Leishmaniasis is a type of parasitic infection which can occur due to several species of Leishmania protozoans. These parasites are usually spread due to the bite of an infected female Phlebotomus sand fly that is usually active during the warmer months from dusk to dawn and is quite common in several temperate and tropical countries of Asia, East Africa and South America.
Leishmaniasis is generally of 3 types:
Also known as kala-azar, it is a chronic infection and is potentially fatal if left untreated and often causes damage to the liver, lymph nodes or spleen and ultimately results in organ enlargement, anemia, fever, and thrombocytopenia.
It is the most common form of the infection and causes skin ulcers, lesions or an open sore at the site of the bite, leaving an ugly looking scar.
It mostly causes both skin and mucosal ulcers and causes damage in the oral or nasal cavity.
When an infected sand-fly bites a human being, during the blood meal, it injects the infective stage (i.e. metacyclic promastigote) of the Leishmania protozoan. These promastigotes within the human blood or puncture wound transform into macrophages and further into amastigotes. These amastigotes multiply and enter into tissues and cells and are ultimately responsible for the infection.
And further, when a non-infected sand fly bites an infected person, it picks up the infective protozoan during the blood meal, and hence the parasite again enters into the promastigote phase thus completing the life cycle of the parasite. The parasite can also transfer during blood transfusions or sharing of contaminated needles between infected and non-infected persons. The parasite can also enter into the foetus from a pregnant infected woman. Also Read: Parasitic Infections Can Affect Kids With Weaker Immunity
The parasitic infection is prevalent in people who have an already weakened immune system and are often noticeable in areas where there is:
- A large migration of people due to war, urbanization, climatic change etc
- Lack of proper health resources
The general incubation period is often weeks to months after the person is bitten by an infected sand-fly. Quite often people who have been infected don’t show common signs for a prolonged time period. The various symptoms depend upon the type of Leishmania species and the part the sand-fly is biting, which includes:
- Skin ulcers
- Skin lesions
- High fever
- Weight loss
- Low blood count
- Enlargement of liver and spleen
- High immunoglobulin levels in the blood
- Swollen lymph nodes
- Runny nose
- Difficulty in breathing
- Nose bleeds
Diagnosis and Treatment
It is strictly advisable to consult a doctor at the earliest once you notice any of the above-mentioned symptoms. The doctor usually diagnoses the particular type of leishmaniasis by the following tests:
In the case of cutaneous type, the doctor may simply scrape off a small amount of skin from the ulcer or lesion and analyse it through a biopsy to look for any DNA or genetic material of the parasite. Although in some cases, the ulcer may heal on its own, in case of chronic conditions, to reduce scarring, speed up healing and lessen pain, the doctor may prescribe for some medications. In case, the skin is totally disfigured, the doctor may also perform plastic surgery to cover up the scar.
In case of the visceral type, the doctor acknowledges the patients past medical history followed by a knowledge of any travelling in the past few months. The doctor also performs a physical examination of the enlarged spleen or liver, followed by a blood test or a biopsy of the bone marrow.
Treatment options for both visceral and mucocutaneous leishmaniasis mostly involve prescribed medications.
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Although there is no vaccine for this parasitic infection, one can follow some of the below mentioned preventive measures to avoid get bitten by a sand fly and evade this infection:
- Using screens and bed nets while sleeping
- You can also use mosquito repelling skin ointments containing DEET or picaridin to get protection for a longer time duration. Also Read: How To Safely Use Mosquito Repellents And Bug Sprays
- Wearing clothing that covers the whole body
- Using proper screening devices and window nets that do not allow sand flies and other insects to enter
- Spray insecticides in the indoor sleeping areas
- Avoid strolling out during in the evenings and night
- Apply mosquito repellent containing pyrethroid to your clothes, shoes, other travel equipment, and mosquito nets