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APHA Scientific Session and Event Listing

Recorded presentation

Eyal Klement, DVM, MSc¹, Raid Kayouf, MSc², Nadav Davidovitch, MD, MPH, PhD³, Oren Auster¹, Tamar Halperin, PhD¹, Itamar Grotto, MD, MPH⁴, Oshri Wassertzug, MD¹, Yael Bar-Zeev¹, Ran Balicer, MD, MPH¹, Tamar Sela¹, Joseph El-On, PhD⁵, Charles Jaffe, PhD⁶, Moshe Ephros, MD⁷, and Salman Zarka, MD, MPH⁸. (1) Army Health Branch, Medical Corps, IDF, 02149, Tel Hashomer, Israel, 000, klement@agri.huji.ac.il, (2) IDF, Army Health Branch, Medical Corps, IDF, Tel-Hashomer, Israel, (3) Sociomedical Sciences, Mailman School of Public Health, Columbia University, 722 West 168th Street, 9th floor, New York, NY 10032, (4) Epidemiology Department, Ben-Gurion University of the Negev, PO BOX 653, Beer-Sheva, 84105, Israel, (5) Department of Parasitology, Ben-Gurion University, Soroka Medical School, Beer-Sheva, Israel, (6) Kuvin Center for the Study of Tropical and Infectious Diseases, Hebrew university, Hadassah Medical School, Jerusalem, Israel, (7) Department of Pediatrics, Technion-Israel Institute of Technology, Faculty of Medicine, Carmel Medical Center, Haifa, Israel, (8) Army Health Branch and Haifa University School of Public Health, Medical Corps, IDF and Haifa University, 02149, Tel Hashomer, Israel

Background: Cutaneous leishmaniasis (CL) is hyper endemic in several regions in Israel. An outbreak of CL caused by Leishmania major occurred during winter 2003-2004 among new recruits training in the region of Qeziot in southern Israel. Objective: Description of the outbreak and assessment of potential risk factors for CL. Methods: A multidisciplinary outbreak investigation was initiated, which included active CL case finding, distribution of questionnaires, physical examination and laboratory testing of suspected lesions by ITS1-PCR. Results: From December 2003 until February 2004, 326 soldiers who were examined of whom sixty-two (19%) had typical CL lesions. During the next two endemic seasons (2004-2005, 2005-2006) 111of 745 additional recruits had typical CL lesions (incidence of 14.9%). Diagnosis of CL was confirmed by ITS1-PCR in 79 of 113 subjects tested (70%) from all three outbreak periods. The number of lesions per soldier ranged from 1 to 10: 41 (24%) had face or neck lesions; 122 (72%) and 45 (27%) had lesions on hands or legs, respectively, and 13(8%) had truncal CL. In each of the three outbreaks, two seasonal peaks of disease were observed, one in August/September and one in November, coinciding with two separate conscription periods, March and August, respectively. Country of birth, military occupation and insect repellent use were not correlated with CL. Conclusion: The high incidence of CL in Qeziot emphasizes the need for multidisciplinary efforts for the development and implementation of effective measures for preventing CL.

Learning Objectives: At the conclusion of this session the participant will be able to

• Recognize the morbidity pattern and diagnostic methods for the assessment of an outbreak of cutaneous leishmaniasis.
• Evaluate the effectiveness of a number of strategies for the prevention of cutaneous leishmaniasis.
• Apply the tools given in the session for the investigation of cutaneous leishmaniasis outbreak and for its prevention in hyper endemic areas.

Keywords: Infectious Diseases, Prevention

Presenting author's disclosure statement:

Any relevant financial relationships? No

Recorded presentation