Outbreak of Cutaneous Leishmaniasis in Peruvian Military Personnel Undertaking Training Activities in the Amazon Basin, 2010

Abstract

Military personnel deployed to the Amazon Basin are at high risk for cutaneous leishmaniasis (CL). We responded to an outbreak among Peruvian Army personnel returning from short-term training in the Amazon, conducting active case detection, lesion sample collection, and risk factor assessment. The attack rate was 25% (76/303); the incubation period was 2–36 weeks (median = 8). Most cases had one lesion (66%), primarily ulcerative (49%), and in the legs (57%). Real-time polymerase chain reaction (PCR) identified Leishmania (Viannia) braziliensis (59/61 = 97%) and L. (V.) guyanensis (2/61 = 3%). Being male (risk ratio [RR] = 4.01; P = 0.034), not wearing long-sleeve clothes (RR = 1.71; P = 0.005), and sleeping in open rooms (RR = 1.80; P = 0.009) were associated with CL. Sodium stibogluconate therapy had a 41% cure rate, less than previously reported in Peru (∼ 70%; P < 0.001). After emphasizing pre-deployment education and other basic prevention measures, trainees in the following year had lower incidence (1/278 = 0.4%; P < 0.001). Basic prevention can reduce CL risk in deployed militaries.

Spatial distribution, Leishmania species and clinical traits of Cutaneous Leishmaniasis cases in the Colombian army

“…[ 5 ] The increase in the number of cases has been attributed to different factors such as the colonization of vectors into new geographical areas, the urbanization of the disease [ 4 ] and the human activities that expose immune populations to infection, such as traveling, migration, civil conflict and military operations. [ 4 , 6 – 8 ] Regarding the latter, the army population shows the highest incidence of the disease and constitute the most vulnerable group, due to the continuous deployment of troops to areas of high endemicity and high circulation of the insect vector. [ 8 ] Several CL outbreaks in the army population have been reported in different countries of the world including Colombia.…”

Prevalence of and Factors Associated with Negative Microscopic Diagnosis of Cutaneous Leishmaniasis in Rural Peru

“…During the time of their infection, as part of the military training, the military personnel were purposely exposed to extremely poor sanitary conditions. 41 These conditions would be abnormal for the average rural citizen exposed to leishmaniasis and, thus, the inclusion of these samples would likely jeopardize the generalizability of our findings. If these individuals had contracted the disease while on military duty, not during an artificially created environment, they certainly would have been included in the analysis.…”

An An outbreak of cutaneous leishmaniasis in Erbil governorate of Iraqi Kurdistan Region in 2015

“…The high proportion of military personnel (Peshmarga) with CL, 30.7% of cases, might be attributed to their serving in endemic areas bordering Kirkuk and Ninawa governorates. Similarly, military personnel deployed to the endemic areas reported a high incidence of CL infection in South America [34].…”