Emergence of Autochthonous Cutaneous Leishmaniasis in Northeastern Texas and Southeastern Oklahoma

Clarke, Carmen; Bradley, Kristy; Wright, James H.; Glowicz, Janet

doi:10.4269/ajtmh.2012.11-0717

Cited by 45 publications

(42 citation statements)

References 31 publications

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“…Of these, 6 cases matched the demographics of those previously reported in the medical literature and were excluded from further analysis. 27,33 Of the remaining 69 novel cases of leishmaniasis identified, 41 (59%) were autochthonous, occurring in patients with documentation of no history of travel outside of the United States ( Figure 2). The median age at diagnosis was 61 years (range, 3-89 years), and 28 (68%) of the endemic cases occurred in female patients.…”

Section: Resultsmentioning

confidence: 99%

Incidence of Endemic Human Cutaneous Leishmaniasis in the United States

2018

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IMPORTANCE Leishmaniasis is recognized as an endemic human disease in Africa, the Middle East, Asia, and South America. Yet despite case reports of endemic human leishmaniasis in the United States, and well-documented occurrences of disease in various animal vectors and reservoirs, the endemicity of leishmaniasis in North America has not yet been established. Moreover, leishmaniasis is not a federally reportable disease in the United States. Clinical awareness of endemic disease therefore remains low, with North American physicians considering leishmaniasis a tropical disease. OBJECTIVE To assess the endemicity of human leishmaniasis in the United States. DESIGN, SETTING, AND PARTICIPANTS This cross-sectional multicenter observational study reviewed cases of human leishmaniasis occurring in the United States from 2007 through 2017. Previously diagnosed, deidentified cases of leishmaniasis were reported by the institutions of the authors and acknowledged contributors, as well as the Texas Department of State Health Services. Cases of leishmaniasis were identified by searching by disease name (leishmaniasis) or International Classification of Diseases, 9th and 10th Revisions diagnosis codes in the respective laboratory information systems. EXPOSURES Via examination of deidentified demographics, cases of leishmaniasis were classified as one of the following: (1) documentation of no history of travel outside of the United States within 10 years; (2) positive history of travel outside of the United States within 10 years; or (3) unknown or no documentation of travel history. MAIN OUTCOMES AND MEASURES Cases of leishmaniasis were considered endemic if identified in patients with documentation of no travel history outside of the United States within 10 years. RESULTS Of the 69 novel cases of human cutaneous leishmaniasis identified in this study, 41 (59%) were endemic; the median age at diagnosis was 61 years (range, 3-89 years), and 28 (68%) of the endemic cases occurred in female patients. Twenty-two (32%) cases had documentation of Leishmania speciation performed by polymerase chain reaction, and in 100% of these cases the infectious organism was identified as Leishmania mexicana. CONCLUSIONS AND RELEVANCE Human cutaneous leishmaniasis is endemic in the United States, and, at least regionally, is acquired endemically more frequently than it is via travel. Our data argue in favor of making leishmaniasis a federally reportable disease and may have substantial implications on North American public health initiatives, with climate models predicting the number of citizens exposed to leishmaniasis will double by 2080.

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Section: Resultsmentioning

confidence: 99%

Incidence of Endemic Human Cutaneous Leishmaniasis in the United States

2018

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“…Over the last few years, there has been greater awareness of the disease in the state of Texas, with several authors pointing to an increase of known autochthonous cases of leishmaniasis there [ 11 , 21 , 48 , 51 , 91 ] in Oklahoma [ 11 ] and more recently, as far north as North Dakota [ 18 ]. In addition to the human cases reported in Texas, cutaneous and visceral leishmaniases have also been reported in dogs [ 19 , 61 , 74 ] and cats [ 14 , 82 ].…”

Section: Discussionmentioning

confidence: 99%

Ecology of phlebotomine sandflies and putative reservoir hosts of leishmaniasis in a border area in Northeastern Mexico: implications for the risk of transmission ofLeishmania mexicanain Mexico and the USA

et al. 2017

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Leishmaniases are a group of important diseases transmitted to humans through the bite of sandfly vectors. Several forms of leishmaniases are endemic in Mexico and especially in the Southeast region. In the Northeastern region, however, there have only been isolated reports of cases and scanty records of sandfly vectors. The main objective of this study was to analyze the diversity of sandflies and potential reservoir hosts of Leishmania spp. in the states of Nuevo León and Tamaulipas. Species richness and abundances of sandflies and rodents were recorded. A fraction of the caught sandflies was analyzed by PCR to detect Leishmania spp. Tissues from captured rodents were also screened for infection. Ecological Niche Models (ENMs) were computed for species of rodent and their association with crop-growing areas. We found 13 species of sandflies, several of which are first records for this region. Medically important species such as Lutzomyia anthophora, Lutzomyia diabolica, Lutzomyia cruciata, and Lutzomyia shannoni were documented. Leishmania spp. infection was not detected in sandflies. Nine species of rodents were recorded, and Leishmania (Leishmania) mexicana infection was found in four species of Peromyscus and Sigmodon. ENMs showed that potential distribution of rodent pest species overlaps with allocated crop areas. This shows that Leishmania (L.) mexicana infection is present in the Northeastern region of Mexico, and that previously unrecorded sandfly species occur in the same areas. These findings suggest a potential risk of transmission of Leishmania (L.) mexicana.

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“…New World species, which include Leishmania mexicana, Leishmania amazonensis, and Leishmania venezuelensis, are found in the Western Hemisphere in Mexico and Central and South America (with the exception of Uruguay and Chile). The geographic distribution may be expanding; recently, there are case reports of cutaneous leishmaniasis acquired in Texas and Oklahoma [13]. Old World species, such as Leishmania donovani, Leishmania major, Leishmania tropica, Leishmania aethipica, and Leishmania infantum, are mostly found in the Middle East, northern Africa, and southern Europe; endemic foci exist in southern France and Greece; and periodic outbreaks have occurred in Spain [14][15][16].…”

Section: Cutaneous Leishmaniasismentioning

confidence: 99%

Skin Infections in Returned Travelers: an Update

Zimmerman

Belanger

Pfeiffer

2015

Curr Infect Dis Rep

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Dermatologic manifestations of travel-related illness are particularly vexing due to the broad differential diagnosis and clinicians' unfamiliarity with uncommonly seen diseases. This paper aims to educate and update the reader on selected infectious diseases in the returned traveler whose disease manifestations are primarily dermatologic. First, the evolving epidemiology of these infections is examined; understanding the geographic distribution of infectious etiologies helps refine and narrow the differential diagnosis. This is followed by a discussion of six important clinical syndromes including cutaneous larva migrans (CLM), cutaneous leishmaniasis, tungiasis, myiasis, antibiotic-resistant skin and soft tissue infection, and selected infections associated with fever and rash (e.g., measles, chikungunya virus infection, dengue fever, rickettsial spotted fevers). Familiarity with these syndromes and a situational awareness of their epidemiology will facilitate a prompt, accurate diagnosis and lead to appropriate treatment and prevention of further disease spread.

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Emergence of Autochthonous Cutaneous Leishmaniasis in Northeastern Texas and Southeastern Oklahoma

Cited by 45 publications

References 31 publications

Incidence of Endemic Human Cutaneous Leishmaniasis in the United States

Incidence of Endemic Human Cutaneous Leishmaniasis in the United States

Ecology of phlebotomine sandflies and putative reservoir hosts of leishmaniasis in a border area in Northeastern Mexico: implications for the risk of transmission ofLeishmania mexicanain Mexico and the USA

Skin Infections in Returned Travelers: an Update

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