Revisiting leishmaniasis in the time of war: the Syrian conflict and the Lebanese outbreak

Abstract

This new outbreak of leishmaniasis in Lebanon is the first of its kind for more than a decade. The sudden increase in Leishmania cases in Lebanon in 2013 is attributed to the increasing numbers and wide distribution of Syrian refugees in Lebanon. This serves as an example of the risks associated with military conflicts and the ability of communicable diseases to cross borders.

A distinct cutaneous leishmaniasis lesion on the tip of the patient’s nose: A visual warning for European colleagues

“…Therefore, the number of cutaneous leishmaniasis cases increased significantly in neighbouring countries like Turkey, Jordan and Lebanon [3]. Alawieh et al reported that 96.6% of the all new cases in Lebanon in 2013 occured among Syrian refugees [4]. C u t a n e o u s l e i s h m a n i a s i s i s e n d e m i c i n southeastern Anatolia, eastern Anatolia and eastern mediterranean regions of Turkey.…”

Cutaneous Leishmaniasis and Conflict in Syria

“…According to the United Nations High Commissioner for Refugees, >4.2 million Syrians have been displaced into neighboring countries; Turkey, Lebanon, and Jordan have accepted most of these refugees. As a result, cutaneous leishmaniasis has begun to emerge in areas where displaced Syrians and disease reservoirs coexist ( 5 ). …”

“…However in 2013 alone, 1,033 new cases were reported, of which 96.6% occurred among the displaced Syrian refugee populations ( 5 ). Similarly in Turkey, nonendemic parasite strains L. major and L. donovani were introduced by incoming refugees ( 6 ).…”

“…data). Consequently, the movement of large refugee populations into regions that are ill-equipped to manage imported cutaneous leishmaniasis has resulted in outbreaks in Turkey and Lebanon ( 5 , 6 ). …”

Building capacity to reduce biological threats in the Middle East

“…The breakdown in veterinary and medical public health systems in Syria has resulted in the resurgence of several such endemic, though previously controlled, zoonoses (Jacobson 2011, Alawieh and others 2014). Before the start of the current conflict there were increases in the number of cases of rabies and leishmaniasis reported in Syria (Hotez and others 2012).…”