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Epidemiology of Imported Cutaneous Leishmaniasis at the Hospital for Tropical Diseases, London, United Kingdom: Use of Polymerase Chain Reaction to Identify the Species

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  • Department of Clinical Parasitology, Hospital for Tropical Diseases, London, United Kingdom; London School of Hygiene and Tropical Medicine, London, United Kingdom

This study reviewed all patients diagnosed with imported cutaneous leishmaniasis (CL) at the Hospital for Tropical Diseases in London, United Kingdom, over an 11-year period. Diagnostic and epidemiologic information was collected prospectively for all patients with imported CL to this hospital during 1998–2009. A total of 223 patients were given a diagnosis of CL. Ninety patients were diagnosed with Old World CL, which was caused most commonly by Leishmania donovani complex (n = 20). A total of 71% were tourists to the Mediterranean region, 36% were migrants or visiting friends and relatives, and 17% were soldiers. One hundred thirty-three patients were given a diagnosis of New World CL. The Leishmania subgenus Viannia caused 97 of these cases; 44% of these were in backpackers and 29% were in soldiers. Polymerase chain reaction was more sensitive and faster for detecting Leishmania DNA (86% for Old World CL and 96% for New World CL) than culture. This is the largest study of imported leishmaniasis, and demonstrates that tourists to the Mediterranean and backpackers in Central and South America are at risk for this disease.

Author Notes

*Address correspondence to Emma C. Wall, Hospital for Tropical Diseases, Mortimer Market Centre, Capper Street, London WC1E 6JB, United Kingdom. E-mail: emma.wall@doctors.org.uk

Financial support: This study was supported by the Special Trustees of the Hospital for Tropical Diseases. Margaret Armstrong is supported by The Special Trustees of the Hospital for Tropical Diseases. All authors are supported by the University College London Hospitals Comprehensive Biomedical Research Centre Infection Theme. The funding agencies had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

Disclosure: None of the authors have any conflicts of interests.

Authors' addresses: Emma C. Wall and Margaret Armstrong, Hospital for Tropical Diseases, Mortimer Market Centre, Capper Street, London WC1E 6JB, United Kingdom, E-mails: emma.wall@doctors.org.uk and Margaret.Armstrong@uclh.nhs.uk. Julie Watson, Department of Clinical Parasitology, Hospital for Tropical Diseases, Mortimer Market Centre, Capper Street, London WC1E 6JB, United Kingdom, E-mail: Julie.Watson@uclh.nhs.uk. Peter L. Chiodini, Hospital for Tropical Diseases, Mortimer Market Centre, Capper Street, London WC1E 6JB, United Kingdom, Department of Clinical Parasitology, Hospital for Tropical Diseases, Mortimer Market Centre, Capper Street, London WC1E 6JB, United Kingdfom, and London School of Hygiene and Tropical Medicine, Keppel Street, London WC1E 7HT, United Kingdom, E-mail: Peter.Chiodini@uclh.nhs.uk. Diana N. Lockwood, Hospital for Tropical Diseases, Mortimer Market Centre, Capper Street, London WC1E 6JB, United Kingdom and London School of Hygiene and Tropical Medicine, Keppel Street, London WC1E 7HT, United Kingdom, E-mail: Diana.Lockwood@lshtm.ac.uk.

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