A newly emerged cutaneous leishmaniasis focus in northern Israel and two new reservoir hosts of Leishmania major

• Published in: PLoS neglected tropical diseases Vol. 7; no. 2; p. e2058
• Main Authors: Faiman, Roy, Abbasi, Ibrahim, Jaffe, Charles, Motro, Yoav, Nasereddin, Abdelmagid, Schnur, Lionel F, Torem, Moshe, Pratlong, Francine, Dedet, Jean-Pierre, Warburg, Alon
• Format: Journal Article
• Language: English
• Published: United States Public Library of Science 01.02.2013; Public Library of Science (PLoS)
• Subjects: Agriculture; Alfalfa; Animals; Arvicolinae - parasitology; Biology; Deoxyribonucleic acid; Dermatology; Diagnosis; Disease Reservoirs; Distribution; DNA; DNA, Protozoan - genetics; DNA, Protozoan - isolation & purification; DNA, Ribosomal Spacer - genetics; DNA, Ribosomal Spacer - isolation & purification; Emerging diseases; Experiments; Farming; Female; Gerbillinae - parasitology; Human health and pathology; Humans; Infections; Infectious diseases; Insecticides; Insects; Israel - epidemiology; Leishmania major - genetics; Leishmania major - isolation & purification; Leishmaniasis, Cutaneous; Leishmaniasis, Cutaneous - epidemiology; Leishmaniasis, Cutaneous - parasitology; Life Sciences; Medicine; Microbiology and Parasitology; Military personnel; Organic farming; Parasites; Parasitic diseases; Parasitology; Phlebotomus - parasitology; Rodents; Sand & gravel; Studies; Tropical diseases; Vector-borne diseases; Israel; Asia; Animals; Leishmaniasis, Cutaneous; DNA, Ribosomal Spacer; Gerbillinae; Phlebotomus; Humans; Arvicolinae; Female; Disease Reservoirs; Israel; DNA, Protozoan; Leishmania major
• ISSN: 1935-2735; 1935-2727; 1935-2735
• DOI: 10.1371/journal.pntd.0002058

In 2006/7, 18 cases of cutaneous leishmaniasis (CL) were reported for the first time from Sde Eliyahu (pop. 650), a village in the Beit She'an valley of Israel. Between 2007-2011, a further 88 CL cases were diagnosed bringing the total to 106 (16.3% of the population of Sde Eliyahu). The majority of cases resided in the south-western part of the village along the perimeter fence. The causative parasite was identified as Leishmania major Yakimoff & Schokhor, 1914 (Kinetoplastida: Trypanosomatidae). Phlebotomus papatasi (Scopoli), 1786 (Diptera: Psychodidae) was found to be the most abundant phlebotomine species comprising 97% of the sand flies trapped inside the village, and an average of 7.9% of the females were positive for Leishmania ITS1 DNA. Parasite isolates from CL cases and a sand fly were characterized using several methods and shown to be L. major. During a comprehensive survey of rodents 164 Levant voles Microtus guentheri Danford & Alston, 1880 (Rodentia: Cricetidae) were captured in alfalfa fields bordering the village. Of these 27 (16.5%) tested positive for Leishmania ITS1 DNA and shown to be L. major by reverse line blotting. A very high percentage (58.3%-21/36) of Tristram's jirds Meriones tristrami Thomas, 1892 (Rodentia: Muridae), found further away from the village also tested positive for ITS1 by PCR. Isolates of L. major were successfully cultured from the ear of a wild jird found positive by ITS1 PCR. Although none of the wild PCR-positive voles exhibited external pathology, laboratory-reared voles that were infected by intradermal L. major inoculation, developed patent lesions and sand flies became infected by feeding on the ears of these laboratory-infected voles. This is the first report implicating M. guentheri and M. tristrami as reservoirs of Leishmania. The widespread co-distribution of M. guentheri and P. papatasi, suggests a significant threat from the spread of CL caused by L. major in the Middle East, central Asia and southern Europe.