IDENTIFICATION AND GENETIC COMPARISON OF LEISHMANIAL PARASITES CAUSING VISCEROTROPIC AND CUTANEOUS DISEASE IN SOLDIERS RETURNING FROM OPERATION DESERT-STORM

Six Leishmania major and seven L. tropica parasites were isolated and identified from participants in Operation Desert Shield/Storm. A compl ete enzyme analysis (21 enzymes) revealed that there was enzyme polymo rphism among the isolates of each species group. Any one Desert Storm L. major isolate could differ from any other for 1-3 enzymes, and any L. tropica isolate could differ from any one other for up to eight enz ymes. Enzyme polymorphism data from other L. major and L. tropica isol ates from Africa and the Middle East region were obtained and combined with the Desert Storm data to produce population enzyme polymorphism estimates. Results from these population data indicated that L. major parasites could be expected to differ from each other for as many as e ight enzymes and still be L. major and similarly, L. tropica isolates could differ for as many as 14 enzymes. These expected isolate variati on extremes have not been observed among the isolates studied. All L. major and most L. tropica isolates were from patients who, as expected , presented with cutaneous disease, but the Desert Storm and two Kenya n patients infected with L. tropica presented with a viscerotropic dis ease, the symptoms of which are unlike those of classic visceral leish maniasis. Such unrecognized presentation for these L. tropica-infected patients indicates that both parasite and patient can play critical r oles in disease manifestations. The Desert Storm isolates are, as indi cated, either L. major or L. tropica.