites in Mexico

Cutaneous leishmaniasis (CL) is endemic to the Yucatan Peninsula of Mexico. The main causative agent is the parasite Leishmania mexicana (Biagi) (Kinetoplastida: Trypanosomatidae) and, based on the classic work of Dr Biagi's research team, it has been generally accepted and frequently reported that the only vector of L. mexicana in the region is the sandfly Lutzomyia olmeca olmeca (Vargas & Diáz-Nájera) (Diptera: Psychodidae). Evidence gathered from recent entomological studies conducted mainly in Calakmul, Campeche, however, suggests that other species may also be vectors of L. mexicana. We conducted a field study in two villages in Calakmul, Campeche in the Yucatan Peninsula, where recent cases of CL have been reported, to document the species composition and relative abundances of the sandfly fauna and to identify which species are likely to be the main vectors by assessing the biting rates and parasite infection rates of the suspected vector species. Sandfly catches were conducted from November 2005 to February 2006 in Unión 20 de Junio and Dos Lagunas Sur. Sandflies were captured using Shannon (18.00-22.00 hours), Disney and CDC light traps (18.00-06.00 hours). Biting and infection rates were calculated for the four most abundant species: Lutzomyia cruciata (Coquillett), Lu. o. olmeca, Lutzomyia panamensis (Shannon) and Lutzomyia shannoni (Dyar). In Dos Lagunas Sur, Lu. panamensis and Lu. o. olmeca exhibited the highest biting rates throughout the sampling period. In Unión 20 de Junio, Lu. cruciata and Lu. o. olmeca had the highest biting rates over the same period. Regarding infection rates, we report herein the establishment of a polymerase chain reaction protocol and validation of IR1 and LM17 oligonucleotides to analyse the infection rates of sandflies. Out of 769 females analysed, the overall infection rates were 1.4% in Dos Lagunas Sur and 5.3% in Unión 20 de Junio. In Dos Lagunas Sur we found L. mexicana infections in two sandfly species, Lu. shannoni and Lutzomyia ylephiletor (Fairchild & Hertig), whereas in Unión 20 de Junio we found infections in Lu. shannoni, Lu. cruciata, Lu. o. olmeca and Lu. panamensis. The possible role of these four sandfly species in relation to L. mexicana transmission in Calakmul is discussed.

Sandfly stratification on tree buttresses in a Costa Rican tropical rainforest

In humid forests tree buttresses and tree trunks are used as diurnal resting sites by phlebotomine sandflies (Diptera: Psychodidae). When several species are present on the same buttress, the sandfly species are spatially segregated resulting in a pattern of vertical stratification on the buttress within 100 cm of ground level. A change in the distribution of one species induces a change in the distribution of an adjacent species. This is demonstrated under both natural and experimental conditions. Observations of sandflies at dawn and dusk have revealed that the buttress is used as a swarming site; this behaviour provides our favoured explanation for the patterns of vertical stratification on tree buttresses.

Relative abundances of sandfly species (Diptera: Phlebotominae) in two villages in the same area of Campeche, in southern Mexico

Leishmania mexicana is the parasite causing most cases of human cutaneous leishmaniasis in southern Mexico, where Lutzomyia olmeca olmeca and Lu. cruciata are the most probable vectors. In the present study, sandflies were collected during one transmission season (November 2001-March 2002) in the village of La Guadalupe and the nearby village of Dos Naciones, in the southern Mexican county of Calakmul. Using Shannon traps, Disney traps and CDC light traps, 5983 sandflies (Brumptomyia and Lutzomyia) were caught. In Dos Naciones the numbers of Lu. panamensis caught in Shannon or CDC traps outnumbered those of the other sandfly species. In La Guadalupe, in contrast, the most abundant species in the collections made with Shannon or CDC traps was Lu. cruciata , followed by Lu. olmeca olmeca and Lu. deleoni. In both locations, the numbers of sandflies attracted to Shannon traps peaked between 18.00 and 22.00 hours. Given the abundance of Lu. olmeca olmeca in the collections made with Shannon and Disney traps (it was the only species caught in the latter), this species is probably the primary vector of Le. mexicana in Calakmul county.

