Mallorca’s overlooked illness: What you should know about Leishmaniasis

What is Leishmaniasis?

Leishmaniasis is an infection caused by a tiny parasite called Leishmania. The disease is spread by the bite of infected female sandflies, which are small, mosquito-like insects active mainly from dusk to dawn.

There are three main forms of leishmaniasis:

• Cutaneous leishmaniasis (the most common), which causes skin sores.
• Visceral leishmaniasis (the most serious), which affects internal organs like the liver and spleen.
• Mucocutaneous leishmaniasis, which affects the nose, mouth, and throat.

In Mallorca and the rest of Spain, Leishmania infantum is the main type found, and both cutaneous and visceral forms of the disease can occur.

How Common is Leishmaniasis in Mallorca?

The Balearic Islands, including Mallorca, have some of the highest rates of leishmaniasis in Spain, though the number of human cases reported each year is still relatively low compared to other countries. While official figures suggest that there are 20-30 cases per year in Mallorca, one study conducted in Manacor found that an estimated 70% of cases could be unreported, meaning that many are excluded from official statistics.

Who is at Risk?

Anyone can get leishmaniasis if they are bitten by an infected sandfly, but some people are at higher risk:

• People who spend time outdoors, especially in rural or semi-rural areas.
• Children, who are more likely to play outside and have developing immune systems.
• People with weakened immune systems.
  Dog owners are also at risk. Dogs are the main reservoir for Leishmania infantum in Spain and
• can become very ill from the disease. Infected dogs can help keep the parasite circulating in the environment.

Leishmaniasis is not spread directly from person to person or from dogs to people. The parasite must be transmitted by a bite from an infected sandfly. Most sandfly bites do not cause infection, but repeated bites increase your risk.

What are the Symptoms?

Cutaneous leishmaniasis usually starts as a small bump or sore at the site of the sandfly bite. This can grow into a painless ulcer with a raised edge. The sore may take weeks or months to heal and can leave a scar but this is otherwise a mild and non-life-threatening illness.

Visceral leishmaniasis causes fever, weight loss, swelling of the spleen and liver, and low blood counts. This form is much more serious and can be fatal if not treated.

How is Leishmaniasis Diagnosed and Treated?

Diagnosis usually involves a physical examination and laboratory tests on samples from the sore or blood. Treatment depends on the type and severity of the disease, but may involve special medications given by mouth or injection. Early diagnosis and treatment are important to prevent complications and most cases can be cured.

How Can You Prevent Leishmaniasis?

here is no vaccine for leishmaniasis, so prevention is key. Here are some practical steps:

• Avoid sandfly bites: Sandflies are most active from dusk to dawn and from May to October. Use insect repellent on exposed skin and clothing, especially in the evening and at night.
• Wear protective clothing: Long sleeves and trousers help reduce bites.
• Use screens and nets: Keep windows and doors screened. Use bed nets if sleeping in areas where sandflies are common.
• Protect your pets: Dogs should be kept indoors at night if possible. Talk to your vet about preventive measures for dogs, such as insecticide collars or spot-on treatments.
• Reduce sandfly habitats: Sandflies breed in dark, humid places. Keeping your surroundings clean and dry can help.

What about my dog?

If you have a dog, there are steps you can take to prevent them from getting infected, and your vet will be able to provide personalised advice. Sandfly-repellant collars are available, and dog-friendly insect repellants are also available. Interestingly, while there is no human vaccine against leishmaniasis, vets do recommend vaccination for some dogs including those who live in high-risk areas. You can also reduce your dog’s risk of bites by keeping them indoors at dusk, dawn and overnight, screening doors and windows and limiting your dog’s access to the dark and humid outdoor areas where sandflies breed.

When to Seek Medical Advice

If you notice a skin sore that doesn’t heal, especially after an insect bite, or if you feel unwell with fever and weight loss, see a doctor. Early diagnosis and treatment are important for the best outcome.