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

PLoS Negl Trop Dis. 2013;7(2):e2058. doi: 10.1371/journal.pntd.0002058. Epub 2013 Feb 21.

Abstract

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.

Publication types

  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Animals
  • Arvicolinae / parasitology*
  • DNA, Protozoan / genetics
  • DNA, Protozoan / isolation & purification
  • DNA, Ribosomal Spacer / genetics
  • DNA, Ribosomal Spacer / isolation & purification
  • Disease Reservoirs*
  • Female
  • Gerbillinae / parasitology*
  • Humans
  • Israel / epidemiology
  • Leishmania major / genetics
  • Leishmania major / isolation & purification*
  • Leishmaniasis, Cutaneous / epidemiology*
  • Leishmaniasis, Cutaneous / parasitology
  • Phlebotomus / parasitology

Substances

  • DNA, Protozoan
  • DNA, Ribosomal Spacer

Grants and funding

This research was supported by a grant from the Deployed War-Fighter Protection (DWFP) Research Program, funded by the U.S. Department of Defense through the Armed Forces Pest Management Board (AFPMB) and grant No. SCHO 448/8-2 from the Deutsche Forschungsgemeinschaft (DFG): “Emergence of Cutaneous Leishmaniasis due to Leishmania tropica and L. major in The Palestinian Authority and Israel”. Additional funding was provided by The Israel Science Foundation (grant No. 135/08). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.