Spatial Relationship between a Regional Outbreak and a Higher-than-Expected Incidence of Leishmaniasis in Urban Southern Madrid, Spain

Jesús Alonso-Carrillo Unit of Infectious Diseases, Hospital Universitario “12 de Octubre”, Instituto de Investigación Sanitaria Hospital “12 de Octubre” (imas12), Madrid, Spain;

Search for other papers by Jesús Alonso-Carrillo in
Current site
Google Scholar
PubMed
Close
,
Ana Pérez Ayala Department of Microbiology, Hospital Universitario “12 de Octubre”, Instituto de Investigación Sanitaria Hospital “12 de Octubre” (imas12), Madrid, Spain;

Search for other papers by Ana Pérez Ayala in
Current site
Google Scholar
PubMed
Close
,
Mario Fernández-Ruiz Unit of Infectious Diseases, Hospital Universitario “12 de Octubre”, Instituto de Investigación Sanitaria Hospital “12 de Octubre” (imas12), Madrid, Spain;
Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III (ISCIII), Madrid, Spain;
Department of Medicine, School of Medicine, Universidad Complutense, Madrid, Spain

Search for other papers by Mario Fernández-Ruiz in
Current site
Google Scholar
PubMed
Close
,
José Tiago Silva Unit of Infectious Diseases, Hospital Universitario “12 de Octubre”, Instituto de Investigación Sanitaria Hospital “12 de Octubre” (imas12), Madrid, Spain;

Search for other papers by José Tiago Silva in
Current site
Google Scholar
PubMed
Close
,
Sara Castaño-Pérez Unit of Infectious Diseases, Hospital Universitario “12 de Octubre”, Instituto de Investigación Sanitaria Hospital “12 de Octubre” (imas12), Madrid, Spain;

Search for other papers by Sara Castaño-Pérez in
Current site
Google Scholar
PubMed
Close
,
Mónica Prieto Unit of Infectious Diseases, Hospital Universitario “12 de Octubre”, Instituto de Investigación Sanitaria Hospital “12 de Octubre” (imas12), Madrid, Spain;

Search for other papers by Mónica Prieto in
Current site
Google Scholar
PubMed
Close
,
Nuria Valdeolivas Unit of Infectious Diseases, Hospital Universitario “12 de Octubre”, Instituto de Investigación Sanitaria Hospital “12 de Octubre” (imas12), Madrid, Spain;

Search for other papers by Nuria Valdeolivas in
Current site
Google Scholar
PubMed
Close
,
María Asunción Pérez-Jacoiste Asín Unit of Infectious Diseases, Hospital Universitario “12 de Octubre”, Instituto de Investigación Sanitaria Hospital “12 de Octubre” (imas12), Madrid, Spain;

Search for other papers by María Asunción Pérez-Jacoiste Asín in
Current site
Google Scholar
PubMed
Close
,
Manuel Lizasoain Unit of Infectious Diseases, Hospital Universitario “12 de Octubre”, Instituto de Investigación Sanitaria Hospital “12 de Octubre” (imas12), Madrid, Spain;
Department of Medicine, School of Medicine, Universidad Complutense, Madrid, Spain

Search for other papers by Manuel Lizasoain in
Current site
Google Scholar
PubMed
Close
,
José María Aguado Unit of Infectious Diseases, Hospital Universitario “12 de Octubre”, Instituto de Investigación Sanitaria Hospital “12 de Octubre” (imas12), Madrid, Spain;
Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III (ISCIII), Madrid, Spain;
Department of Medicine, School of Medicine, Universidad Complutense, Madrid, Spain

Search for other papers by José María Aguado in
Current site
Google Scholar
PubMed
Close
, and
Francisco López-Medrano Unit of Infectious Diseases, Hospital Universitario “12 de Octubre”, Instituto de Investigación Sanitaria Hospital “12 de Octubre” (imas12), Madrid, Spain;
Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III (ISCIII), Madrid, Spain;
Department of Medicine, School of Medicine, Universidad Complutense, Madrid, Spain

Search for other papers by Francisco López-Medrano in
Current site
Google Scholar
PubMed
Close
Restricted access

ABSTRACT.

The largest outbreak of human leishmaniasis in Europe took place in Fuenlabrada, Spain, between 2009 and 2017. The University Hospital “12 de Octubre” in Madrid serves the population residing in three districts of Madrid located just north of the outbreak area (Villaverde, Usera, and Carabanchel). Villaverde and Usera are connected by rail to the outbreak area, unlike Carabanchel. We performed a retrospective study including all cases of leishmaniasis diagnosed between 2011 and 2020. Fifty-one cases were documented. In the districts connected by rail to the outbreak area, a higher-than-expected incidence was observed (13.45–15.55 versus 5.2 per 100,000 inhabitants). Apart from the linear distance from the place of residence to the railway tracks, no differences in terms of demographics or risk factors were detected between the populations of the districts. We hypothesize that the direct connection with the outbreak area by rail could explain the higher incidence observed in Villaverde and Usera.

