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What people say makes us excited::
http://www.baxterbulletin.com/apps/pbcs.dll/article?AID=/20041130/NEWS01/411300308/1002/NEWS01
Many soldiers in Iraq are dealing with a little-known parasite called Cutaneous Leishmaniasis that causes chronic festering sores. This condition affects the skin and is caused by sand fly bites that deposit the parasite in the skin, eventually causing weeping sores that are difficult to heal.
Troops have been trying to protect themselves from fleas and sand flies by using flea collars that are sold for dogs and cats, according to a press release from the American Legion. They hang them on their belts, tie them to their shoes and also attach them to the bottoms of their sleeping cots for protection. It is important that the collars not contain liquid inside the collar.
The American Legion Auxiliary is donating postage for shipping a box of flea deterrents and donating as many as they can collect.
If the public would like to purchase flea collars or tags, the American Legion will collect them at the American Legion Alley-White Post 52 Hall, 717 Market St., any Tuesday afternoon, Friday evening and Saturday morning until 11:30 a.m.
Donations to purchase these items also will be accepted at these times.
It has been reported by Lt. Col. Peter Weina of the Walter Reed Institute of Research that lesions have been measured up to 3 inches in diameter and occur on the face, hands and over joints. Many of these lesions take up to a year to heal. They are disfiguring if on the face and can limit movement of the hands if located over a joint.
The sand flies that have been tested exhibit some extraordinary infection rates, thus most servicemen are being exposed to this violent bacteria, according to the news release. Since the only U.S. Military hospital where treatment can be offered is the Walter Reed Army Medical Center, treatment is difficult.
Ear tag insecticides reserved for cattle and horses also are being used, according to the American Legion. They are time released, last for three to four months and can be purchased at farm service supply stores.
Originally published November 30, 2004
Parasites and Bug Spit
By Josie Glausiusz
DISCOVER Vol. 15 No. 08 | August 1994 | Biology & Medicine
Sand flies transmit a deadly parasite, and also spit. The parasite needs the spit--which suggests a new approach to a vaccine.
Leishmaniasis, a parasitic disease transmitted by sand flies, is not a scourge in the United States, but it is elsewhere. An estimated 12 million people worldwide are infected with Leishmania, the genus of protozoan parasites that cause the disease. Although some species of Leishmania produce no more than pimples, others are lethal: in the southern Sudan alone, for instance, leishmaniasis has killed as many as 100,000 people in the past decade, as villagers fleeing a civil war have taken refuge in forests that are sand-fly breeding grounds. A species of Leishmania found in the Amazon basin has been known to eat away the entire face of its victim, until he starves to death or suffocates, sometimes many years after the initial infection. In part because leishmaniasis takes so many different forms, researchers have been unable to develop an effective vaccine against it.
But now Richard Titus, a cellular immunologist at the Harvard School of Public Health, thinks he may have found the parasite’s Achilles’ heel. He and his co-workers, including José Ribeiro of the University of Arizona, have discovered that all species of Leishmania seem to depend for their survival on a particular protein in sand-fly saliva. The researchers have even produced a vaccine against the protein that offers protection against the parasite--at least to mice.
Sand flies, Titus explains, are more than just flying syringes for drawing blood. When a sand fly jabs a human, it dribbles saliva into the wound. The saliva contains a protein called erythema-inducing factor, or EIF, which dilates the blood vessels (an erythema is the red spot around a bug bite), as well as a second protein that keeps the blood from clotting. EIF itself also suppresses the human immune response that might otherwise disable both proteins. The benefit of all this to the sand fly is that it keeps the blood meal flowing freely.
A few years ago Titus showed that Leishmania benefits from sand- fly saliva too. In fact, the parasite can’t do without it. When Titus injected mice with parasites--but not with saliva--the mice emerged from the assault free of disease. Recently, Titus has found that the key to the parasite’s well-being is EIF. In protecting itself from an immune response, EIF protects the parasite too.
