Travel Health – Leishmaniasis

There are dozens of countries in the old world and the new where you could get this disfiguring and potentially fatal disease. However in the past 2 decades most of the press has been on soldiers returning from the Middle East with this disease.

Leishmaniasis is not a single disease, but a group of syndromes due to a variety of species of this parasite. The affect different populations and are related to a characteristic vector, the sandfly.

The disease can range from asymptomatic infections to those causing significant illness and death. Disease can appear on a spectrum from a single skin ulcer to destructive lesions of the face to terminal organ disease.

Leishmaniasis is found in 88 countries worldwide and is broken down between Old World and New World.
Old World leishmaniasis is primarily found in parts of Asia, East and North Africa, Soouthern Europe and the Middle East.

New World leishmaniasis occurs from northern Mexico to northern Argentina, with rare cases reported in parts of Texas and Oklahoma. In South America it is not found in Chile or Uruguay.

Leishmaniasis in the US is typically indicative of immigration and travel.

The vector for this parasite is a phlebotomine sandfly. There are a few different species implicated depending on the part of the world.

Sandflies are very small (about 1/3 the size of a mosquito) and make no noise when flying. There bites can sometimes be painless; because of these reasons, many people have no idea they were bitten.

Even one bite of a sandfly can transmit disease, so travelers on short trips can still get infected.

When the female sandfly takes a blood meal it injects the parasite into the wound. Macrophages pick up the parasite and here they multiply until the cell bursts from overcrowding. The parasite goes on to infect more macrophages.

Some of these cells get carried to organs of the body including the liver, spleen and the bone marrow.

There are several species of Leishmania that cause disease in humans. The most common are Leishmania donovani (kala-azar), L. tropica (Baghdad boil), and L. braziliensis (espundia).

After getting bitten by a sandfly, disease may manifest itself from a week to many months later.

It starts out as a papule that enlarges to an ulcer. The ulcer can give the appearance of a volcano crater. Lesions may appear singly or multiple; many heal spontaneously within weeks to months to years.

Certain species (L. braziliensis) can disseminate to the mucosal areas of the face and mouth and cause very destructive and disfiguring disease (espundia) that appears similar to leprosy.

Kala-azar, an Indian name given to systemic type of the disease due to the grayish appearance of the body, can result in enlarged spleen and liver, diarrhea, emaciation, weakness and death.

Laboratory diagnosis I usually based on stained microscopic examination of the infected tissue. More specialized techniques like culture, molecular techniques and antibody detection are available but are not available in most diagnostic laboratories.

If you get leishmaniasis, your doctor should consult the Centers for Disease Control and Prevention (CDC) for treatment guidelines.

So you plan to travel to a part of the world where leishmaniasis is endemic, what can you do to prevent the horrible disease?

There is not a vaccine available to prevent leishmaniasis. The best way is to avoid sandfly bites. The CDC recommends the following:

Avoid outdoor activities, especially from dusk to dawn, when sand flies generally are the most active.

When outdoors (or in unprotected quarters):
o Minimize the amount of exposed skin. To the extent that is tolerable in the climate, wear long-sleeved shirts, long pants, and socks; and tuck your shirt into your pants.
o Apply insect repellent to exposed (uncovered) skin and under the ends of sleeves and pant legs. Follow the instructions on the label of the repellent. The most effective repellents are those that contain the chemical DEET (N,N-diethylmetatoluamide).

When indoors:
o Stay in well-screened or air-conditioned areas.
o Keep in mind that sand flies are much smaller than mosquitoes and therefore can get through smaller holes.
o Spray living/sleeping areas with an insecticide to kill insects.
o If you are not sleeping in a well-screened or air-conditioned area, use a bed net and tuck it under your mattress. If possible, use a bed net that has been soaked in or sprayed with a pyrethroid-containing insecticide (permethrin or deltamethrin). The same treatment can be applied to screens, curtains, sheets, and clothing (clothing should be retreated after five washings).