Author Notes

Financial support: This work was supported by Instituto de Salud Carlos III, Spanish Ministry of Science and Innovation, cofinanced by the European Development Regional Fund (ERDF) and the European Social Fund (ESF) “A way to achieve Europe—The ESF invests in your future.” M. Fernández-Ruiz holds a research contract “Miguel Servet” (CP18/00073) from the Instituto de Salud Carlos III, Spanish Ministry of Science and Innovation.

Current contact information: Jesús Alonso-Carrillo, José Tiago Silva, Sara Castaño-Pérez, Mónica Prieto, Nuria Valdeolivas, and María Asunción Pérez-Jacoiste Asín, Unit of Infectious Diseases, Hospital Universitario “12 de Octubre”, Instituto de Investigación Sanitaria Hospital “12 de Octubre” (imas12), Madrid, Spain, E-mails: jesusalonsocarrillo@gmail.com, j.tiago.silva@hotmail.com, sarcaspe@gmail.com, monica.prieto@live.com, nuria.valdeolivas.hidalgo@gmail.com, and mperezja82@hotmail.com. Ana Pérez Ayala, Department of Microbiology, Hospital Universitario “12 de Octubre”, Instituto de Investigación Sanitaria Hospital “12 de Octubre” (imas12), Madrid, Spain, E-mail: apayalabalzola@salud.madrid.org. Mario Fernández-Ruiz, José María Aguado, and Francisco López-Medrano, Unit of Infectious Diseases, Hospital Universitario “12 de Octubre”, Instituto de Investigación Sanitaria Hospital “12 de Octubre” (imas12), Madrid, Spain, Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III (ISCIII), Madrid, Spain, and Department of Medicine, School of Medicine, Universidad Complutense, Madrid, Spain, E-mails: mario_fdezruiz@yahoo.es, jaguadog1@gmail.com, and flmedrano@yahoo.es. Manuel Lizasoain, Unit of Infectious Diseases, Hospital Universitario “12 de Octubre”, Instituto de Investigación Sanitaria Hospital “12 de Octubre” (imas12), Madrid, Spain, and Department of Medicine, School of Medicine, Universidad Complutense, Madrid, Spain, E-mail: manuel.lizasoain@salud.madrid.org.

Address correspondence to Francisco López-Medrano, Unit of Infectious Diseases, Hospital Universitario “12 de Octubre,” Centro de Actividades Ambulatorias, 2a planta, bloque D. Avda. de Córdoba, s/n, 28041 Madrid, Spain. E-mail: flmedrano@yahoo.es
  • 1.

    Aronson N , Herwaldt BL , Libman M , Pearson R , Lopez-Velez R , Weina P , Carvalho EM , Ephros M , Jeronimo S , Magill A , 2016. Diagnosis and treatment of leishmaniasis: Clinical practice guidelines by the Infectious Diseases Society of America (IDSA) and the American Society of Tropical Medicine and Hygiene (ASTMH). Clin Infect Dis 63: 15391557.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 2.

    Aguado M , Espinosa P , Romero-Maté A , Tardío JC , Córdoba S , Borbujo J , 2013. Outbreak of cutaneous leishmaniasis in Fuenlabrada, Madrid. Actas Dermosifiliogr 104: 334342.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 3.

    Consejería de Sanidad, Comunidad de Madrid , 2015 General Direction of Public Health. Leishmaniasis in the Region of Madrid [in Spanish]. Available at: http://www.madrid.org/bvirtual/BVCM017837.pdf. Accessed July 2, 2023.

    • PubMed
    • Export Citation
  • 4.

    Ruiz-Fons F , Ferroglio E , Gortázar C , 2013. Leishmania infantum in free-ranging hares, Spain, 2004–2010. Euro Surveill 18: 20541.

  • 5.

    Dirección General de Salud Pública, Consejería de Sanidad, Comunidad de Madrid , 2016. Leishmaniasis Outbreak of Leishmaniasis in Fuenlabrada and Other Municipalities of the Region of Madrid. Role of Hares and Rabbits as Reservoirs [in Spanish]. Available at https://www.madrid.org/bvirtual/BVCM017962.pdf. Accessed July 2, 2023.

    • PubMed
    • Export Citation
  • 6.

