In recent decades, there has been an alarming increase in cases of tropical mosquito-borne diseases such as dengue fever and malaria in Europe. Climate directly affects the spread and distribution of pathogen-transmitting insects, as their life cycle and survival are linked to temperature and humidity.
Read also: Leishmaniasis – Kalazar: The dangerous bite of the mosquito – Permanent enemy for pets and humans
Leishmaniasis (kalazar) is one of the tropical diseases that is spreading due to global warming and is included in the list of neglected tropical diseases of the World Health Organization (WHO). It is a group of diseases caused by the parasite Leishmania infantum, transmitted by the bite of mosquitoes. These insects are smaller and hairier than mosquitoes.
Leishmaniasis has a number of different symptoms. In their cutaneous form, the disease causes sores on the skin that can develop into painful ulcers, and the mucocutaneous variant affects the membranes of the nose, mouth and throat, causing sores.
However, the most severe is the visceral form, which affects internal organs such as the liver and spleen, causing fever, weight loss and anemia. If not treated in time, it can even cause death.
Unlike other tropical infections, it is present in southern European countries as a zoonosis, meaning it is transmitted to humans through contact with animals. One of the carriers of the parasite are dogs. The people most at risk are young children and immunocompromised patients.
Terrible spread in Europe
In recent years, there has been an increase in cases in areas of Europe where the disease is endemic, such as Portugal, Northern Italy, Greece and the Balkans.
However, a recent survey conducted by the European Center for Disease Prevention and Control (ECDC) revealed that reporting of leishmaniasis cases is not mandatory in all countries with locally transmitted cases and that few countries monitor or control infections in animals or humans.
The lack of preparation on the part of European governments has contributed significantly to the spread of the disease. The increase in cases has been directly linked to global warming: it is estimated that an average increase of one degree in air temperature leads to a significant increase in leishmaniasis cases.
Warmer conditions increase the survival and mobility of gnats, the density of their populations, the number of bites and the growth of the parasite within them. Hotter summers extend the period of transmission and the risk of infection of the hosts, be they humans or dogs.
Global warming is also encouraging northward movement of populations, leading to local transmission from imported cases to areas where the disease was not previously endemic. Currently, the midges are already widespread throughout the Iberian Peninsula, northern Italy and the Balkans, but have reached as far as Germany. Further expansion is expected in the coming years.
The biggest risk is actually the movement of millions of tourists from the north to the Mediterranean coast. This affects not only humans, but also pets: a large number of infected dogs live in non-endemic areas and can become the source of the parasite that creates the contagion.
Another factor associated with the rise of leishmaniasis in Europe is the increase in the number of immunocompromised individuals. As in the 1990s, when co-infection with HIV and Leishmania led to a resurgence of leishmaniasis in southern Europe, many new cases are found in people who have had organ transplants or are receiving immunosuppressive therapy. These conditions increase their susceptibility to developing the disease in case of infection.
For example, an outbreak of leishmaniasis was identified in Sweden among immunocompromised patients who had visited the Mediterranean coast, highlighting the high rate of transmission. Without this vulnerability of patients, these cases might well have gone completely unnoticed.
An additional threat is the parasite’s apparently increasing resistance to the few drug treatments available. In Europe, it is common to treat dogs suffering from leishmaniasis, but treatment is not always successful and animals may relapse. This leads the parasite to develop resistance over time, which also affects treatment in humans.
Change of mindset
We need to understand that leishmaniasis is a growing public health concern in Europe, the Conversation article points out. Therefore, taking measures to reduce and control it is imperative.
Measures include monitoring cases in humans and dogs and monitoring the spread of mosquitoes, the parasite’s resistance to drugs and its emergence in previously non-endemic areas.
Governments have the opportunity to take proactive, rather than reactive, measures. This will allow them to limit the spread of the disease and be ready to face any challenges.
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