Leishmaniasis

Cutaneous leishmaniasis
Cutaneous leishmaniasis causes single or multiple skin lesions that do not heal. Some strains will infect mucous membranes and cause disfigurement of the nose and throat. Lesions can last for weeks to many months, and recurrences can occur in healed lesions. These sores can change in size and appearance; they may be closed or open like an ulcer. Some people may also experience swollen glands near the site of the sore.

Visceral leishmaniasis (kala-azar)
Kala-azar often affects the spleen, liver and bone marrow and is characterised by a high fever that can persist for long periods and is very debilitating. Symptoms may also include a feeling of general malaise, muscle and stomach pains, loss of appetite and diarrhoea. After months of infection, the skin becomes grey and scaly, hence the name kala-azar, which means ‘black disease’.

There is no vaccine or preventative drug available, so effective insect bite avoidance is essential in high-risk areas. The risk of contracting leishmaniasis is low for most travellers, but backpackers and campers are at a higher risk.

In Australia, health authorities recommend using insect repellents that you apply directly to exposed skin to prevent mosquito bites and reduce the risk of mosquito-borne diseases. These includeinsect repellents containing an effective active ingredient, such as DEET 30–40%, oil of lemon eucalyptus (OLE) or PMD, or picaridin 20%.

You should also wear long-sleeved clothing and treat your clothing and gear with permethrin. Infected sand flies are generally very small and can easily penetrate mosquito nets. Using an impregnated bed net may be of benefit.

Cutaneous leishmaniasis
Anti-protozoal agents are used to treat skin lesions caused by the disease.

Visceral leishmaniasis (kala-azar)
Drugs are available to treat visceral leishmaniasis. Severe infections typically result in death if untreated.