Molecular epidemiology of imported cases of leishmaniasis in Australia from 2008 to 2014.
Leishmaniasis is a vector borne disease caused by protozoa of the genus Leishmania. Human leishmaniasis is not endemic in Australia though imported cases are regularly encountered. This study aimed to provide an update on the molecular epidemiology of imported leishmaniasis in Australia. Of a total of 206 biopsies and bone marrow specimens submitted to St Vincent's Hospital Sydney for leishmaniasis diagnosis by PCR, 55 were found to be positive for Leishmania DNA. All PCR products were subjected to restriction fragment length polymorphism analysis for identification of the causative species. Five Leishmania species/species complexes were identified with Leishmania tropica being the most common (30/55). Travel or prior residence in a Leishmania endemic region was the most common route of acquisition with ~47% of patients having lived in or travelled to Afghanistan. Cutaneous leishmaniasis was the most common manifestation (94%) with only 3 cases of visceral leishmaniasis and no cases of mucocutaneous leishmaniasis encountered. This report indicates that imported leishmaniasis is becoming increasingly common in Australia due to an increase in global travel and immigration. As such, Australian clinicians must be made aware of this trend and consider leishmaniasis in patients with suspicious symptoms and a history of travel in endemic areas. This study also discusses the recent identification of a unique Leishmania species found in native kangaroos and a potential vector host which could create the opportunity for the establishment of a local transmission cycle within humans.
Department of Microbiology, SydPath, St. Vincent's Hospital, Victoria St, Darlinghurst, N.S.W, Australia; School of Medical and Molecular Sciences, University of Technology, Sydney, Ultimo, N.S.W, Australia.
Tamalee
T
Roberts
School of Medical and Molecular Sciences, University of Technology, Sydney, Ultimo, N.S.W, Australia; i3 Institute, University of Technology, Sydney, Ultimo, N.S.W, Australia.
Joel
J
Barratt
Department of Microbiology, SydPath, St. Vincent's Hospital, Victoria St, Darlinghurst, N.S.W, Australia.
Indy
I
Sandaradura
Centre for Infectious Diseases and Microbiology Laboratory Services, ICPMR, Westmead Hospital, Westmead, N.S.W, Australia.
Rogan
R
Lee
Department of Microbiology, SydPath, St. Vincent's Hospital, Victoria St, Darlinghurst, N.S.W, Australia.
John
J
Harkness
Department of Microbiology, SydPath, St. Vincent's Hospital, Victoria St, Darlinghurst, N.S.W, Australia.
Deborah
D
Marriott
School of Medical and Molecular Sciences, University of Technology, Sydney, Ultimo, N.S.W, Australia.
John
J
Ellis
Department of Microbiology, SydPath, St. Vincent's Hospital, Victoria St, Darlinghurst, N.S.W, Australia.
Damien
D
Stark
D000293:Adolescent; D000328:Adult; D000346:Afghanistan / Q000453:epidemiology; D000368:Aged; D002648:Child; D002675:Child, Preschool; D016054:DNA, Protozoan / Q000235:genetics* / Q000302:isolation & purification; D054242:Emigrants and Immigrants / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D007892:Leishmania braziliensis / Q000145:classification / Q000235:genetics* / Q000302:isolation & purification; D007893:Leishmania donovani / Q000145:classification / Q000235:genetics* / Q000302:isolation & purification; D007895:Leishmania tropica / Q000145:classification / Q000235:genetics* / Q000302:isolation & purification; D016773:Leishmaniasis, Cutaneous / Q000175:diagnosis / Q000453:epidemiology* / Q000469:parasitology / Q000473:pathology; D007898:Leishmaniasis, Visceral / Q000175:diagnosis / Q000453:epidemiology* / Q000469:parasitology / Q000473:pathology; D008297:Male; D008875:Middle Aged; D017720:Molecular Epidemiology; D058889:Molecular Typing; D016133:Polymerase Chain Reaction; D012150:Polymorphism, Restriction Fragment Length; D014195:Travel / Q000706:statistics & numerical data; D055815:Young Adult
D016054:DNA, Protozoan