As if years of oppression, terrorism and war weren’t distressing enough for the citizens of Syria, the country is now experiencing a flesh-eating disease called leishmaniasis.
The head of the Kurdish Red Crescent is reported to have recently stated that the problem was made worse due to Islamic State leaving bodies to rot in the streets. Although leishmaniasis is a serious issue in Syria, this picture of a flesh-eating disease made worse by terrorists is not totally accurate.
What is leishmaniasis?
Leishmaniasis has actually been common in Syria for hundreds of years and was once commonly known as “Aleppo evil.” This skin-infecting form of the disease isn’t really flesh-eating, although another type found in Brazil and some other areas of South America can be. Leishmaniasis is caused by the Leishmania parasite, which is carried by sandflies. Once you are bitten, the parasites can enter your blood and occupy the macrophage immune cells that usually kill bugs, resulting in terrible open sores near the bite.
In other areas, especially India, a different type of the parasite spreads to the spleen and liver and results in death as those crucial visceral organs break down. In the Brazilian form, the parasites cause macrophages to move to the mucosal surfaces around the nose and mouth. Here the parasites are attacked by the immune system and results in significant damage to the surrounding tissue, eating away the flesh, leading to serious disfigurements.
Actually, sandflies do not really eat rotting bodies in the street, they suck blood from living people, so the reports about IS spreading the disease aren’t totally true. However, the political events in Syria – including the escalation of Islamic State – have resulted in the collapse of Syria’s health care systems, as well as every other part of the social structure there. Consequently, leishmaniasis has been spreading more widely.
Can leishmaniasis be treated?
Currently, around 1.3 million people are infected with leishmaniasis each year across the sub-tropics and tropics. Majority of the sufferers have the cutaneous form, such as in Syria, while visceral type can be fatal. But because it is generally found among the globe’s poorest people, it receives little attention with regards to developing new vaccines or drugs and is considered a neglected tropical disease.
Treatments to exist however, and in a working health system drugs can be used to cure leishmaniasis. Scientists continue to debate on the best treatment for the cutaneous disease but we presently have four different drugs that can be used. The best treatment for visceral leishmaniasis is called amphotericin B and is very efficient at curing the disease when injected. Only a few injections of the medicine can be sufficient to cure leishmaniasis, but it does carry side effects such as vomiting, headaches and fever.
Could it spread more widely?
In addition to increasing incidences of leishmaniasis in Syria itself, some refugees leaving the country will carry parasites with them. However, countries receiving refugees do not have to worry about its introduction.
It is not people, but sandflies that transmit leishmaniasis, and though they are found across the tropics and sub-tropics, they are unable to survive in colder climates. Visceral leishmaniasis is already common in parts of southern Europe including Italy, Spain and the south of France, but the disease generally manifests itself in those with weak immune systems such as those infected with HIV.
It is also crucial to understand that different species of sandflies are responsible for transmitting different Leishmania parasites. Those that transmit the cutaneous form found in Syria are less common in southern Europe. It is also important to highlight that those with access to good nutrition and are in generally good health are less vulnerable to the disease.
Seeing that leishmaniasis cannot be spread to countries with colder climates and is restricted by good healthcare, the suggestion that it could be brought in by refugees holds no force.