Preface

Chapter 6 **Ecoepidemiology of American Visceral Leishmaniasis in**

**(Lutz & Neiva, 1912) (Diptera: Psychodidae:**

Chapter 7 **Leishmaniasis in Tunisia: History and New Insights into the Epidemiology of a Neglected Disease 117**

Chapter 8 **Eco-Epidemiological and Immunological Features of Localized**

Najoua Haouas and Hamouda Babba

Sosa-Bibiano and Elsy Nalleli Loria-Cervera

Chapter 9 **Survey of Cutaneous Leishmaniasis in Mexico: Leishmania Species, Clinical Expressions and Risk Factors 153** Amalia Monroy-Ostria and Gustavo Sanchez-Tejeda

**Phlebotominae) 91**

**VI** Contents

Elizabeth Ferreira Rangel

**of Study 137**

**Tocantins State, Brazil: Factors Associated with the Occurrence and Spreading of the Vector Lutzomyia (Lutzomyia) longipalpis**

Margarete Martins dos Santos Afonso, Sérgio Augusto de Miranda Chaves, Mônica de Avelar Figueiredo Mafra Magalhães, Renata Gracie, Carina Azevedo, Bruno Moreira de Carvalho and

**Cutaneous Leishmaniasis in Southeastern Mexico: Thirty Years**

Fernando J. Andrade-Narvaez, Nicole R. Van Wynsberghe, Erika I.

Leishmaniasis is a disease of great variability. It manifests in a variety of forms, from cutane‐ ous to the deadly visceral forms. It is endemic to a variety of habitats, from deserts to jun‐ gles, though it is usually considered a disease of the developing world. It occurs in multiple locations throughout the world, from Latin America to North Africa to the Middle East and other areas. Although there are cases in which the disease is spread by unusual means such as blood transfusions or organ transplants, most transmission occurs through the bite of a phlebotomine sand fly. Like the disease, the fly occupies a variety of habitats, from desert rodent burrows to the canopy of tropical forests.

This variety in transmission and endemicity of the disease is reflected in the different epi‐ demiologies of the disease throughout the world. The reservoir may be a sloth in South America or a dog in Southern Europe or a rodent in the Middle East. Multiple species of sand flies, with a variety of habitats, can serve as the disease vector for leishmaniasis.

Although leishmaniasis is indeed considered a neglected tropical disease primarily of the developing world, it does pose a threat outside those regions. For a variety of reasons, it is considered an emerging disease. The journal *Emerging Infectious Diseases* has published arti‐ cles on human or canine cases of this disease in Germany, Spain, Italy, Israel, Canada, France, Japan, and the United States. Many of the cases were diagnosed in travelers, includ‐ ing military personnel or dogs who were deployed to endemic regions; however, autochtho‐ nous transmission was confirmed in several places outside the developing world. It is obvious that leishmaniasis is indeed an important infectious disease: emerging, neglected, and often deadly.

Any writing which attempts to describe the epidemiology of leishmaniasis must, therefore, acknowledge the fact that there are multiple epidemiologies of this complex disease result‐ ing from the diversity of local cultures, the biology of the regional vectors and reservoirs, and the composition of the local habitats. The opening section of the book contains chapters on the application of the epidemiological method to the study of leishmaniasis. The second section consists of several chapters on the epidemiology of the disease in different sections of the world including North Africa, Central America, and South America. The chapters will demonstrate the truly complex epidemiology of the disease provided by the varying vectors, agents, and habitats involved in the transmission of leishmaniasis.

> **David M. Claborn, DrPH** CDR USN (Ret.) Master of Public Health Program Missouri State University, USA

**Section 1**

**Basic Epidemiology**

#### **Living on the Edge: Border Countries Should Have Strict Veterinary and Health Policy on Leishmaniasis Living on the Edge: Border Countries Should Have Strict Veterinary and Health Policy on Leishmaniasis**

Tina Kotnik and Vladimir Ivović Tina Kotnik and Vladimir Ivović

Additional information is available at the end of the chapter Additional information is available at the end of the chapter

http://dx.doi.org/10.5772/65273

#### **Abstract**

First human and canine cases as well as presence of competent Phlebotomine fly vectors are reported for the first time in Slovenia. Number of infected dogs in Slovenia has been increasing in the last few years. Having increased number of infected dogs and a presence of proven Phlebotomine fly vectors at the same time in a climatically suitable region may lead to endemic spread of the disease. And that is the kind of situation calling for governmental regulation. Basic preparedness and rapid response mecha‐ nisms should be in place. Leishmaniasis cases should be detected early and reaction should be quick. In epidemic‐prone areas and before the anticipated outbreak season, the responsibilities of the outbreak task force members should be defined; the necessary needs for response, surveillance, and control should be assessed; the surveillance system should be reinforced; criteria for epidemic alert should be set up; and all health facilities should be provided with minimum stocks of basic diagnostic and treatment supplies. Successful preventive measures should include regular veterinary checks of all imported dogs and dogs traveling outside the country, vector control, use of effective repellents, sleeping indoors with nets on the windows, and antileishmanial vaccination of dogs.

**Keywords:** leishmaniasis, CanL, Phlebotomine, visceral leishmaniasis, *L. infantum*, *P. perniciosus*