More precisely, it allows Leishmania to thrive inside macrophages, the scavenger cells that normally engulf and destroy foreign invaders. To do its job, a macrophage must release signal proteins that activate other immune cells (T cells), prompting them to secrete another signal protein (interferon), which tells the macrophage to kill the parasite inside it. EIF somehow prevents the macrophage from stimulating T cells, and also from making hydrogen peroxide and nitric oxide, the toxic molecules that would normally kill the parasite. Far from being destroyed, the parasite multiplies inside the macrophage. It then infects other macrophages.
Titus’s vaccine is designed to defeat the parasite by blocking the action of EIF. The vaccine consists simply of EIF itself, mutated so that it no longer has its immunosuppressive power. In a recent experiment, Titus injected the vaccine into mice and found that they produced antibodies against EIF. When he later injected them with parasites and sand-fly saliva, one out of every five mice developed no symptoms at all. The rest developed lesions that were half the size and contained one- twentieth the number of parasites found in unvaccinated animals. Considering that Titus had injected up to a million parasites into each mouse--10,000 times as many as a sand fly normally transmits--his vaccine was a great success.
Next he plans to test it in dogs and monkeys--and eventually, if all goes well, in humans. If we had circulating antibodies in our blood and in our skin, they would neutralize EIF as it entered our body, says Titus. That would be very bad news for the parasite. And the beauty of this is it doesn’t matter what form of Leishmania the sand fly is carrying- -you’re going to be resistant to it.
In the United States, Leishmania afflicts only people who caught it abroad--Gulf War veterans, for instance. But that doesn’t mean Titus’s research on insect saliva doesn’t have implications close to home. He has recently found that a protein in the spit of deer ticks also suppresses the human immune response. Deer ticks transmit Lyme disease.
http://www.cdc.gov/ncidod/dpd/parasites/leishmania/factsht_leishmania.htm
People who have cutaneous leishmaniasis have one or more sores on their skin. The sores can change in size and appearance over time. They often end up looking somewhat like a volcano, with a raised edge and central crater. Some sores are covered by a scab. The sores can be painless or painful. Some people have swollen glands near the sores (for example, under the arm if the sores are on the arm or hand).
People who have visceral leishmaniasis usually have fever, weight loss, and an enlarged spleen and liver (usually the spleen is bigger than the liver). Some patients have swollen glands. Certain blood tests are abnormal. For example, patients usually have low blood counts, including a low red blood cell count (anemia), low white blood cell count, and low platelet count.
The number of new cases of cutaneous leishmaniasis each year in the world is thought to be about 1.5 million. The number of new cases of visceral leishmaniasis is thought to be about 500,000.
Leishmaniasis is found in parts of about 88 countries. Approximately 350 million people live in these areas. Most of the affected countries are in the tropics and subtropics. The settings in which leishmaniasis is found range from rain forests in Central and South America to deserts in West Asia. More than 90 percent of the world's cases of visceral leishmaniasis are in India, Bangladesh, Nepal, Sudan, and Brazil.
Leishmaniasis is found in some parts of the following areas:
Leishmaniasis is not found in Australia or Oceania (that is, islands in the Pacific, including Melanesia, Micronesia, and Polynesia).
Probably not. It is possible but very unlikely that you would get leishmaniasis in the United States. Very rarely, people living in rural southern Texas have developed skin sores from cutaneous leishmaniasis.
No cases of visceral leishmaniasis are known to have been acquired in the United States.
Leishmaniasis is spread by the bite of some types of phlebotomine sand flies. Sand flies become infected by biting an infected animal (for example, a rodent or dog) or person. Since sand flies do not make noise when they fly, people may not realize they are present. Sand flies are very small and may be hard to see; they are only about one-third the size of typical mosquitoes. Sand flies usually are most active in twilight, evening, and night-time hours (from dusk to dawn). Sand flies are less active during the hottest time of the day. However, they will bite if they are disturbed, such as when a person brushes up against the trunk of a tree where sand flies are resting. Rarely, leishmaniasis is spread from a pregnant woman to her baby. Leishmaniasis also can be spread by blood transfusions or contaminated needles.
