What is Leishmaniasis

Leishmaniasis is a disease caused by the Leishmania parasite. Sand flies pick up this parasite when they bite animals or people who are carrying the parasite in their blood. Animals that carry the parasite include dogs and rodents. The parasite can spread to humans when an infected sand fly bites them.

A person infected by this parasite may develop skin sores (cutaneous leishmaniasis). Leishmania may also affect organs inside the body (visceral leishmaniasis). These include the liver, spleen, and bone marrow. A rare form of leishmaniasis can spread from the skin to the mucous membranes of the nose and mouth (mucocutaneous leishmaniasis).

Common sand flies that are found in the U.S. do not carry this parasite. There have been cases of leishmaniasis in Texas and Oklahoma, but almost all cases occur among people who have traveled to:

• Asia.
• Africa.
• The Middle East.
• South America.

What are the causes?

This condition is caused by the Leishmania parasite, which most often spreads to humans through the bite of an infected sand fly. The parasite may also spread:

• From an infected pregnant woman to her child during birth.
• Through a blood transfusion with contaminated blood.
• Through contaminated needles.

What increases the risk?

This condition is more likely to develop in people who live in or have traveled to a part of the world where leishmaniasis is common. In those regions, your risk is greater if:

• You have been in rural areas.
• You have been outdoors from dusk to dawn. That is when sand flies feed.

What are the signs or symptoms?

Symptoms of this condition will vary depending on the type of leishmaniasis.

Cutaneous leishmaniasis

Symptoms may not start for a few weeks or a few months after a bite from an infected sand fly. Some people may carry the parasite and never show any symptoms.

The main symptom of cutaneous leishmaniasis is having one or more sores on the skin. The sores can change in size and appearance over time. These sores may have:

• Raised edges with a central crater.
• Scabs that form over them.
• Swelling of glands near the sores.

Visceral leishmaniasis

It may take a few months for people with visceral leishmaniasis to become sick. Symptoms of visceral leishmaniasis may include:

• Fever.
• Weight loss.
• Enlarged liver and spleen.
• Weakness.

How is this diagnosed?

This condition may be diagnosed based on:

• Your symptoms and medical history. It is very important to tell your health care provider where and when you have traveled.
• A physical exam.
• Samples of fluid taken from your sores to check under a microscope.
• Blood tests.

How is this treated?

Treatment for this condition depends on the type of infection you have.

• Cutaneous leishmaniasis may not need to be treated. In time, the skin sores will heal on their own.
• If sores are large and severe, you may get treatment to prevent scars. Treatment may include:
  • Freezing the sores with liquid nitrogen (cryotherapy).
  • Using electric energy on the sores (thermotherapy).
• Medicines may be used for severe cases of leishmaniasis, including:
  • Medicines (antimonial medicines) given orally.
  • Medicine given through an IV tube.
  • Antibiotic medicine.

Follow these instructions at home:

• Take over-the-counter and prescription medicines only as told by your health care provider.
• Keep all follow-up visits as told by your health care provider. This is important.

How is this prevented?

To prevent leishmaniasis when you are in an area where the infection is common:

• Stay in screened or air-conditioned areas as much as possible.
• Avoid outdoor activities from dusk to dawn.
• Wear long-sleeved shirts, long pants, and socks when you are outside. Tuck your shirt into your pants.
• Apply insect repellent on your uncovered skin and under the ends of your sleeves and pant legs. Make sure to use a product that repels sand flies. Follow the directions carefully. Do not use these products on children who are younger than 2 years of age.

Contact a health care provider if:

• You have traveled to an area where leishmaniasis is common and you:
  • May have been bitten by a sand fly there.
  • Have unusual symptoms.
• You have been diagnosed with leishmaniasis and your symptoms change or get worse.