-19- 



naturally infected sand flies, Lu. intermedia (Lutz and Neiva) and Lu . 

 pessoai (Coutinho and Barretto) in Brazil. The former species is found 

 in low, secondary forests and is known also to invade houses, while 

 the latter is essentially syl vatic, but has been collected in houses 

 up to 300 m from the forest edge. With this in mind, it was suggested 

 that cutaneous leishmaniasis in southern Brazil may have a 

 peridomestic transmission, the original source of the infection being 

 in nearby wooded areas (Lainson, 1982). 



In Serra dos Carajas, Para State, North Brazil, where both 

 cutaneous and mucocutaneous leishmaniasis are serious public health 

 problems, Lainson _et aj_. (1973) concluded that Lu. we 1 come i 

 (Fraiha, Shaw, and Lainson) was a major vector to man. Attempts to 

 infect hamsters by inoculation with parasites isolated from naturally 

 infected Lu . wellcomei were largely unsuccessful, but it was shown 

 that the parasite was the same as that infecting man in the same area. 

 Lu . wel Icomei was considered to be of particular importance because of 

 the avidity with which it attacks man both during the night and the 

 day. 



Leishmaniasis in the United States of America 



Few studies have been conducted on the epidemiology of 

 leishmaniasis in the USA. Prior to 1976 leishmaniasis was not 

 generally thought to occur autochthonously in the USA, and 

 potential sand fly vectors were reported so rarely as to be considered 

 of 1 ittle medical consequence. 



McEwen (1914) reported the first case of leishmaniasis in the 

 USA, referring to it as "oriental sore." There is little doubt that 



