Ecology of phlebotomine sandflies and putative reservoir hosts of leishmaniasis in a border area in Northeastern Mexico: implications for the risk of transmission of Leishmania mexicana in Mexico and the USA

Surveillance of sand flies (Psychodidae, Phlebotominae) from Mexico: Altitudinal and climatic patterns after historical and new geographic records in endemic areas of leishmaniasis

This study updates knowledge on historical geographic distribution of sand fly species through identifying altitudinal and bioclimatic patterns in leishmaniasis endemic areas in Mexico. We analyze and identify sand fly specimens obtained through national efforts by the Instituto de Diagnóstico y Referencia Epidemiológicos (InDRE, Mexico), collected between 1995 and 2001, 2008-2012, and 2017-2023, and add bibliographic information (427 additional records). After a principal components analysis of WorldClim variables and altitudinal ranges, variables that better explain the distribution of sand fly species were chosen (BIO6, BIO12, and BIO16, explaining 72 % of variation). A total of 1,187 specimens of 22 species were retrieved from eight states, providing 29 new municipalities and 48 new localities, being Lutzomyia cruciata, Micropygomyia chiapanensis, and Psathyromyia shannoni the most common species. We presented new historical records of distribution for sand fly species from Morelos (3), Oaxaca (7) and Tabasco (1). The 82.7 % of sand fly species analyzed were distributed in areas with altitudinal ranges below 420 m. The anthropophilic species Psathyromyia shannoni, and Lutzomyia cruciata showed the greatest variability regarding altitudinal range, and climatic preferences, while several wild species showed abiotic preferences. It is likely that the effect of urbanization and climate change generate new beneficial biotopes for the proliferation of the vector sand fly species. Complementary studies that consider seasonality, vegetation types, and change in land use could provide new information to better understand the spread of vector-borne diseases.

Species diversity, barcode, detection of pathogens and blood meal pattern in Phlebotominae (Diptera: Psychodidae) from northeastern Mexico

More than 90 species of phlebotomines are vectors of parasites, bacteria, and viruses, which cause disease in animals and humans. Therefore, their study is necessary to establish prevention and control strategies. Mexico is an endemic country for leishmaniasis, mostly in the center and southern regions of the country, yet only few studies have been conducted in the northern part of the country. The present study aims to: (a) assess the alpha diversity of Phlebotominae in an annual cycle, (b) to correlate climatic variables with abundance, (c) to generate barcodes of these insects as part of the integrative taxonomy, and (d) to detect Leishmania, Wolbachia and blood sources in an area close to where a case of autochthonous leishmaniasis has been detected in Nuevo Leon, Mexico. A systematic sampling was conducted during three consecutive nights from 17:00 to 22:00 h., placing Shannon traps, CDC traps with incandescent light, and BG Sentinel 2 + BG Lure traps. A total catch effort of 660 nights/traps/hours was achieved, in which a total number of 707 phlebotomines (58% female and 42% male) of six species were collected and identified. The most abundant species were Psathyromyia cratifer (57%) and Psathyromyia shannoni sensu stricto (26%). The highest abundance (72%; 507/707) was collected during March, April and May 2021. Barcodes were generated for four species of phlebotomines, which represent new records for Mexico. For the molecular detection of microorganisms, 302 specimens were analyzed, although no specimens were positive for Leishmania spp. Wolbachia strains were detected in phlebotomines with an infection rate of 1.32% (4/302) and found in Pa. cratifer and Lu. cruciata. Likewise, human DNA was identified in female Lu. cruciata and Pa. cratifer phlebotomines. These findings indicate the presence of potential vector species of the parasite Leishmania spp. This result shows the need for further entomological surveillance to elucidate the transmission mechanisms in these northern areas of the country.

