But cutaneous leishmaniasis is not a threat to Europe
by BRYSON MASSE
The images of cutaneous leishmaniasis are striking. The tenor of its coverage, more so. Faces of Syrian refugees with terrible boils and bubbling skin lead headlines that claim there is an imminent threat to Europe.
Of course, this isn’t true. But that doesn’t mean this terrible disease’s rapid spread doesn’t represent a crisis. Potentially millions of Syrians are at risk.
A frustrated-sounding Alvaro Acosta-Serrano, an associate professor at the Liverpool School of Tropical Medicine, told War Is Boring that the tabloids in the United Kingdom are misrepresenting the results of his study of cutaneous leishmaniasis.
The study is a collaboration between the Liverpool School of Tropical Medicine and Baylor College.
“All the stories made by tabloids about ISIS leaving corpses infected with with it, and that’s how the disease has spread, are completely false,” Acosta-Serrano said.
Known by many other names — including “Aleppo boil” —cutaneous leishmaniasis is not a flesh-eating bacterial disease, as is being widely reported. Cutaneous leishmaniasis is a disfiguring disease caused by a single-cell parasite spread by sandfly bites.
There have been no cases of person-to-person transfer.
The disease has historically been a constant factor in Middle East conflicts. Hidden behind sensationalist headlines is an unparalleled resurgence of cutaneous leishmaniasis in war-torn Syria and surrounding nations. It risks becoming an epidemic.
“You get countries like Lebanon, whose population has increased 25 percent due to displaced Syrian refugees,” Acosta-Serrano said. “There are over a thousand cases reported. In the past, there were only two or three a year.”
Before the Syria war, cases of cutaneous leishmaniasis were on the decline. It was treatable and non-fatal. The World Health Organization categorized it as a “neglected tropical disease.”
Owing to the widespread displacement of the Syrian population — the scale of which rivals displacement during World War II — cutaneous leishmaniasis has gained a new foothold. According to the study, there were 41,000 documented cases in Syria in the first half of 2013. To make things worse, the WHO estimates that early numbers could be under-reported by as much as a factor of five.
Acosta-Serrano and his team found was that there were long-term social and economic consequences to being infected. Women and children were denied work opportunities and suffered stigmatization after being afflicted by the scarring parasite.
Acosta-Serrano said imagery of the suffering has been used as political tool to foster anti-immigrant attitudes before the upcoming referendum to determine the United Kingdom’s membership status within the European Union.
The unchecked spread of the disease is another consequence of Syria’s ravaged medical infrastructure. As many as half of Syria’s public hospitals have been destroyed. In many parts of Syria, there’s no health infrastructure at all and no capacity to handle outbreaks of cutaneous leishmaniasis.
Even information on infection rates is hard to come by. By leveraging the experience and contacts of doctoral-student Waleed Al Salem, Acosta-Serrano and his team were able to get details from obscure and local sources.
Acosta-Serrano said Al Salem worked with NGOs and what is left of the Syrian medical community to capture the small amount of information trickling out of the region. “He had the hard task to gather all of this information and make sense of it.”
The study concluded what is needed next is funding — and a plan to combat the disease. Better diagnostics and treatment options will be critical to pushing back the spread.
“There is an urgent need to get accurate epidemiological data from the refugee camps, distribute insecticide-impregnated bed nets and deliver treatment to the affected people,” Acosta-Serrano said. “We need funding.”