People of all ages are at risk for leishmaniasis if they live or travel where leishmaniasis is found. Leishmaniasis usually is more common in rural than urban areas; but it is found in the outskirts of some cities. The risk for leishmaniasis is highest from dusk to dawn because this is when sand flies are the most active. All it takes to get infected is to be bitten by one infected sand fly. This is more likely to happen the more people are bitten, that is, the more time they spend outside in rural areas from dusk to dawn. Adventure travelers, Peace Corps volunteers, missionaries, ornithologists (people who study birds), other people who do research outdoors at night, and soldiers are examples of people who may have an increased risk for leishmaniasis (especially cutaneous leishmaniasis).
People with cutaneous leishmaniasis usually develop skin sores within a few weeks (sometimes as long as months) of when they were bitten.
People with visceral leishmaniasis usually become sick within several months (rarely as long as years) of when they were bitten.
Yes, it can be. The skin sores of cutaneous leishmaniasis will heal on their own, but this can take months or even years. The sores can leave ugly scars. If not treated, infection that started in the skin rarely spreads to the nose or mouth and causes sores there (mucosal leishmaniasis). This can happen with some of the types of the parasite found in Central and South America. Mucosal leishmaniasis might not be noticed until years after the original skin sores healed. The best way to prevent mucosal leishmaniasis is to treat the cutaneous infection before it spreads.
If not treated, visceral leishmaniasis can cause death.
See your health care provider, particularly if you have traveled to an area where leishmaniasis is found and you have developed skin sores that aren't healing. Be sure to tell your health care provider where you have traveled and that you might be at risk for leishmaniasis.
It is very rare for travelers to get visceral leishmaniasis.
The first step is to find out if you have traveled to a part of the world where leishmaniasis is found. Your health care provider will ask you about any signs or symptoms of leishmaniasis you may have, such as skin sores that have not healed. If you have skin sores, your health care provider will likely want to take some samples directly from the sores. These samples can be examined for the parasite under a microscope, in cultures, and through other means. A blood test for detecting antibody (immune response) to the parasite can be helpful, particularly for cases of visceral leishmaniasis. However, tests to look for the parasite itself should also be done. CDC staff can help with the laboratory testing. Diagnosing leishmaniasis can be difficult. Sometimes the laboratory tests are negative even if a person has leishmaniasis.
Your health care provider can talk with CDC staff about whether your case of leishmaniasis should be treated, and, if so, how. Most people who have cutaneous leishmaniasis do not need to be hospitalized during their treatment.
The best way for travelers to prevent leishmaniasis is by protecting themselves from sand fly bites. Vaccines and drugs for preventing infection are not yet available. To decrease their risk of being bitten, travelers should:
NOTE: Bed nets, repellents containing DEET, and permethrin should be purchased before traveling and can be found in hardware, camping, and military surplus stores.
Yes. Some people have had cutaneous leishmaniasis more than once. Therefore, you should follow the preventive measures listed above whenever you are in an area where leishmaniasis is found.
Herwaldt BL. Leishmaniasis. Lancet 1999;354:1191-9.
Herwaldt BL, Stokes SL, Juranek DD. American cutaneous leishmaniasis in U.S. travelers. Ann Intern Med 1993;118:779-84.
Berman JD. Human leishmaniasis: clinical, diagnostic, and chemotherapeutic developments in the last 10 years. Clin Infect Dis 1997;24:684-703.
Desjeux P. Leishmaniasis: public health aspects and control. Clin Dermatol 1996;14:417-23.
This fact sheet is for information only and is not meant to be used for self-diagnosis or as a substitute for consultation with a health care provider. If you have any questions about the disease described above or think that you might have a parasitic infection, consult a health care provider.
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