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article imageAn old disease has reared its ugly head, and it's spreading

By Karen Graham     May 29, 2016 in Health
Cutaneous leishmaniasis, a disease once contained to areas around Aleppo and Damascus in Syria, has now been given new life thanks to the ongoing conflict in the region, reaching catastrophic proportions.
Look up cutaneous leishmaniasis on YouTube and you will find hundreds of videos, most of them showing the disfiguring damage this disease causes people in areas where it is endemic. There are lots of videos of Syrian refugees with the disease.
In Syria, the disease had been confined to areas around Aleppo and Damascus, and in better times, was controlled to a great extent with proper health care. But today it is quite different, and health authorities are fearful the disease, which has already spread to Turkey, Lebanon, and Jordan, may end up in Europe, reports
This map shows how the disease has spread out of Syria into countries such as Jordan  Iraq and Turke...
This map shows how the disease has spread out of Syria into countries such as Jordan, Iraq and Turkey.
Cutaneous leishmaniasis is caused by the bite of a female Phlebotomus sand fly. Cutaneous leishmaniasis in Syria and its environs is usually caused by L.L. major and L.L. tropica, although at least 20 species have been identified as causing cutaneous leishmaniasis. There are no vaccines or drugs available to prevent infection.
According to scientists who have been gathering information and collating data on the disease from refugee camps and conflict zones, hundreds of thousands of people across the Middle East region are now affected by cutaneous leishmaniasis. The figures, which have spiked with the advent of war, were published May 26 in a PLOS editorial.
“The numbers are looking very bad and there’s no access to intra-lesional antimony compounds. We're seeing lots of diseases, including leishmaniasi in these conflict zones and we need to ring-fence them or risk another situation like Ebola out of the conflict zones in West Africa in 2014,” says Peter Hotez, dean of the US National School of Tropical Medicine, US Science Envoy to the Middle East, and lead author of the PLOS editorial.
A male Phlebotomus sp. sandfly.
A male Phlebotomus sp. sandfly.
CDC Public Health Image Library
According to a Digital Journal story in April 2015. an increase in cases was reported in war-torn Syria in 2014 and doctors from organisations like Medicines Sans Frontieres were trying to curb the outbreak but had to leave the area when ISIS took control.
Bombed out buildings, a lack of medical care, poor water, and sanitation services, as well as no insect control left the region under ISIS a breeding ground for disease. All this conspired to leave refugees fleeing the conflict no other recourse but to take the disease into non-immune areas or arrive in endemic areas without immunity themselves.
Syria's Ministry of Health says the number of cases of leishmaniasis jumped from 23,000 before the war to 41,000 in 2013. Since then, millions of refugees have fled Syria into neighboring countries, taking the disease along with them. In Lebanon, which had six cases in the previous 12 years, there were over 1,033 cases in 2013. Other neighboring countries have also seen hundreds of cases.
Bombed out buildings  poor sanitation  and little water is the perfect formula for the spread of dis...
Bombed out buildings, poor sanitation, and little water is the perfect formula for the spread of disease.
The U.S. Centres for Disease Control and Prevention (CDC) reported that the disease has recently begun to flourish in Syria’s neighbouring countries. The CDC report also pointed out that in May of 2013, the World Health Organization (WHO) donated 10,000 doses of meglumine antimonate (85 mg/mL; 5-mL ampoules) to health authorities in Lebanon to treat the 1,275 patients identified as having the disease.
But more important is the numbers of refugees without treatment. CDC data gave the mean age of those infected as being 17.1 years old. And because the disease has been left untreated for so long, the lesions on most refugees are horrendously disfiguring.
The Daily Mail is reporting there is the possibility the disease might spread to Saudi Arabia as young refugees flee the country. One thing is certain, most of the refugees are malnourished and not in the best of health. With weakened immune systems, leishmaniasis can eventually kill them if left untreated.
More about Cutaneous leishmaniasis, Aleppo boil, sand flea, Parasite, syrian refugees
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