A deadly disease transmitted by flies: leishmaniasis

Leishmaniasis (LH), a blood parasite, Leishmania spp. It is a protozoan infectious disease that can spread widely, from the cutaneous form which can heal spontaneously (cutaneous CL) caused by various skin types, to the organic form (visceral LV), which can lead to death if it is not processed.

Different species of the causative agent can be found in countries of the Mediterranean region, countries of the Middle East and Asia, parts of Latin America, the Indian subcontinent, subtropical regions of Asia and ‘Africa and female sandflies, also known as rowan, mucuk, scorch and the sandfly in different regions of our country.It is transmitted to humans from domestic and wild animals and humans. Humans and infected animals (dogs are the most common animal species) serve as reservoirs for sand flies, from which blood-sucking flies transmit the disease to other creatures. Therefore, this disease is also a zoonosis.


HL, whose importance has been highlighted by the World Health Organization (WHO) since the early 1980s, continues to be a major problem, ranking 3rd among vector-borne (mediated) diseases after malaria and lymphatic filariasis. The disease threatens 350 million people in 88 tropical and subtropical countries or regions, 12 million people are infected worldwide and an average of 1 to 2 million cases are added each year; It is reported that 500,000 people have an organ form and 1.5 million people have a skin form. According to some reports, it causes 59,000 deaths per year and 2,357,000 people with tissue damage that reduces life expectancy. It is emphasized that LH is the most important infectious disease effective in rural areas where the poorest population in the world lives.

He indicated that Colombia, Afghanistan, Algeria, Brazil, Iran, Syria, Ethiopia, North Sudan, Costa Rica and Peru are among the ten countries representing 70-75% of the total estimated incidence of cutaneous leishmaniasis in the world. In Europe, however, it varies considerably from country to country.

Although the geographic distribution of the disease is limited to the habitat of the parasite-carrying sandflies, tourism is an important factor and travel to endemic countries has an impact on the spread. Rural and forest areas, suburbs of some cities; peacekeepers, missionaries, soldiers, ornithologists (ornithologists) and those who stay out at night are at risk. It can also happen through the use or sharing of contaminated (dish) needles or blood transfusions. It can also be passed from an infected pregnant woman to her baby. The disease is common in regions of Turkey with hot and humid climates (southeast, Mediterranean, Aegean, Marmara) and in Cyprus.

According to the WHO definition, the presence of a fever and an enlarged spleen (splenomegaly) lasting more than two weeks is sufficient to define a clinical case in terms of LH for a person living in an area endemic. Unfortunately, these clinical definitions are not specific to LH, as such manifestations are also common in other diseases that may be common in endemic areas, such as malaria, enteric fever, disseminated tuberculosis, brucellosis and hematological malignancies.

Although diagnosis is made by certain serological tests and examination of tissue samples under a microscope, there is no specific test for each type of agent and sometimes parasites may not be found in tissue samples. . This leads to a false negative or positive diagnosis.


Although there are certain protocols used for its treatment, results can be obtained from applications performed before irreversible organ damage occurs, especially in the form of organs. Skin lesions can heal spontaneously, leaving scars after a long period of time. The treatments do not guarantee that the agent is eliminated from the body. For this reason, the infection can be reactivated, especially in cases where the immune system is weakened. Although immunity is known to occur in people who have been infected, there is no protective vaccine application. The most important means of prevention is to control mosquitoes and especially in endemic regions by having pets that act as reservoirs of the disease tested from time to time.


The skin: This is the most common type. It is characterized by a sore that appears on the skin a few weeks to a few months after a fly bite. These sores are usually painless. Sometimes it can also be painful. In some people, the lymph nodes may swell near the sores. It usually occurs in areas conducive to insertion, such as the face, arms, and legs. The wounds heal within a few months, usually leaving scars. It is also known as Antep’s Boil among people.

Organ (Kala-Azar): The disease develops a few months after a mosquito bite. In dogs, this period can last up to seven years and is the most severe form of the disease. Patients typically present with high fever, severe weight loss, enlarged spleen and liver, and low blood counts such as anemia, leukopenia, and thrombocytopenia. If left untreated, the disease can affect the bone marrow, lymph nodes, especially the kidneys and other internal organs, and has a high mortality rate of 100% within two years. In humans and dogs, dry eye can be formed by skin lesions of the eyelids (blepharitis), corneal oedema, uveitis or retinal problems that can lead to intraocular hemorrhages and blindness; In some cases, all eye tissues can become infected, resulting in eye loss.

Mucosa: This is the least common form. The parasites spread through the skin and cause sores on the mucous membranes of the nose, mouth and throat.

Medical specialists answer questions from our readers in the field of health. You can send your questions to my doctorimesorurum@aydinlik.com.tr.

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