CHANGING PATTERNS OF CUTANEOUS LEISHMANIASIS IN ISRAEL AND NEIGHBORING TERRITORIES

The most frequent form of cutaneous leishmaniasis (CL) in Israel and t he neighbouring territories is due to Leishmania major, which is endem ic mainly in the Jordan Valley and in the Rift Valley. CL due to L. tr opica is much less common, and in the past only sporadic cases have be en reported. In this study we present data obtained during the years 1 988-1992 regarding CL in the area. Our clinic has diagnosed a total of 371 leishmaniasis cases, most of whom acquired the infection in the J ordan Valley, mainly during June and July. About one-third of the pati ents had single lesions, and one-third more than 5 lesions. We also de scribe an outbreak of leishmaniasis in Kfar Adumim, a village 15 km ea st of Jerusalem, where leishmaniasis was previously unknown. Parasites were characterized by the polymerase chain reaction and by immunostai ning, and found to be both L. tropica and L. major. The localization o f the homes of the affected people on a dope where hyraxes were abunda nt suggests that these animals might have been involved in the transmi ssion of L. tropica in this area.