Authors
W S Al Salem2; K Mondragon-Shem1; K S Subramaniam1; L R Haines1; A F Acosta-Serrano1; 1 Liverpool School of Tropical Medicine; 2 Saudi Ministry of Health Discussion
Cutaneous leishmaniasis (CL) cases in Syria increase exponentially as the conflict continues. Thousands of victims of the Syrian conflict are going through leishmaniasis endemic areas. CL mapping with the most current available datasets show distribution overlaps with the presence of refugee camps. The fluctuating distribution of Leishmania species, reservoir hosts and vector sandflies in these areas of conflict results in the creation of new leishmaniasis foci. The consequences further extend to healthcare workers and military personnel, and the disfiguring effects of CL lead to severe victim stigmatization. There is also a risk associated with the migration of Leishmania-infected individuals into other countries. Unawareness of leishmaniasis transmission cycles has led to sensationalist media disseminating false information about CL. However, it is important to know that disease transmission can only occur in the presence of the sandfly vector. Even though some sandfly species currently inhabit parts of southern Europe, local healthcare systems and active case detection aid the timely treatment of cases. Updated information of leishmaniasis epidemiology in the Middle East will contribute to understand the real impacts of this war on this and other vector-borne diseases. Control programmes that include vector surveillance can help to manage these and future outbreaks. 
