The advance of the mosquito transmitted leishmaniasis in South America, (Uruguay and Chile are the only countries with no registered cases) motivated a recent symposium to address the challenge in Punta del Este.
Leishmaniasis is a disease caused by protozan parasites that belong to the genus Leishmanina and is transmitted by the bite of certain species of mosquitoes and sand flies belonging to the subfamily Phlebotominae.
The advance of Leishmaniasis which attacks dogs and humans was the main issue of discussions at the Ibero-American symposium on emerging and re-emerging zooneses, sponsored by the Pan American health organization.
The main problem is that the transmission insect, contrary to ordinary mosquitoes, belongs to the phlebotomy family, is two/three millimetres long and larvae don’t grow in water but in the soil.
“The combat in infinitely more difficult”, said Tomás Orduna an Argentine infectology expert who specializes in regional pathologies and tropical medicine. “The transmission insect will grow any place with shade, organic residues, heat and humidity”
Orduna warned it was essential for all countries of the region to be alert in the detection of the insect because it is the first link of the deadly chain.
The first step if for the transmission insect to bite a dog, and the leishmaniasis protozoan parasite rapidly reproduces. Then another same kind of insect bites an infected dog and later a human, triggering the spread of the disease.
There are two forms of leishmaniasis, coetaneous and visceral: the first can be seen in sores, ulcers and papules and is some case it attacks body mucus. The visceral is far more serious and is when the parasites have migrated to organs such as the liver and spleen with significant swelling and causing severe abdominal distension, loss of body mass, malnutrition and anaemia.
The most severe version attacks mostly children below the age of ten and if not properly treated has a death rate of at least 50%.
Some of the most common symptoms are prolonged fever and swollen visceral organs which do not respond to traditional treatments.
Uruguay and Chile are the only South American countries free of the disease but Uruguay detected in the north of the country next to the Brazil and Argentina border some insects of the pphlebotomy family. With the help of the Pan American Health Organization all dogs in the region were tested twice, proving negative.
But there are serious concerns in Uruguay since the disease is advancing south in Argentina and has reached the provinces of Corrientes and Entre Rios, which are only separated by the wide Uruguay river. However as neighbouring regions there is an abundant traffic of people, goods and why not pets, which means the “transmission insect and dogs can get across”.
“It’s an explosive cocktail, once you have phlebotomy insects and dogs, it is only a matter of time before cases in humans are reported”, concluded the Argentine infectology expert Orduna.
Uruguayan doctor Eduardo Savio and president of the Pan American Infectology Association said that local doctors “don’t have a clear diagnosis since there have been no such disease cases reported in humans in Uruguay”.
However in 2012 with the help of the Pan American Health Organization Uruguay will begin training doctors and veterinarians. “We must be prepared and trained for such a scenario”, said Dr. Savio.