Medical Surveillance Monthly Report (MSMR). Volume 10, Number 6, November/December 2004

摘要

Leishmaniasis is a zoonotic disease caused by protozoa of the genus Leishmania-the parasite is transmitted to humans through bites of female sand flies. The disease is endemic in many regions of Africa, South and Central America, southern Europe, Asia, and the Middle East. Clinical expressions of leishmaniasis are dependent on the infecting species and host immune responses. Cutaneous, mucosal, and visceral leishmaniasis, the three major clinical forms, are manifestations of skin, naso-oropharyngeal mucous membrane, and systemic infections, respectively. The courses of cutaneous and mucosal leishmaniasis are characterized by papules that progress to nodules and eventually to ulcers. The manifestations of visceral leishmaniasis (which can be life threatening) include fever, weakness, hepatosplenomegaly, pancytopenia, hyperglobulinemia, and emaciation. Not all infected persons develop signs or symptoms of leishmaniasis; however, among those who do, times from infection to first clinical manifestations generally range from a week to many months, with much longer periods (e.g., up to 10 years) for visceral infections. Leishmaniasis is of current military medical surveillance interest because it is endemic in many areas of Iraq, Afghanistan, and Kuwait. Many U.S. military members have been exposed to leishmaniasis risk during their service in Operations Enduring Freedom and/or Iraqi Freedom. A recent report in the MSMR9 summarized the leishmaniasis experience of the U.S. military from 1999 through 2003 (based on data available at the time of the analysis). This report summarizes frequencies, rates, and demographic and military characteristics of U.S. service members who were diagnosed/reported with leishmaniasis from January 2003 through November 2004.