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Parasitology

Leishmania: case management and UK transmission

02 November 2022
Clinical
10 mins read
02 November 2022
Volume 13 · Issue 9
Figure 1. Leishmania amastigotes (image courtesy of Virbac).

Abstract

Leishmania are vector-borne protozoan parasites that cause a wide range of clinical disease (leishmaniosis). Leishmania infantum is the species mainly causing leishmaniosis in European cats and dogs, and has zoonotic potential. Sandflies are the principal vector of transmission, but non-vectorial routes such as venereal, transplacental and blood transfusion have been described. There is no gold-standard diagnostic test, so leishmaniosis is diagnosed using a combination of methods alongside relevant clinical signs. Early diagnosis is essential for assessing prognosis, successfully managing the disease and minimising transmission. This article discusses the epidemiology, diagnosis and management of leishmaniosis in dogs and cats, and the risk of it becoming established in the UK.

Leishmania spp. are intracellular protozoan parasites in the family Kinetoplastidae and the cause of a range of clinical disease known as leishmaniosis. Different Leishmania spp. are endemic in parts of Europe, South America, Africa and Asia. Canine leishmaniosis is predominantly caused by Leishmania infantum in Europe, which can also infect humans and cats. Transmission occurs primarily through the bites of infected phlebotomine sandflies. Other less frequent forms of transmission include blood transfusion, congenital and venereal routes, and possibly dog bites (Tabar et al, 2008; Naucke and Lorentz, 2012; Naucke et al, 2016).

In the mammalian host, Leishmania occurs as amastigotes (Figure 1) preferentially within phagocytic cells in the skin, bone marrow and visceral organs. In the gut of sandflies, Leishmania occurs as flagellated promastigotes (Figure 2). L. infantum infection occurs when a feeding sandfly deposits promastigotes into the dermis of the mammalian host. Following a local multiplication in dendritic cells and macrophages in the skin, the parasites disseminate to various organs via the lymphatic system and blood.

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leishmania
leishmaniosis
L. infantum
parasitic disease
zoonosis