THE HEMOFLAGELLATES 



69 



and Rollo (1955) reviewed the chemother- 

 apy of leishmaniosis briefly. 



Control : Prevention of leishmanial 

 infections depends on breaking the life 

 cycle by elimination of sandflies. This 

 can be done by residual spraying of houses, 

 barns and outside resting places with DDT 

 or other chlorinated hydrocarbon insecti- 

 cides (Hertig, 1949; Corradetti, 1954; 

 Deane, 1958). In addition, insect repel- 

 lents such as dimethylphthalate can be 

 rubbed on the skin, houses can be screened 

 with very fine mesh wire, and decaying 

 vegetation and other breeding places can 

 be cleaned up. 



In regions where kala-azar is a 

 zoonosis, treatment of infected dogs and 

 destruction of strays will eliminate the 

 reservoir of infection for man. 



LEISHMANIA TROPICA 

 (WRIGHT, 1903) 

 LUHE, 1906 



Synonyms : Helcosoma tropicnm, 

 Sporozoa furuncidosa, Ovoplas»ia orien- 

 tale, Plasmosoma jericiiaense, Leish- 

 mania wrighti, L. Cunningham i, L. nilo- 

 tica, L. recidiva, L. brasilieiisis, L. 

 peruviana. 



Disease : Cutaneous leishmaniosis, 

 mucocutaneous leishmaniosis, Oriental 

 sore, Aleppo button, Jericho boil, Delhi 

 boil, espundia, uta, chiclero ulcer, buba, 

 plan bois, American forest leishmaniosis. 



Hosts : The usual hosts are man, the 

 dog and, in parts of the Old World, gerbils 

 {Rhombomys opimus) and other wild ro- 

 dents. 



Location : L. tropica occurs in the 

 monocytes and other cells of the reticulo- 

 endothelial system, in cutaneous lesions 

 and in the skin. It may also occur in the 

 lymph nodes and in the mucous membranes. 



Types of Disease, Geographic Distri - 

 bution and Epidemiology : 



Two forms of cutaneous leishmaniosis 

 have been described in man in the Old 



World and 4 in the New. Separate sub- 

 specific names have been given to some 

 of them: 



1. Classical Oriental sore is found in 

 regions with a hot, dry climate from 

 the Mediterranean basin to central and 

 northern India. It is caused by L. 

 tropica minor. The incubation period 

 is several months. The lesions are 

 circumscribed, "dry" sores in the 

 skin. They heal spontaneously and do 

 not extend to the mucous membranes. 

 The lymph nodes are involved in about 

 10% of the cases. Dogs are commonly 

 infected, and the disease is urban in 

 distribution. In Teheran, Iran, for 

 example, 40 to 50% of the dogs have 

 skin ulcers. The disease is transmit- 

 ted by Phleboto)}ins papatasii, P. ser- 

 genti, P. perfiliewi and P. tongicuspis. 



2. "Moist" or "wet" Oriental sore is found 

 in Central Asia and southern USSR. It 

 is caused by L. tropica major; there is 

 no cross-immunity between this sub- 

 species and L. t. minor. The incuba- 

 tion period is 1 to 6 weeks. The lesions 

 are wet and ulcerative, but do not ex- 

 tend to the mucous membranes. They 

 heal spontaneously. The lymph nodes 

 are often involved. The disease is rural 

 in distribution. The reservoir hosts 

 are various desert rodents, the gerbil 

 {Rhombomys opimus) being the most 

 important. The vector is P. caucasicus, 

 which lives in the gerbil burrows. 



3. Mucocutaneous leishmaniosis or espun- 

 dia is found in the Brazilian rain for- 

 ests. It is caused by L. tropica bra- 

 siliensis, which many authors consider 

 a separate species, L. brasiliensis. 

 The skin lesions are chronic and spread- 

 ing, often invading the mucous mem- 

 branes either by metastasis or extension, 

 and sometimes causing great disfigure- 

 ment. Spontaneous recovery is rare. 

 The lymph nodes are seldom involved. 

 Dogs and occasionally cats have been 

 found naturally infected, but the true res- 

 ervoir hosts have not been discovered; 

 they are probably wild jungle mammals. 

 The retus monkey and various squirrels 

 can be readily infected, but the golden 

 hamster is refractory. The vectors are 



