Leishmaniases and the Cyprus paradox

Abstract

In Cyprus, leishmaniasis has been considered exclusively a veterinary problem. It was prevalent before 1945, and until its recent reemergence, it was nearly eradicated by 1996 as a consequence of the destruction of reservoir hosts and vectors. A survey carried out to provide an unbiased estimate of current transmission rates in dogs and humans showed a 9-fold increase in dog seroprevalence (reaching 14.9%) compared with 10 years ago. However, no human cases caused by Leishmania infantum were detected, although L. donovani cases were reported recently. The 62 strains isolated from dogs were typed as L. infantum MON-1 (98.4%), which is the predominating zymodeme in the Mediterranean region, and MON-98 (1.6%). The Phlebotomus species P. tobbi (vector of L. infantum in Cyprus), P. galilaeus, and P. papatasi were the predominant species captured. Two transmission cycles seem to run in parallel in Cyprus: in dogs with L. infantum and in humans with L. donovani.

Figure 1.

Map of Cyprus showing dog seropositivity (%) caused by L. infantum in the 30 squares studied (the boundaries of the selected villages in each square are shown). CL and VL, both caused by L. donovani MON-37, and the presence of the main Phlebotomus spp. caught in the four prefectures are shown.

Figure 2.

Map of Southwestern Cyprus showing the location of the three villages where the three human CL cases occurred as well as the village of Mesana, where the fourth CL individual was probably infected; the presence of the main Phlebotomus spp. is also shown.