DRAMATIC INCREASE IN LABORATORY DIAGNOSED HUMAN CUTANEOUS LEISHMANIASIS CASES IN SOUTHERN ISRAEL, 2007-2013

Shalom Ben-Shimol 1,2 Orli Sagi 2,3 Shlomi Codish 2,4 Victor Novack 2,4 Chiya Barrett 2 Yariv Fruchtman 2 Anat Berkowitz 2,3 Yonat Shemer Avni 2 David Greenberg 1,2
1Pediatric Infectious Disease Unit, Soroka University Medical Center, Beer Sheva
2Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva
3Parasitology Laboratory, Soroka University Medical Center, Beer Sheva
4Clinical Research Center, Soroka University Medical Center, Beer Sheva

Background: Cutaneous leishmaniasis (CL) is an endemic zoonosis in southern Israel. In recent years, substantial urbanization is taking place in this region. Introduction of populations into endemic foci was previously reported to facilitate human CL outbreaks.

Our aim was to describe a continuous CL outbreak in southern Israel, through laboratory reports of CL diagnosis.

Methods: The Soroka University Medical Center Parasitology laboratory is the major laboratory confirming CL cases in our region. Data regarding patients referred to the hospital for CL diagnosis were retrospectively collected. Cases were defined by microscopic findings of skin lesions biopsies.

Results: Annual number of cases sent for CL laboratory confirmation increased from a mean of 77±9 in the years 2007-2010 to 178, 327 and 528 in the years 2011, 2012 and 2013, respectively. The respective increase in annual CL confirmed/positive cases was from 36±12 to 117, 171 and 282, leading to respective increase in CL rate (per 100,000) from 5.8±1.9 to 18.4, 26.3 and 42.7. The outbreak was mainly (>60%) observed in the north-west area of the region.

Conclusions: In conclusion, a seven-fold increase in laboratory-confirmed CL was observed in southern Israel in 2007-2013, probably reflecting a bigger outbreak, possibly related to urban expansion bordering with CL foci.









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