During 12 months in 1964–65, 21 cases of leishmaniasis were confirmed among the U.S. military in the Canal Zone. These represent an important military medical problem on the basis of duty-time lost and hospitalization costs, due largely to the need to monitor reactions to the antimonial compounds used in therapy. Detailed knowledge of the schedule and movements of the military units during exposure in the endemic area disclosed the exact place and time of infection in many cases and indicated the existence of “microfoci,” small hyperendemic areas, where the hazard of infection was many times greater than in the general area. In only one case was there mucocutaneous involvement. However, there was a wide range of clinical variation of the cutaneous lesions although they were acquired within a small geographic area and over a short period of time. A leishmanial ulcer at the site of a Phlebotomus bite incurred while making a biting collection that consisted almost entirely of P. panamensis affords evidence that this species may be of importance as a vector.
Present address: Mayo Graduate School of Medicine, University of Minnesota School of Medicine, Rochester, Minnesota.