Travellers

Travel Health Information Sheets

Updated September 2012

Leishmaniasis

What is Leishmaniasis?

Leishmaniasis is a parasite humans can catch from infected sandfly bites. Animals like dogs, foxes and rodents can carry the infection: a sandfly bites them and then passes it on to humans by biting them.

There are more than 20 different types of parasite that can spread to humans and cause two main types of illness:

  • Visceral - your internal organs can be damaged, this may be fatal.

  • Cutaneous – affects your skin and can cause permanent scarring.

 

There is also a third, much rarer type, called muco-cutanous leishmaniasis. This causes severe mouth and nose ulcers, which may cause lifelong facial deformity. 

Where is it found?

Leishmaniasis is found in more than 80 countries in parts of Africa, Asia, Central and South America, the Mediterranean and the Middle East.

What is my risk?

Activities that increase your chance of sandfly bites increase your risk. Sandflies are usually found in forests, cracks of stone or mud walls, termite mounds or animal burrows and bite between dusk and dawn.

Adventure travellers, missionaries, soldiers and anyone who travels to risk areas, particularly deserts or jungles, are at risk. Leishmaniasis in less adventurous travellers is unusual, but does occur.

What are the symptoms?

Cutaneous leishmaniasis skin ulcers can develop weeks or months after you are first infected. They may vary in appearance from a red, bumpy sore to scaly lesions. You may get swollen glands (lymph nodes) as well.

Visceral leishmaniasis does not always cause symptoms. If symptoms occur, they can include anaemia, fever, enlarged liver and spleen and weight loss. Life-threatening illness can occur. You are more likely to get ill with leishmaniasis if you are HIV positive.

How can I reduce my risk?                                   

Avoiding sandfly bites as much as possible is the only way to reduce your risk. Sleeping in an air-conditioned room or under a mosquito net is very important. However, sandflies are smaller than mosquitoes and can pass through the holes in mosquito nets. If your net is pre-soaked in a strong insecticide, like permethrin (most new mosquito nets are pre-treated) this usually stops bites. Sandflies usually fly near the ground, so sleeping off the floor, such as in a hammock, may also help reduce your risk.

Use an insecticide spray in the room you sleep in. Apply insect repellent to any exposed skin and to your clothes. When you’re outside, try to wear clothes that reduce the amount skin you expose to the air.

If you are camping, avoid pitching your tent near any animal burrows, as some animals carry leishmaniasis.

Is there a vaccine?

There is no vaccine, so avoiding sandfly bites is very important.

Can it be treated?

Yes, but it can be difficult to treat, especially the advanced form. You need intensive treatment and monitoring and should be referred to a specialist tropical disease hospital for tests to find out which type you have. There are several treatments; a specialist doctor needs to choose the right drug once they have worked out the type of you have.

You will not develop any immunity to it after you recover; therefore it is important you take care not to become infected again.

Links

Centres for Disease Control: Leishmaniasis - Prevention and Control.

Health Protection Agency: Leishmaniasis

World Health Organization: Leishmaniasis