Species diversity and detection of pathogens in phlebotomine sand flies collected from forest management areas of Quintana Roo, Mexico

Sand flies have expanded their areas of distribution, thereby increasing the risk of pathogen transmission in non-endemic areas. To establish efficient prevention and control strategies for the transmission of vector-borne pathogens, it is important to understand seasonal dynamics of their vectors. In Mexico, there are several areas where the contact between sand flies, hosts and reservoirs favours the transmission of the pathogen. We compared sand fly communities in a forest management area and a conserved area in Noh-Bec, Quintana Roo, Mexico. The analysis included species diversity, activity peaks and molecular detection of pathogens. Sand flies were collected from November to December 2021 and April to May 2022, during 84 night-traps. The conserved area showed higher numbers and greater species heterogeneity of sand flies as compared with the other sites. The β-diversity analysis revealed that sites disturbed by logging (S1, S2, S3) had greater similarity (90%) in their sand fly species composition than a conserved area (S4) (similarity = 36%). Although none of the specimens were infected with Leishmania, we detected Wolbachia (19.4%) in all four sites, as well as Bartonella (3.25%) only in the disturbed sites. Further studies on the dynamics of sand fly populations and their association with pathogens are necessary.

Molecular Detection of Bartonella sp. in Psathyromyia shannoni and Lutzomyia cruciata From Northeastern Mexico

Phlebotomine sand flies are vectors of Leishmania spp., Bartonella bacilliformis, and several arboviruses worldwide. In Mexico, the presence of Bartonella species is associated sporadically with arthropods and little is known on the diversity of insects that could be incriminated with its transmission. The aim of this study was to perform a molecular detection of Bartonella DNA in sand fly species collected in northeastern Mexico. Sand flies were collected at the states of Nuevo Leon and Tamaulipas from June to August 2010, using 16 light traps per night. Sand fly species were morphologically identified, and for Bartonella detection, we amplified ~378 bp of the citrate synthase gene (gltA). DNA sequences were compared in a phylogenetic reconstruction based on maximum likelihood. A total of 532 specimens from seven sand fly species were morphologically identified, where 11 specimens from Tamaulipas tested positive for the presence of a new lineage of Bartonella sp. associated with Psathyromyia shannoni and Lutzomyia cruciata. This work represents the second record of Bartonella-associated with sand flies outside of the endemic area of Carrion’s disease. More studies are necessary to understand their life cycle, transmission dynamics, and their relationship with sand fly species.

Species diversity and blood meal sources of phlebotomine sand flies (Diptera: Psychodidae) from Los Tuxtlas, Veracruz, Mexico

Phlebotomine sand flies can transmit several species of the genus Leishmania, that cause leishmaniasis, a serious neglected tropical disease worldwide. Although Mexico is an endemic country for the disease, studies on the biology, ecology, and the identification of blood meal sources of phlebotomine sand flies in some states remain unexplored. For this reason, this study aimed to evaluate the species diversity of sand flies, and identify their blood meal sources in the Biosphere Reserve Los Tuxtlas, Veracruz, an area with a high prevalence of Leishmania infantum. The cumulative sampling effort of sand flies covered 300 trap-nights between March 2011 and May 2013. For estimating species diversity, we calculated the species richness (q = 0), the diversity of the species (q = 1) and the dominant species (q = 2). To identify the blood meal sources, we amplified and sequenced a fragment of ≈400 bp of the vertebrate Cytb gene. A total of 951 specimens belonging to 15 species were collected. Psathyromyia aclydifera and Psychodopygus panamensis were the most abundant species. We were able to identify seven terrestrial vertebrate species, among which human beings were the most common source of the blood meal. In this study, relevant information on the structure of sand fly populations and their blood meal sources was obtained, providing basic and important information about the interactions between sand flies, hosts and Leishmania species.

