Leishmaniasis

Background

Leishmaniasis is a disease caused by a parasite and spread by the bite of infected sand flies. It is found throughout tropical areas worldwide, including Southwest Asia. There are several different forms of leishmaniasis. Most common is the skin form (cutaneous leishmaniasis), which causes scarring skin sores. The internal form (visceral leishmaniasis) affects internal organs and is the most serious form.

Sandflies that transmit leishmaniasis in Southwest Asia are active from March through November. Sandflies bite at any time, but they prefer to bite at night. Although it is not possible to prevent all sandfly bites, Service members can do much to protect themselves by limiting opportunities that sand flies have to bite exposed skin. While effective treatment is available, prevention remains the best option.

Below, we have provided information on leishmaniasis including clinical guidance, policies and directives, training material, and other resources, to assist healthcare providers and Service members and their families.

Table of Contents

• Policies and Directives
  • DoD / Joint Forces
  • Army
  • Air Force
  • Navy / Marines
  • VA (Veterans Administration)
• Clinical Guidance
• Forms and Measures
• Fact Sheets
• Other Related Information
• Education and Training
• Research
• Related Links

Policies and Directives

DoD / Joint Forces

• CENTCOM Memorandum, CENTCOM Policy on Cutaneous Leishmaniasis Diagnosis and Treatment, 15 Nov 04
  
  
• ASD Memorandum, Medical Advisory - Leishmaniasis, 12 Sep 03
  
  

Army

• MEDCOM Memorandum, Guidance for the Management of Suspected Cutaneous Leishmaniasis, 22 Nov 10 (Document is accessible on AKO)
• OTSG Information Paper, Leishmaniasis and Other Parasitic Diseases Among OIF/OEF Soldiers, 29 Mar 06
  
  
• OTSG Information Paper, Emerging Health Issues: Leishmaniasis among Soldiers in OIF/OEF, 28 Apr 05
  
  
• OTSG Executive Summary - Update - Leishmaniasis Among US Military Personnel in Southwest Asia, 16 Mar 04
  
  

Air Force

• AETC Memorandum, Medical Advisory - Leishmaniasis, 10 Dec 03 (including Hdqs USAF/SGO Memorandum, Medical Advisory - Leishmaniasis, 17 Nov 03)

Navy / Marines

VA (Veterans Administration)

• IL 10-2004-03, Under Secretary for Health's Information Letter, Guidance for the Diagnosis and Treatment of Leishmania Infection, 6 Oct 04

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Clinical Guidance

• Walter Reed Army Institute of Research (WRAIR) Leishmaniasis Diagnostics Laboratory
  
  
• Leishmaniasis Diagnostic Services Available Through WRAIR, 28 Jul 09



• MEDCOM Memorandum, Guidance for the Management of Suspected Cutaneous Leishmaniasis, 22 Nov 10 (Document is accessible on AKO)
  
  
• Cutaneous Leishmaniasis in OIF/OEF Soldiers, Leishmaniasis Working Group PowerPoint Presentation, Jul 09


• CDC Leishmaniasis Resources for Health Professionals


• Review: Leishmaniasis in the United States: Treatment in 2012, Am J Trop Med Hyg 2012 Abstract 86:434-440
• Old World Leishmaniasis: An Emerging Infection Among Deployed US Military and Civilian Workers, Clinical Infectious Diseases 2004; 39: pages 1674-80
  
  
• Cutaneous Leishmaniasis: Battling the Baghdad Boil, Federal Practitioner, Mar 04 pages 59-67
  
  
• USAPHC Technical Guide 273, Diagnosis and Treatment of Diseases of Tactical Importance to U.S. Central Command, Oct 05
  
  
• Medscape E-Medicine Article on Leishmaniasis, 16 Aug 10
  
  
• Medscape E-Medicine Article on Pediatric Leishmaniasis, 10 Aug 11
  
  
• Leishmaniasis Overview, Tulane University
  
  
• CDC Leishmaniasis Laboratory Identification
  
  
• Update: Cutaneous Leishmaniasis in US Military Personnel - Southwest/Central Asia, 2002-2004, MMWR 53(12) Pages 264-265; April 2, 2004
  
  
• Two Cases of Visceral Leishmaniasis in US Military Personnel - Afghanistan, 2002-2004, MMWR 53(12) Pages 265-268; April 2, 2004
  
  
• Cutaneous Leishmaniasis in US Military Personnel - Southwest/Central Asia, 2002-2003, MMWR 52(42) Pages 1009-1012; October 24, 2003
  
  
• Information on Pentostam® Injection (sodium stibogluconate)
  (Pentostam is a well-established antileishmanial agent that is used in many countries of the world. It is administered under an IND protocol at Walter Reed Army Medical Center and Brooke Army Medical Center and is available to U.S. licensed physicians under an IND protocol through the CDC.)
  