Estratificação vertical da fauna de flebótomos (Diptera, Psychodidae) numa floresta primária de terra firme da Amazônia Central, Estado do Amazonas, Brasil

Estudos sobre a estratificação vertical da fauna de flebótomos, foram realizados numa floresta primária de terra firme, da Estação Experimental de Silvicultura Tropical - Instituto Nacional de Pesquisas da Amazônia, durante os meses de outubro de 1998 a março de 1999. Utilizando-se armadilhas luminosas CDC, colocadas a 1, 10 e 20 metros de altura do solo, foram coletados 2.859 flebótomos, pertencentes a dois gêneros, Lutzomyia (99,93 %) e Brumtomyia (0,07%), abrangendo 38 espécies. Dentro do gênero Lutzomyia, os sub-gêneros mais representados foram Nyssomyia, com 43,4%, e Psychodopygus com 22,8%. As espécies Lutzomyia umbratilis, L. anduzei, L. rorotaensis, L. trichopyga e L. olmeca nociva, foram dominantes a 1m de altura, enquanto que L. davisi, L. infraspinosa, L. umbratilis, L. trichopyga e L. anduzei, foram dominantes a 10m. As espécies L. anduzei, L. tuberculata, L. dendrophyla e L. dreisbachi foram mais abundantes a 20m. L. umbratilis, presente nos três níveis de estratificação vertical, é dotada de alta importância epidemiológica como vetora da Leishmania (Viannia) guyanensis.

Ecology of phlebotomine sandflies (Diptera, Psychodidae) in Brazilian Atlantic Forest

The phlebotomine sandfly fauna of a primary forest reserve at Morretes (eastern Paraná State) was studied, using CDC-like light traps, one night per month, at canopy and ground level, between April 1995 and March 1996. A total of 3,106 insects were collected, identified as belonging to nine species. Lutzomyia ayrozai and Lu.geniculata were predominant, seven other species also being present. Monthly mean temperature, rainfall and the temperature of the collection night significantly influenced the numbers of Lu. ayrozai while the two first factors influenced the numbers of Lu. geniculata, besides the collected quantities of females of the two species. The influence of the factors on Lu. ayrozai numbers was more immediate than in those of Lu. geniculata. Numbers of both species and of the females of Lu. geniculata collected in different seasons, but not at the different heights, varied significantly. Differences between the behaviour of Lu. ayrozai in Morretes and in other regions could be attributed to environmental differences and/or to regional variations in the species, which could constitute species complexes. Hourly variations of collections were different in the species and seasons.

Ootaxonomic investigation of five Lutzomyia species (Diptera, Psychodidae) from Venezuela

The eggshell fine structure of five sand fly species from Venezuela belonging to the genus Lutzomyia (L. migonei, L. ovallesi, L. absonodonta, L. gomezi and L. panamensis) was examined by scanning electron microscopy. The chorionic sculpturing of L. migonei, L. ovallesi, L. absonodonta and L. gomezi was characterized by series of columns arranged in palisade to form sinuous ridges. In inter-ridge areas, the basal layer was covered with fibrous material. The outer chorion of L. panamensis had a pattern known as "mountain- or volcano-like". The morphology of the posterior pole and aeropyle had a common structure in the five species, with some species-specific characters. The eggshell features of the five species are compared with those of other phlebotomine sand flies.

Association of Lutzomyia columbiana (Diptera: Psychodidae) with a leishmaniasis focus in Colombia due to species of the Leishmania mexicana complex

In Colombia, Leishmania mexicana has a scattered geographical distribution and no sand fly vectors have been associated with its transmission. During the present study, the anthropophilic sand fly Lutzomyia columbiana was found to be the only species collected using diverse methods, in a small focus of Le. mexicana in the municipality of Samaniego, SW Colombia. Ecological data indicate that this sand fly species is present in both peri and intradomestic habitats, where it readily bites man. Further evidence comes from experimental infections of wild-caught Lu. columbiana with Le. mexicana after feeding on infected hamsters. Based on these results, it is suggested that this sand fly is the most likely vector in the study area, suggesting the existence of a previously unknown sand fly-parasite association.

