Leishmaniasis once only infected international travelers. Now it may be endemic in parts of the United States.
As if there weren’t enough problems plaguing public health in the U.S., a flesh-eating parasite may be spreading locally in Texas and other southern states.
Leishmaniasis is a disease caused by leishmania parasites and is spread by infected sand flies. It was once believed to be linked to international travel, but the Centers for Disease Control and Prevention (CDC) has now detected it in people who haven’t traveled outside of the country.
Dr. Mary Kamb, epidemiologist at the CDC’s Division of Parasitic Diseases and Malaria, told CBS News, “This genetic information adds credence to this idea that leishmaniasis is occurring here in the United States, it’s endemic here in the United States, at least in Texas and maybe southern border states.”
What Is Leishmaniasis?
Female sand flies spread the infection. They become infected by sucking the blood of infected humans or animals. People may not even realize they’ve been bitten, especially as the flies are often silent and unnoticeable.
According to the World Health Organization (WHO), there are over 90 sand fly species that can transmit leishmania parasites. There are different forms of leishmaniasis: cutaneous, mucosal, and visceral forms. Cutaneous is the most common clinical syndrome, both in the U.S. and worldwide.
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Some people with leishmaniasis never develop symptoms. But those infected with the cutaneous form develop skin sores. These sores can appear months after being bitten and the lesions may last for years—the scars may be lifelong. The WHO says that around 600,000 to a million cases occur every year worldwide, but only 200,000 are reported to the organization.
Visceral leishmaniasis can be fatal if not treated. Though it is not known to be acquired in the U.S., cases occur in Brazil, India, and east Africa. The mucocutaneous form destroys the mucus membranes of the nose, throat, and the mouth.
Texas is the only U.S. state that requires doctors to report leishmaniasis cases and most of the samples from this study also come from there. Locally acquired infections have also been reported in Oklahoma. Dr. Luiz Oliveira, a staff scientist at the National Institutes of Health, told CNN that about half a dozen cases in the U.S. come from non-travelers every year.
Related: Great, Another Flesh-Eating Bacteria Identified on U.S. East Coast
Preventing Leishmaniasis and Sandfly Bites
There are currently no vaccines or drugs available for leishmaniasis, per the CDC. It’s also possible to contract cutaneous leishmaniasis more than once and people of all ages are at risk, especially adventure travelers, soldiers, eco-tourists, ornithologists, and those who are active outdoors at night or twilight.
If you’re traveling, or if you’re living in the areas in the U.S. where infections are being detected, make sure to avoid outdoor activities from dusk to dawn when sand flies are most active. While outdoors, you should keep yourself covered–if the weather allows–and use insect-repellent sprays.
Indoors, you should stay in air-conditioned and well-screened areas, or use bed nets. Choose hotels with window screens and use a mosquito net if necessary. You can also treat the mosquito net and your clothing and gear with 0.5% permethrin, the CDC advises.
Related: Did the CDC Issue a Travel Advisory for Florida?