  
  • CDC Lesihmaniasis Guidance
  
  
  • GlaxoSmithKline United Kingdom, Pentostam® Injection
  
  
  • Guidance for Administration
  
  
  • Package Leaflet: Information for the User

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Forms and Measures

• Forms and Measures
  
  

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Fact Sheets

• USAPHC Just the Facts - Leishmaniaisis, Jan 10


• Leishmaniasis Information for Clinicians, 11 Aug 09


• Leishmaniasis Information for Service Members, 21 Jun 04
  
  
• Preventing Leishmaniasis For Servicemembers and Their Families Fact Sheet, 1 Jun 07
  
  
• OIF Redeployment Medical Guide Trifold, 20 Apr 03
  
  
• USAPHC Pocket Card , Entomology: Leishmaniasis Card, 04
  
  
• USAPHC Pocket Card, Entomology: Defend Yourself Against Sand Flies, Nov 10
  
  
• USAPHC Pocket Card, Entomology: DoD Insect Repellent System Card, Jun 12
  
  
  • USAPHC Fact Sheet, DoD Insect Repellent System, Jun 07


• AFPMB (Armed Forces Pest Management Board), Protect Yourself Against Biting Insects, Feb 01
  
  

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Other Related Information

• US Army Medical Materiel Command, Arthropod Vector Rapid Detection Devices (AV-RDD) (Real-time 'dipstick' assays for use by preventive medicine personnel in determining where mosquitoes and sand flies are infected with malaria, dengue, and leishmaniasis in an area of operations.)
  
  
  • Article, 11 Jun 12
  
  
  • Video 10 Jul 12
  
  
  • Leishmania AV-RDD Video, 8 Jun 12
  
  
  
• AFHSC Leishmaniasis Annual Report 2002-2011



• US Army Web Page Article, FDA Approves Test for Diagnosing Leishmaniasis Caused by Sand Flies, 7 Jun 11



• US Food and Drug Administration (FDA) Center for Devices and Radiological Health (CDRH) Clearance of SMART Leish PCR Assay through the Premarket Notification process [510(k)], 25 May 11 (Premarket notification including description of assay and FDA clearance letter.)



• Washington Post Article, Sand Flies Infect U.S. Forces with Parasite That Leaves Them With 'Baghdad Boil’. 22 Jun 10 (Includes video of Life Cyle of a Sand Fly)



• Cutaneous Leishmaniasis in Pakistan, Dermatology Online Journal Vol 11 No 1, 2005



• Spread of Vector-borne Diseases and Neglect of Leishmaniasis, Europe, Emerg Infect Dis Vol 14 Number 7 July 2008



• Leishmaniasis in Relation to Service in Iraq/Afghanistan, US Armed Forces, 2001-2006, AMSA Medical Surveillance Monthly Report, Vol 14 No 1, Apr 07
  
  
• Leishmaniasis Registry, PowerPoint Presentation to Armed Forces Epidemiological Board, 23 May 06
  
  
• Leishmaniasis Among US Armed Forces, January 2003-November 2004, AMSA Medical Surveillance Monthly Report Vol 10 No 6, Nov/Dec 04
  
  
• Leishmaniasis, US Armed Forces, 2003, AMSA Medical Surveillance Monthly Report Vol 10 No 1, Jan/Feb 04
  
  
• USAPHC, DoD Insect Repellent System Page
  
  

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Education and Training

• Cutaneous Leishmaniasis in OIF/OEF Soldiers, Leishmaniasis Working Group PowerPoint Presentation, Jul 09



• Leishmaniasis Diagnostic Scraping Video
  
  
• Deployment Health Clinical Training Series, Leishmaniasis, 29 Jan 04
  • Training Document
  • Slide Presentation
  • Video
    
    

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  Research

  • Lipsosomal Amphotericin B for Treatment of Cutaneous Leishmaniasis, Am J Trop Med Hyg 2010 83: 1028-1033
  
  
  
  • A Randomized Controlled Trial of Local Heat Therapy Versus Intravenous Sodium Stibogluconate for the Treatment of Cutaneous Leishmania major Infection, PLoS Neglected Tropical Diseases, 2010; 4 (3): e628. doi:10.1371/journal.pntd.0000628
  
  
  
  • ClinicalTrial.gov # NCT00657618, Department of Defense Protocol for the Use of Sodium Stibogluconate (Pentostam) as a Treatment for Leishmaniasis (Start date Oct 04, Estimated completion date Oct 09)
  
  
  
  • Institute of Medicine, Gulf War and Health Reports: Volume 5 Infectious Disease, 16 Oct 06
    
    
  • Leishmania: risk to the blood supply, Commentary in Transfusion, Vol 46, Sep 06
    
    
  • Visceral Leishmaniasis: New Health Tools Are Needed, PLoS Med 2(7): e211, Jul 05
    
    
  • National Institute of Allergy and Infectious Diseases (NIAID) Leishmaniasis Research
  
  
  
  • WHO/TDR (Tropical Disease Research) Visceral Leishmaniasis
    
    

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  Related Links

  • AFPMB (Armed Forces Pest Management Board)
  
  
  
  • CDC Division of Parasitic Diseases - Leishmaniasis
  
  
  
  • CDC Traveler’s Health – Yellow Book
    
    • Cutaneous Leishmaniasis
    • Visceral Leishmaniasis
    
    
  
  
  • Medline Plus
    • Medical Encyclopedia, Leishmaniasis
    • Health Topics, Leishmaniasis
  
  
  • WHO Leishmaniasis
    
    
  • LeishRisk (LeishRisk is a European Union-funded project which aims to network the EU-funded projects working on leishmaniasis; promote dissemination of their findings relevant for improved surveillance and control of leishmaniasis at a regional scale; and prepare future joined actions.)
  
  
  
  • The Canine Leishmaniasis Web Site

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