A two years study on vectors of cutaneous Leishmaniasis. Evidence for sylvatic transmission cycle in the state of Campeche, Mexico

Vectors of cutaneous leishmaniasis in the State of Campeche were studied in relation to the transmission cycle of Leishmania (Le.) mexicana. To determine how transmission of leishmaniasis occurs, we collected phlebotomine sand flies for two years. In the first year (October 1990 to November 1991) the collections were made with CDC light traps, Shannon traps and direct captures at natural shelters around the village (< 200 m) of La Libertad. In the second year (February 1993 to January 1994) the catches were performed at 8 km southeast of La Libertad in the forest. Female sand flies were examined for Leishmania. During the first year, 347 sand flies of nine species were collected, most of which were Lutzomyia deleoni (61.3%). When all nine species were considered, more females than males were captured. Low densities of anthropophillic species of sand flies around the village indicated that sylvatic transmission was taking place. For the second year. 1484 sand flies of 16 species were caught. The most common were L. olmeca olmeca (21.7%), L. cruciata (19.2%) and L. ovallesi (14.1%). Similarly, more females were caught than males. Thirty-five females of five species were found infected with flagellates believed to be Leishmania sp. The highest infection rate was found in L. olmeca olmeca (7.1%) followed by L. cruciata (4.5%) and L. ovallesi (1.1%). These data plus other evidence on the epidemiology of human cases and results from reservoir studies are discussed in relation to the sylvatic transmission cycle.

Population dynamics and biting rhythm of the anthropophilic sandfly Lutzomyia cruciata (Diptera: Psychodidae) in Southeast, Mexico

Sandflies attracted by human bait were caught in an endemic focus of localized cutaneous leishmaniasis in the state of Campeche, Mexico. Catches were carried out monthly from February 1994 to January 1995 between 18:00 and 22:00 h. Lutzomyia cruciata was the only species caught. The highest population peak of Lu. cruciata was found in March with lesser peaks in February, December 1994, and January 1995. Maximum biting rate of Lu. cruciata was found between 18:00 and 19:00 h. The host-seeking females of Lu. cruciata were directly related to levels of humidity between 88 and 100%. Low and high temperature had a negative effect upon Lu. cruciata activity. The possible role of Lu. cruciata as vector of leishmaniasis in the state of Campeche, Mexico is discussed.

Vectors of cutaneous leishmaniasis in north-central Venezuela

An entomological survey was undertaken from January 1991 to February 1992 in El Ingenio, Miranda State, Venezuela, an endemic area of cutaneous leishmaniasis: prevalence of 10.7 cases per 100,000 inhabitants. A total of 4863 female sandflies (Phlebotominae) of fourteen species were collected in Shannon traps, then dissected and examined for leishmanial infections. Lutzomyia ovallesi (85.4%) and Lu. gomezi (11.2%) were the predominant anthropophilic species of sandfly. Fifty-one (1.19%) Lu.ovallesi and two (0.47%) Lu.gomezi had natural infection with Leishmania promastigotes. Identification of the parasites was done by using the polymerase chain reaction (PCR) and DNA hybridization. Two isolates from Lu.gomezi and forty-nine from Lu.ovallesi were typed as Leishmania braziliensis and three of the latter reacted with Le.mexicana also. This is the first report of Lu.gomezi with parasites typed as Le.braziliensis. We concluded that Lu.ovallesi is the primary vector of cutaneous leishmaniasis in the north-central area of Venezuela and Lu.gomezi should be regarded as an additional vector.

Niche breadth in parasites: an evolutionarily stable strategy model, with special reference to the protozoan parasite Leishmania

A parasite's host range essentially defines its niche breadth, which, as foraging theory predicts, is influenced by resource availability. For parasites, the interaction of infection and transmission characteristics with host population dynamics determines host availability. An epidemiological model, involving two host types and describing competition between a "generalist" parasite strain and a related "specialist" strain, is used to examine the interplay among host range, relative host availabilities, and adaptational compromises engendered by increased host range. Results show that the generalist can predominate even when it cannot maintain itself in either host alone, but that the specialist can persist if its reproductive rate attains some threshold relative to either of the generalist's respective rates in its two hosts. The model is in rough, qualitative agreement with observed dynamics of two Leishmania parasite-host systems, and overall results suggest that infection of two species with a common parasite can lead to complex, indirect coevolutionary dynamics.

