title: Leishmaniasis in travelers: a literature review.
abstract: Leishmaniasis is a vector-borne protozoan infection whose clinical spectrum ranges from asymptomatic infection to fatal visceral leishmaniasis. Over the last decades, an increase in imported leishmaniasis cases in developed, non-endemic countries, have been pointed-out from a review of the international literature. Among the possible causes are increasing international tourism, influx of immigrants from endemic regions and military operations. The main area for the acquisition of cutaneous leishmaniasis, especially for adventure travelers on long-term trips in highly-endemic forested areas, is represented from South America, whereas popular Mediterranean destinations are emerging as the main areas to acquire visceral variant. Leishmaniasis should be considered in the diagnostic assessment of patients presenting with a compatible clinical syndrome and a history of travel to an endemic area, even if this occurred several months or years before. Adventure travelers, researchers, military personnel, and other groups of travelers likely to be exposed to sand flies in endemic areas, should receive counseling regarding leishmaniasis and appropriate protective measures.
authors.affiliation: Department of Internal Medicine and Biomedicine, University of Palermo, Italy. Electronic address: pasquale.mansueto@unipa.it.
authors.forename: Pasquale
authors.initials: P
authors.lastname: Mansueto
authors.affiliation: Department of Internal Medicine and Biomedicine, University of Palermo, Italy.
authors.forename: Aurelio
authors.initials: A
authors.lastname: Seidita
authors.affiliation: Department of Internal Medicine and Biomedicine, University of Palermo, Italy.
authors.forename: Giustina
authors.initials: G
authors.lastname: Vitale
authors.affiliation: Department of Human Pathology, University of Messina, Italy.
authors.forename: Antonio
authors.initials: A
authors.lastname: Cascio
mesh_terms: D000818:Animals; D000981:Antiprotozoal Agents / Q000494:pharmacology; D054242:Emigrants and Immigrants; D006801:Humans; D007303:Insect Vectors / Q000469:parasitology; D007891:Leishmania; D007896:Leishmaniasis / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology / Q000503:physiopathology / Q000517:prevention & control; D019083:Mediterranean Region; D008889:Military Personnel; D011576:Psychodidae / Q000469:parasitology; D013020:South America; D014195:Travel
chemical_list: D000981:Antiprotozoal Agents
keywords: Cutaneous leishmaniasis; Mucosal leishmaniasis; Travelers; Visceral leishmaniasis