173309 Epidemiology of Leishmaniasis in the IDF

Wednesday, October 29, 2008

Salman Zarka, MD, MPH , Haifa University School of Public Health, Army Health Branch, Tel Hashomer, Israel
Ran Balicer, MD, MPH , Epidemiology Department, Faculty of Health Sciences, Ben-Gurion University of the Negev, Head, Health Policy Planning Department, Planning and Health Policy Division, Clalit Health Services, Tel-Aviv, Israel
Eyal Klement , Army Health Branch, Medical Corps, IDF, Tel Hashomer, Israel
Raid Kayouf, MSc , Army Health Branch, Medical Corps, IDF, Tel Hashomer, Israel
Tamar Halperin , Army Health Branch, Medical Corps, IDF, Tel Hashomer, Israel
Tamar Sela, Bsc Chemical Eng , Army Health Branch, Medical Corps, IDF, Tel Hashomer, Israel
Hagai Levine, MD , Army Health Branch, Medical Corps, IDF, Tel Hashomer, Israel
Moshe Ephros, MD , Department of Pediatrics, Technion-Israel Institute of Technology, Faculty of Medicine, Haifa, Israel
Yael Bar-Zeev , Army Health Branch, Medical Corps, IDF, Tel Hashomer, Israel
Nadav Davidovitch, MD, MPH, PhD , Health Systems Management, Ben Gurion University, Beer Sheva, Israel
Omer H. Ankol, MD, MPH, MOccH , Army Health Branch, Medical Corps, IDFand Department of Health Management, Ariel University Center of Samaria, Israel, Tel Hashomer, Israel
Nahman Ash, MD , Medical Corps, IDF, Tel Hashomer, Israel
Background: Cutaneous leishmaniasis (CL) is hyper endemic in different regions in Israel. The Army Health Branch follows and investigates every Leishmania case in the army as do the ministry of health for the civilian sector. .

Methods: Physicians all over the army are instructed regarding this disease. Epidemiological investigation in each case of CL is done by the primary physician. The diagnosis of reported CL was based on the clinical presentation, relevant epidemiologic data, and microscopic visualization of the parasite.

Results: Consistently, the average rate of CL among soldiers was higher than the civilian sector. Sometimes this proportion rose 100 times higher. The period of infection was May till November and the average incubation period was one to three months. Attack rates in several platoons were 20-25%.

The majority of the Leishmania isolates in the IDF have been L. major, while in the civilian sector it is L.tropica.

These differences are likely caused by frequent exposure opportunities to the disease in Army personnel, differences in using medical services and perhaps the active surveillance that is frequent in the Army.

Conclusion: There is a high incidence of CL among soldiers especially in the south of Israel. This data emphasizes the need for multidisciplinary efforts, civilian and military for the development and the implementation of effective measures for preventing CL. Regional and international cooperation are needed.

A task force composed from the Ministry of Health, Ministry of Environment, Medical Corps, Israel Nature and Park authority, was established in 2005.

Learning Objectives:
Learning about the epidemiology of CL in the last 10 years among the soldiers population compared to civilian population in Israel. Learning about epidemiological investigation and survelience of Liesh. Learning about cooperation between different sectors facing this disease.

Keywords: Environmental Exposures, Infectious Diseases

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am the head of the branch dealing with this subject
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

See more of: Environmental Epidemiology Poster Session
See more of: Epidemiology