The isolation and isoenzyme characterization of Leishmania braziliensis subsp. from patients with cutaneous leishmaniasis acquired in Belize

Leishmanial organisms were cultivated from cutaneous lesions of British military personnel returning from Belize. Isoenzyme profiles of the freshly isolated organisms and 'marker' strains of New World Leishmania spp. were compared using 10 enzymes (ALAT, ASAT, ME, GPI, MPI, PGM, SOD, 6-PGDH, G-6-PDH and MDH), by starch gel electrophoresis. 19 of the 22 new isolates from Belize were isoenzymically indistinguishable from Leishmania braziliensis braziliensis (10 out of 10 enzymes) and clearly differentiated from L. b. guyanensis and L. b. panamensis (different in 6 out of 10 enzymes) and from L. mexicana mexicana and L. m. amazonensis (9 out of 10 enzymes). Two isolates closely resembled L. m. mexicana and one could not be positively identified. This is the first report of autochthonous human leishmaniasis caused by L. braziliensis group organisms as far north as latitude 16 degrees N.

An outbreak of cutaneous leishmaniasis in Guyana: epidemiology, clinical and laboratory aspects

An outbreak of cutaneous leishmaniasis reached epidemic proportions among military personnel in Guyana during the period from November, 1977 to March, 1980. As the patients presented from widely separated areas of the hinterland it is likely that cutaneous leishmaniasis is endemic throughout the virgin tropical rain forest of Guyana, although infection is normally sporadic. A striking clinical feature was the 'spirotrichoid' involvement of the draining lymphatics and nodes in half the cases, which histologically all came from the middle region of the spectrum (groups II, III or IV of Ridley's 1980 classification). All the cases tested were serologically positive to a Leishmania braziliensis antigen. One hundred and ten patients were successfully treated with pentamidine, with minimal side-effects, but some required a second course. Four relapsed patients all belonged to the same histological group.

The American leishmaniases: some observations on their ecology and epidemiology

As the first species of Leishmania encountered were the agents of human visceral and cutaneous leishmaniasis, it is understandable that studies on these parasites for a long time concentrated on those organisms commonly causing disease in man. Epidemiological studies over the past 20 years or so, however, have led to the inescapable conclusion that the genus Leishmania is comprised of numerous species of well adapted parasites, in a wide range of mammals, throughout most of those tropical and subtropical regions of the world where phlebotomine sandflies exist (Diptera: Psychodidae). Many of the leishmanias probably never gain entrance into man: due either to an incapacity to survive in his tissues, or (more likely) because the natural sandfly vectors do not feed on him. The leishmanias that do infect man are, nevertheless, among the greatest protozoological scourges of mankind, and a better understanding of their life-cycles may well help in future prevention or control of the diseases they cause. With few exceptions the leishmaniases are zoonoses, with a major source of infection in wild or domestic animals. In the Americas, the disease is essentially a rural one, and most commonly acquired by those penetrating forested or wooded regions. The following paper deals with the better known human leishmaniases of the New World, and some new ones, and discusses the major historical events in the laborious task of elucidating their ecology and epidemiology.

Epidemiology of dermal leishmaniasis in the Rio Doce Valley, State of Minas Gerais, Brazil

Dermal leishmaniasis is prevalent in the predominantly settled agricultural areas in the Rio Doce Valley in the eastern part of the State of Minas Gerais, Brazil. The disease has been recorded almost equally in both sexes. Cases have been confirmed in all age groups but youths aged ten to 14 years form the population segment at greatest risk to infection. Cases of single cutaneous lesions, multiple cutaneous lesions and muco-cutaneous lesions have been recorded in the area. Isolates of parasites include representatives of the Leishmania mexicana and L. braziliensis complexes and at least one parasite that does not fit into either category. Infections have not been detected in small mammals (mainly rodents) but about 3% of dogs are infected. The phlebotomine fauna includes no species (or close relatives of species) previously incriminated as vectors of mexicana and braziliensis infections in Brazil. In the complex and confusing epidemiological situation in the Rio Doce Valley it seems unwise to apply traditional specific names to Leishmania of the area.