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Cutaneous leishmaniasis incidence in Israel increased 10-fold from 2001-2012
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After a 15-year period of decreased incidence of cutaneous leishmaniasis in Israel, a recent resurgence of the disease appears to have occurred in the southern, central and northern parts of the country, according to recent findings.
In the study, researchers evaluated surveillance data on cutaneous leishmaniasis conducted by the Israeli Ministry of Health. A computerized notification system compiled information on cases, with reports generated for 15 regional health districts across Israel. The researchers assessed all cases of recent onset cutaneous leishmaniasis from January 2001 to December 2012. Reviewed cases only included the civilian population, not the Israeli military. The researchers used annual population estimates to arrive at the denominators used to calculate crude and specific incidence rates per 100,000 persons based on age, population group and district.
The researchers found there were 2,061 reported cases of cutaneous leishmaniasis during the study period. Fifty-eight percent of affected patients were men, 93.8% were Jewish, and the mean age at onset was 31.1 years. More than 42% of all cases occurred from 2010 to 2012. Additionally, more than 40% of the patients resided in the southern district/Negev region.
The incidence of cutaneous leishmaniasis in Israel increased 10-fold from 2001 through 2012, from 0.4 to 4.4 per 100,000 population. During this time, the mean annual incidence rose by 0.36 per 100,000 population. This appeared to be reflective of the expansion of the disease into central and northern regions of Israel, where cutaneous leishmaniasis prevalence previously had been low. The national incidence rates peaked in 2007-2008, due to an increase in cutaneous leishmaniasis in the southern health district. A new outbreak occurred toward the end of 2012 in Carmiel in the Akko subdistrict.
Many of the outbreaks of cutaneous leishmaniasis in Israel’s northern region appeared to be caused by Leishmania tropica parasites, which had not been associated with prior cutaneous leishmaniasis outbreaks. This increasing emergence of L. tropica was consistent with cutaneous leishmaniasis cases in other countries in the Mediterranean Basin and in other parts of Asia.
According to the researchers, additional research is needed to understand the resurgence of cutaneous leishmaniasis in Israel and on a global level.
“Further study of the factors affecting [cutaneous leishmaniasis] transmission is needed, as are the following: development of effective methods to control [cutaneous leishmaniasis] infection, an increase in health professionals’ awareness of the disease, and a greater degree of public alertness.” the researchers wrote. “Intensive public education regarding control measures in areas of known [cutaneous leishmaniasis] foci is required.”
Disclosure: The researchers report no relevant financial disclosures.
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