THE EPIDEMIOLOGY AND SURVEILLANCE OF VISCERAL LEISHMANIASIS IN THE CAMPANIA REGION OF ITALY - THE VALUE OF ZYMODEME TYPING

Although human visceral leishmaniasis (VL) is a notifiable disease in Italy, there is evidence that the actual number of cases is far higher than that notified. A programme for active surveillance of VL in the 14 Italian endemic regions was launched by the Istituto Superiore di S anita. We report data collected during a 3-year period of active surve illance in Campania, a south Tyrrhenian region covering 4.5% of the It alian territory. Out of 120 clinically suspected cases referred to med ical and diagnostic references centres, there were 52 confirmed VL cas es (17.3/year), i.e. 10-fold more than previously notified. Most of th e infection sites were in rural areas or peripheral districts of towns in hilly parts of Naples province. An epidemic cluster of 10 cases wa s identified in a microfocus of Caserta province. The biochemical anal ysis of 23 Leishmania stocks showed a zymodeme composition indicating Campania as an old and well-established focus of VL. The data obtained emphasize that the present notification system for VL in Italy is ina dequate.