Unsettling Discovery Leishmania in the U.S.
A concerning revelation by the Centers for Disease Control and Prevention (CDC) suggests that Leishmania, a parasite known for causing disfiguring skin lesions, might be locally endemic in Texas and potentially present in other southern states. This development comes after an analysis of over a thousand cases, raising questions about the parasite’s transmission within the U.S.
Decade-Long Study Uncovers Domestic Cases
Between 2005 and 2019, the CDC identified 1,222 U.S. Leishmania cases, traditionally linked to international travel to tropical and subtropical regions. Alarmingly, 86 of these showed no recent travel history, indicating potential local transmission. The discovery of a unique Leishmania strain, distinct from those identified in travel-associated cases, further supports the hypothesis of an indigenous presence.
Texas at the Epicenter, Other States Affected
While it’s premature to declare Texas the exclusive hotspot, the majority of these non-travel cases emerged there, says Vitaliano Cama of the CDC’s Division of Parasitic Diseases and Malaria. Reports also suggest unconfirmed instances in Florida, with sporadic cases in Oklahoma and Arizona, highlighting the evolving understanding of domestic leishmaniasis transmission.
Implications for Public Health and Surveillance
Despite the unsettling findings, experts, including Dr. Mary Kamb from the CDC, emphasize limited public health risk. The focus, they suggest, should be on heightened awareness among healthcare practitioners. However, the current surveillance gaps—exemplified by Texas being the sole state mandating leishmaniasis reporting—underscore the need for improved national reporting protocols.
Identifying and Treating Leishmaniasis
Most domestic cases are attributed to Leishmania mexicana, causing lesions that typically resolve without treatment. However, the global burden of leishmaniasis, especially the visceral type caused by Leishmania infantum, remains substantial. With sandflies acquiring the parasite from infected dogs, there’s concern about Leishmania infantum’s potential U.S. spread through dog imports, necessitating vigilant monitoring and response strategies.
This CDC report marks a pivotal moment in understanding leishmaniasis in the U.S., shifting perceptions of it from an international traveler’s ailment to a domestic public health concern, albeit with a currently low risk for the general populace. The findings serve as a call to action for enhanced clinician awareness, improved surveillance, and proactive public health measures.