How Pests Can Affect Your Health

Pest and rodents may have some harmful effects upon your quality of life and your family’s health. It is essential to understand the dangers stemming from these kinds infestations. Do you know that many of the most common pest in homes are cockroaches, rodents and ants? It’s unsettling to think about us sharing our homes with these pests with the serious threats they pose. Below is a more in depth summary of the health risks affiliated with particular pests.

Cockroaches
The National institute of Environmental Health Sciences (NIEHS) reports that one-in-five children in the United States have severe sensitivities to cockroach allergens, which raise the seriousness of asthma symptoms. These allergens are most commonly introduced in homes through cockroach saliva, droppings along with decomposing bodies of pests. Cockroaches can carry bacteria such as E coli and salmonella on their bodies, which may contaminate food, cooking equipment and food surfaces.

Mosquitoes
Together with the increased prevalence of West Nile Virus during the summer time months, mosquitoes continue to be, not only a summer nuisance pest and also, an important health threat. According to the Centers for Disease Control (CDC), West Nile Virus infections have appeared all over the United States recently, which makes avoiding mosquito nesting/breeding sites and eliminating standing water around or in your house a lot more important to the security of public health. Additionally, to the possibility of West Nile Virus, mosquitoes can cause itchy, unsightly marks together with severe allergic reactions in people.

Ants
Ants are social insects. Therefore, spotting one ant unfortunately signifies there are a lot more to follow. Ants are not simply unsightly- they can also be harmful contaminates to food. The existence of ants and also the chance of food contamination from their presence is a problem that needs to be addressed when thinking about your health and the health of your family.

Fire Ants
Fire ants not only affect your outdoor enjoyment, they are to blame for countless hospital visits every year. Controlling these voracious pests takes additional care and expertise. If you have fire ants present on your property, you can trust a good pest control company to provide a solution designed to safeguard your family and pets.

Stinging Insects (yellow Jackets, Wasps, Hornets & More)
Stinging insects send more than 500,000 people to the hospital each year. These pests are aggressive in nature and quite often sting as a way to protect their colonies or larvae from individuals who try to remedy an infestation themselves. This aggressiveness, put together with being disturbed, often means that these pests usually tend to sting repeatedly, which increases the potential for greater skin irritation or serious allergic reaction. A Pest Control Professional provides a level of expertise and expertise in technology which will best rid these stinging insects and stop future infestations.

Ticks
Lyme disease has emerged lately as a major health risk to human beings. Transmitted by ticks, typically between May and October, Lyme disease is basically found in the Northwestern, upper mid-western states of the U.S. However, there’s been a rise in the diagnosed cases of Lyme diseases in the South. It is critical to be vigilant of ticks, notably if you have been in wooded areas. Signs of Lyme disease will include a “bull’s eye” rash about the bite, flu-like symptoms and extreme fatigue.

Fleas
Fleas aren’t just a problem for man’s best friend. These pests, which commonly show up in warmer months, feast upon the blood from a warm-blooded body. Typically biting human beings, fleas can cause itchy, unsightly marks and severe allergic reactions. Fleas are likely to travel with mammals on the move, which often can include not only you and your pet and also rodents. Should you have a rodent problem in your residence, fleas may soon follow. If you think a flea infestation, contact a Pest Control company to rid your home of fleas and prevent future infestations.

Rodents
Rodents can enter a house through any kind of opening or crack. It is very important inspect for rodent droppings, particularly in undisturbed areas such as pantries, under baseboards, in attics and along walls. Rodent droppings frequently cause allergic reactions in human beings but can also cause disease, including the potentially deadly Hantavirus. More often, though, rodents serve as vectors, carrying bacteria, such as salmonella, on their bodies and contaminating food sources, kitchen surfaces and equipment. A Pest Control trained professional can provide the expertise and understanding of rodent biology to best protect your health and rid your home of any rodent infestation.

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