Leishmaniasis in the United States: Emerging Issues in a Region of Low Endemicity

Leishmaniasis, a chronic and persistent intracellular protozoal infection caused by many different species within the genus Leishmania, is an unfamiliar disease to most North American providers. Clinical presentations may include asymptomatic and symptomatic visceral leishmaniasis (so-called Kala-azar), as well as cutaneous or mucosal disease. Although cutaneous leishmaniasis (caused by Leishmania mexicana in the United States) is endemic in some southwest states, other causes for concern include reactivation of imported visceral leishmaniasis remotely in time from the initial infection, and the possible long-term complications of chronic inflammation from asymptomatic infection. Climate change, the identification of competent vectors and reservoirs, a highly mobile populace, significant population groups with proven exposure history, HIV, and widespread use of immunosuppressive medications and organ transplant all create the potential for increased frequency of leishmaniasis in the U.S. Together, these factors could contribute to leishmaniasis emerging as a health threat in the U.S., including the possibility of sustained autochthonous spread of newly introduced visceral disease. We summarize recent data examining the epidemiology and major risk factors for acquisition of cutaneous and visceral leishmaniasis, with a special focus on implications for the United States, as well as discuss key emerging issues affecting the management of visceral leishmaniasis.

An Atypical Case of Autochthonous Cutaneous Leishmaniasis Associated with Naturally Infected Phlebotomine Sand Flies in Texas, United States

In the United States, phlebotomine sand flies carrying Leishmania (Leishmania) mexicana are endemic along the southern border. However, relatively little is known about the enzootic and zoonotic transmission of L. (L.) mexicana within the United States, and autochthonous cases of the consequent disease are rarely reported. We investigated an atypical case of cutaneous leishmaniasis (CL) caused by L. (L.) mexicana in a patient from central Texas which did not respond to a typical antileishmanial chemotherapy. We also investigated sand fly vectors around the patient's residence. PCR followed by DNA sequencing was used for determination of Leishmania spp., sand fly species, and host blood meal source. The L. (L.) mexicana genotype from the patient was identical to one found in a positive sand fly. Moreover, this genotype presented the same single-nucleotide polymorphisms as other historical CL cases acquired in Texas over the last 10 years, but distinct from those originating in Mexico and Central America. Three sand fly species were identified among the samples analyzed (n = 194), the majority of which were Lutzomyia (Dampfomyia) anthophora (n = 190), of which four specimens tested positive for Leishmania and two blood-fed specimens showed the presence of a human blood meal. This study highlights the complexity of clinical management of CL in a setting where the disease is infrequently encountered. The detection of human blood in Lu. (D.) anthophora is the first documentation of anthropophagy in this species. This is the first report of wild-caught, naturally infected sand flies found in association with an autochthonous case of human leishmaniasis and the specific strain of Leishmania (Leishmania) mexicana in the United States.

Molecular detection of Leishmania infantum in sand flies (Diptera: Psychodidae: Phlebotominae) from Veracruz, Mexico

Phlebotomine sand flies are vectors of Leishmania parasites causing different clinical forms of leishmaniases that represent a serious emerging public health problem worldwide. Mexico harbours a large diversity of sand flies, yet only six species have been considered suspected vectors of Leishmania. The disease has been recorded in 25 states, where the State of Veracruz has recorded the highest number of cases with leishmaniases, although no systematic or epidemiological surveillance studies of Leishmania vectors have been carried out in the region. For that reason, the aim of this study was to perform the molecular detection of Leishmania DNA in phlebotomine sand flies collected from a humid tropical region in Veracruz. We confirmed the presence of Leishmania DNA in eight sand fly species. Sand flies with the highest infection were Psathyromyia aclydifera and Pychodopygus panamensis. This is also the first report of Leishmania DNA in Psathyromyia aclydifera, Psathyromyia carpenteri, Dampfomyia beltrani and Brumptomyia mesai. Our findings highlight the importance of entomological surveys and epidemiological studies, since they enable to determine whether sand fly species may be potential Leishmania vectors in a given area of the Mexico, as transmission dynamics can vary in the different regions.

Diffuse cutaneous leishmaniasis with oral involvement in a patient of Northern Mexico

Diffuse cutaneous leishmaniasis is a rare chronic infectious disease, associated with Leishmania mexicana and L. amazonensis, presenting as multiple non-ulcerative painless nodules, with a tendency to relapse soon after treatment. We report a case of a 56-year-old Mexican woman exhibiting nodular lesions, plaques, crusts and scars involving the whole body. A solitary nodule was present at the junction between hard and soft palates. Diffuse cutaneous leishmaniasis is a disfiguring disease resulting in severe scarring if untreated.