    García N et al., 2014. Evidence of Leishmania infantum infection in rabbits (Oryctolagus cuniculus) in a natural area in Madrid, Spain. Biomed Res Int 2014: 318254.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 7.

    Gomez-Barroso D , Herrador Z , San Martin JV , Gherasim A , Aguado M , Romero-Mate A , Molina L , Aparicio P , Benito A , 2015. Spatial distribution and cluster analysis of a leishmaniasis outbreak in the south-western Madrid region, Spain, September 2009 to April 2013. Euro Surveill 20: 1120.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 8.

    Aránguez Ruiz E et al., 2014. Spatial analysis of an outbreak of leishmaniasis in the south of Madrid’s metropolitan area, 2009–2013 [in Spanish]. Rev Salud Ambient 14: 3953.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 9.

    León P , 2016. Be Cautious, There are Rabbits Herein [in Spanish]. Available at: https://elpais.com/ccaa/2016/04/02/madrid/1459621906_198034.html. Accessed July 2, 2023.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 10.

    Barroso FJ , 2016. Aim: To Erase Rabbits and Hares [in Spanish]. Available at: https://elpais.com/espana/madrid/2020-05-11/conejos-y-liebres-los-enemigos-que-hay-que-batir.html. Accessed July 2, 2023.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 11.

    Callejo D , 2016. Rabbit Burrows Threaten Railways [in Spanish]. Available at: https://cadenaser.com/emisora/2016/03/28/ser_madrid_sur/1459164660_677893.html. Accessed July 2, 2023.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 12.

    Carrasco-Antón N et al., 2017. Environmental factors as key determinants for visceral leishmaniasis in solid organ transplant recipients, Madrid, Spain. Emerg Infect Dis 23: 11551159.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 13.

    González E , Molina R , Iriso A , Ruiz S , Aldea I , Tello A , Fernández D , Jiménez M , 2021. Opportunistic feeding behaviour and Leishmania infantum detection in Phlebotomus perniciosus females collected in the human leishmaniasis focus of Madrid, Spain (2012–2018). PLoS Negl Trop Dis 15: e0009240.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 14.

    Municipality of Madrid , 2019. Exploitation of the Municipal Census of Inhabitants District of Villaverde [in Spanish]. Available at: https://www.madrid.es/UnidadesDescentralizadas/UDCEstadistica/Nuevaweb/Publicaciones/Padr%C3%B3n%20Municipal%20de%20Habitantes/2019/Distrito%2017_19.pdf. Accessed July 2, 2023.

    • PubMed
    • Export Citation
  • 15.

    Spanish National Center for Epidemiology, CIBER de Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III , 2017. Epidemiological Surveillance of Transmissible Diseases in Spain, 2015 Annual Report [in Spanish]. Available at: http://gesdoc.isciii.es/gesdoccontroller?action=download&id=25/01/2019-d8ee271b6f. Accessed July 2, 2023.

    • PubMed
    • Export Citation
  • 16.

    Arce A et al., 2013. Re-emergence of leishmaniasis in Spain: Community outbreak in Madrid, Spain, 2009 to 2012. Euro Surveill 18: 20546.

  • 17.

    Vilas F , Fúster F , 2016. Management of the leishmaniasis outbreak. Outbreak of Leishmaniasis in Fuenlabrada and Other Municipalities of the Region of Madrid. Role of Hares and Rabbits as Reservoirs [in Spanish]. Madrid, Spain: Dirección General de Salud Pública, Consejería de Sanidad, Comunidad de Madrid, 5565.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 18.

    Werneck GL , Costa CH , Walker AM , David JR , Wand M , Maguire JH , 2002. The urban spread of visceral leishmaniasis: Clues from spatial analysis. Epidemiology 13: 364367.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 19.

    Sanchez E , 2019. Railways, A Natural Paradise for the Rabbits [in Spanish]. Available at: https://elpais.com/sociedad/2019/04/06/actualidad/1554570785_625062.html. Accessed July 2, 2023.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 20.

    Pérez-Roldan F , Montilla-Pérez M , Muñoz-Lomas F , 2016. Leishmaniasis’s outbreak in the autonomous community of Madrid. Importance of the measures of protection [in Spanish]. Enfermería Global [Internet] 41: 361374.

    • PubMed
    • Search Google Scholar
    • Export Citation
Past two years Past Year Past 30 Days
Abstract Views 1341 1341 602
Full Text Views 34 34 14
PDF Downloads 46 46 21
 
 
 
 
Affiliate Membership Banner
 
 
Research for Health Information Banner
 
 
CLOCKSS
 
 
 
Society Publishers Coalition Banner
Save