a new challenge for which we are not ready

In recent decades, increase in tropical diseases Transmitted by vectors such as dengue fever, malaria and chikungunya, there are fears that this type of pathology will spread throughout Europe. Climatic factors directly influence the distribution and spread of pathogen-carrying insects because Their life cycle and survival are related to temperature and humidity.

A disease with many faces

Among the tropical diseases whose incidence has increased due to global warming is leishmaniasis, which is included in the World Health Organization’s list of neglected tropical diseases. This is true complex of diseases caused by a parasite Leishmania, It is transmitted through the bite of insects called mosquitoes. They are smaller and hairier than mosquitoes, and their wings are V-shaped when at rest.

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Leishmaniasis has a variety of clinical manifestations. Bye the cutaneous form causes skin ulcers which can develop into painful ulcers, the mucocutaneous variant attacks the lining of the nose, mouth and throat, causing sores that can disfigure the patient. But the most serious modality is visceral.which attacks internal organs such as the liver and spleen, causing fever, weight loss and anemia and, if not treated promptly, death.

Unlike other tropical infections, It is present in southern European countries as a zoonotic leishmaniasis.that is, they are transmitted from animals to humans. Caused by the species Leishmania childhoodits main domestic reservoir is dogs.

Spreads in foci, areas in which there are environmental and epidemiological conditions for transmission parasite, with presence in mosquitoes and a high prevalence in dogs. The main victims are young children and immunocompromised adults.

Alarming expansion across Europe

In recent years, An increase in incidence was observed in endemic areas of Europe. such as Portugal, northern Italy, Greece or the Balkans. However, a recent study by the European Center for Disease Prevention and Control (ECDC) found that leishmaniasis is not reportable in all countries where local cases exist and that few monitor and control infections both in animals and in humans.

This lack of preparedness and more of a reactive rather than proactive attitude on the part of European governments. contributed significantly to the spread of the disease.

The increase in incidence is directly related to global warming: it is estimated that average increase in air temperature by one degree leads to a significant increase in morbidity. Warmer conditions favor mosquito survival and activity, population density, biting rates, and the maturation of the parasite within. Long summer prolongs transmission period and the risk of infection to owners, humans or dogs.

Global warming is also facilitating the northward movement of vector populations, allowing for local transmission from imported cases in previously non-endemic areas. At the moment, mosquitoes have already spread throughout the Iberian PeninsulaNorthern Italy and the Balkans, reaching Germany. Its expansion is expected to continue in the coming years.

Mobility makes the problem worse

Along with climate change, Another aggravating factor is the increasing mobility of people and pets., including travel and forced migration. Although it has been suggested that the arrival of refugees in Europe may pose a risk of introducing new species Leishmania

(How L. tropica And L. Donovani), these species are already sporadically present in Greece and Cyprus.

The biggest risk is the movement of millions of tourists from the north to the Mediterranean coast. This movement affects not only people, but also domestic animals: a large number of infected dogs live in non-endemic areas and can become a source of parasites identify the local source of transmission.

Another factor associated with the increasing incidence of leishmaniasis in Europe is an increase in the number of people with weakened immune systems. Like in the 90s, when HIV co-infectionLeishmania has led to a resurgence of leishmaniasis in southern Europe, with many of the new cases reported in people who have undergone solid organ transplantation or are on immunosuppressive treatment. These circumstances increase your susceptibility to developing the disease in case of infection.

Thus, an outbreak of leishmaniasis identified in Gothenburg (Sweden) among people on immunosuppressive treatment who were on holiday on the Mediterranean coast highlights the high level of transmission. This might have gone unnoticed if not for the greater sensitivity of these patients.

An additional threat is the emergence of resistance in the parasite to the few available drugs. In Europe, dogs are routinely treated for canine leishmaniasis, but treatment is not always effective and animals relapse. This causes the parasite to accumulate resistance over time and also affects treatment in humans.

It is also possible that parasites are spreading resistance to mosquitoes. This process can occur without direct pharmacological intervention, since sensitive parasites They can become resistant when exposed to other resistant parasites. originating from animals or people treated during their cycle within the vector.

Parasitic worms that grow in our bodies

You need to change your attitude

Leishmaniasis should be understood as a growing public health problem in Europe.

It is essential to take measures to reduce and control it, such as monitoring human and dog cases, the spread of mosquitoes, drug sensitivity of parasites, and the emergence of leishmaniasis in previously non-endemic regions.

Definitely, Governments have the opportunity to take a preventive stance instead of reactive. This will allow them to anticipate and better prepare for the challenges associated with the disease.

Francisco Javier Moreno Nuncio, researcher at the National Center for Microbiology, head of the WHO Collaborating Center for Leishmaniasis. , Carlos III Health Institute and Christopher Fernandez-Prada, Associate Professor, University of Montreal (Faculty of Veterinary Sciences); Head of the Diagnostic Laboratory of Animal Parasitology, UdeM; Associate Professor at McGill University (Faculty of Medicine) and Laval University (Faculty of Science). University of Montreal

This article was originally published on The Conversation. Read the original.