Flesh-eating parasite causing skin infections in US, CDC says

AUSTIN, Texas (KXAN) – A flesh-eating parasitic disease, typically seen in people who travel to tropical or subtropical areas, is now spreading through some sand flies in parts of the U.S., according to a new Centers for Disease Control and Prevention analysis.

The disease, known as leishmaniasis, occurs through a bite of an infected female sand fly, which consumes blood to produce eggs.

The infection is most common in parts of Africa, Brazil, and the eastern Mediterranean region, like Iraq, Somalia, Sudan, and Yemen, according to the World Health Organization. 

The CDC now believes the disease may be endemic, or regularly occurring, in Texas and other states. The agency has received anecdotal reports of leishmaniasis in Florida, though the cases haven’t been confirmed, according to NBC News. Past studies have also noted occasional cases among non-travelers in southeast Oklahoma and Arizona.

“Historically, it was considered that cutaneous leishmaniasis, or any type of leishmaniasis, is linked to international travel,” said Vita Cama, a microbiologist working in the CDC’s Division of Parasitic Diseases and Malaria. “We were doing a different kind of analysis to see what kind of samples were coming to the lab at the CDC, and we noticed there was a specific group that did not report any international travel.”

It is thought that the parasite can live in other hosts, like rodents, and spread through the sand fly. All leishmaniasis infections are caused by Leishmania parasites but can have varying clinical presentations. The most common form – called cutaneous leishmaniasis – can cause ulcers and permanent scars. Some more severe variations of the disease can be fatal, according to the CDC.

Cama said that the CDC’s analysis showed that nearly all people who contracted leishmaniasis and did not travel internationally were infected by the same species of Leishmania.

“We thought that most of the cases were only associated with travel. [But] now, It’s like, OK, it’s not necessarily [only] associated with travel,” he continued. 

In Texas, there have been 38 locally acquired and 117 total cases of the disease from 2007 to 2022. While most of the cases have occurred near the Texas and Mexico border, there have been three reported locally acquired cases in Travis County since 2007, according to the Texas Department of State Health Services.

Leishmaniasis is a reportable condition in Texas, and the DSHS encourages doctors to consider the infection if a patient has consistent symptoms and has not recently traveled overseas. 

Cama said that the CDC is potentially finding more cases in Texas because the state has a more robust reporting system than other U.S. states. Until other states develop better reporting procedures, it will be difficult to understand how widespread leishmaniasis may be in the U.S., Cama said.

DSHS prevention guidance is the same in this case as it is for all other insect-transmitted diseases: wear long sleeves or insect repellant when spending time outdoors.