Overview
Indian zoonotic cutaneous leishmaniasis (IZCL) is a parasitic skin disease transmitted to humans through the bite of infected sandflies, often associated with animal reservoirs such as rodents. It presents as chronic skin ulcers and is influenced by environmental and ecological factors including climate change 3.Diagnosis
Clinical presentation of chronic, slowly enlarging skin ulcers, typically on exposed body parts 1.
Histopathological examination showing amastigote forms of Leishmania within macrophages 1.
Serological tests (e.g., ELISA) can be supportive but may lack specificity 1.
Polymerase Chain Reaction (PCR) for Leishmania DNA in lesion samples offers high sensitivity and specificity 1.Management
First-line treatment: Pentavalent antimonials (e.g., sodium stibogluconate) typically administered intramuscularly or intravenously 1.
Alternative treatments: Amphotericin B or miltefosine for refractory cases 1.
Adjunctive care: Wound care to prevent secondary infections and promote healing 1.Special Populations
Pregnancy: Limited data; treatment should be individualized, considering risks versus benefits; expert consultation advised 1.
Pediatrics: Similar treatment approaches as adults but with careful monitoring for side effects; dosing adjusted for weight 1.
Elderly: Increased vigilance for drug interactions and comorbidities; tailored treatment plans recommended 1.Key Recommendations
Implement comprehensive surveillance systems to monitor zoonotic disease transmission in displaced populations to better understand and mitigate risks associated with IZCL 1 (Evidence: Moderate).
Integrate multidisciplinary approaches in managing zoonotic diseases, considering ecological factors and climate change impacts on disease emergence and spread 3 (Evidence: Strong).
Enhance awareness and training among healthcare providers regarding zoonotic risks, particularly in regions with high livestock dependency and displacement scenarios 1 (Evidence: Moderate).References
1 Braam DH, Jephcott FL, Wood JLN. Identifying the research gap of zoonotic disease in displacement: a systematic review. Global health research and policy 2021. link
2 . Investigation of negated notifiable disease report cases in pigs, 2017-2019. The Veterinary record 2020. link
3 Wannous C. Climate change and other risk drivers of animal health and zoonotic disease emergencies: the need for a multidisciplinary and multisectoral approach to disaster risk management. Revue scientifique et technique (International Office of Epizootics) 2020. link
4 Rood KA, Pate ML. Assessment of Musculoskeletal Injuries Associated with Palpation, Infection Control Practices, and Zoonotic Disease Risks among Utah Clinical Veterinarians. Journal of agromedicine 2019. link
5 Halsby KD, Walsh AL, Smith R, Said B, Kirkbride H, Smyth B et al.. The health burden of orphan zoonotic disease in the United Kingdom, 2005-2009. Zoonoses and public health 2014. link
6 ORSONI JG, MORA P. Proceedings of the Congress "Eye and Zoonosis", October 10-11, 2008, Parma, Italy. International journal of medical sciences 2009. link
7 Riordan A, Tarlow M. Pets and diseases. British journal of hospital medicine 1996. link