Localized Cutaneous Leish Maniasis

LOCALIZED CUTANEOUS LEISH MANIASIS

EPIDEMIOLOGY

The disease is a zoonotic infection of tropical and subtropical rodents. It is particularly com-mon in areas of Central Asia, the Indian subcontinent, Middle East, Africa, the Mediter-ranean littoral, and Central and South America. In the latter area, L. mexicana infects several species of arboreal rodents. Humans become involved when they enter forested areas to har-vest chicle for chewing gum and are bitten by infected sandflies. In the eastern hemisphere, the desert gerbil and other burrowing rodents serve as the reservoir hosts of L. tropica. Human infection occurs when rural inhabitants come in close contact with the burrows of these animals. In the Mediterranean area, southern Russia, and India, human disease in-volves urban dwellers, primarily children. In this setting, the domestic dog serves as the reservoir, although sandflies may also transmit L. tropica directly from human to human.