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Volume 14, Number 7—July 2008

Perspective

Spread of Vector-borne Diseases and Neglect of Leishmaniasis, Europe

Jean-Claude Dujardin*Comments to Author , Lenea Campino†, Carmen Cañavate‡, Jean-Pierre Dedet, Luigi Gradoni¶, Ketty Soteriadou#, Apostolos Mazeris**, Yusuf Ozbel††, and Marleen Boelaert*
Author affiliations: *Instituut voor Tropische Geneeskunde, Antwerp, Belgium; †Instituto de Higiene e Medicina Tropical, Lisbon, Portugal; ‡Instituto de Salud Carlos III, Madrid, Spain; §Université Montpellier 1, Montpellier, France; ¶Istituto Superiore di Sanità, Rome, Italy; #Hellenic Pasteur Institute, Athens, Greece; **National Reference Laboratory for Animal Health, Nicosia, Cyprus; ††Ege University Medical School, Bornova, Izmir, Turkey;

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Table

Leishmaniasis situation in 7 disease-endemic countries of Europe (including Turkey)*

Country Human leishmaniasis
Canine leishmaniasis
Notification status Current information from reference centers 
(2000–2006) VL + CL incidence x 100,000† Imported cases (VL + CL)
Portugal‡ Compulsory for VL ≈22 VL cases/y recorded at IHMT 0.07–0.17 ≈2 cases/y recorded at IHMT Average 20% seroprevalence in disease-endemic areas (3)
Spain§ Compulsory in 12/17 autonomous communities; 20%–45% underreporting for VL, ≈100% for CL (4) ≈100 VL cases/y recorded by National Epidemiologic Surveillance Network, RENAVE 0.18–0.29 ≈5 cases/y recorded at ISCIII Average 8.5% seroprevalence (5)
France¶ Not compulsory, but spontaneous reports at UMON ≈24 VL + CL cases/y reported at UMON 0.02–0.19 ≈65 cases/y recorded at UMON Seroprevalence in disease-endemic areas of southern France 4%–20%#
Italy** Compulsory for both VL and CL, but CL underreported ≈200 VL cases/y recorded at ISS; ≈300 CL cases/y estimated by ISS 0.15–0.38 ≈8 cases/y recorded at ISS Average 15% seroprevalence in peninsular Italy; average 2% seroprevalence in continental Italy (6)
Greece†† Compulsory for both VL and CL, but underreported ≈21 VL cases/y notified 0.06–0.49 Unknown Average seroprevalence 25% in disease-endemic areas (7)
Cyprus‡‡ Compulsory for both VL and CL, but
underreported 5 VL + CL cases recorded in 2006 0.25–0.47 Unknown Average seroprevalence 20% in disease-endemic areas
Turkey§§ Compulsory for both VL and CL ≈37 VL cases/y and ≈2,300 CL cases/y notified 1.6–8.53 Unknown Average 15.7% seroprevalence

*Authors’ institutions are national reference laboratories for leishmaniasis diagnosis and surveillance and rely on consolidated countrywide networks of collaborating clinical health centers. Diagnosis records are cross-checked with case notifications to provide more realistic figures and estimates. VL, visceral leishmaniasis; CL, cutaneous Leishmaniasis; WHO, World Health Organization.
†WHO-EURO, WHO Europe, 1996–2005; http://data.euro.who.int/CISID.
‡Instituto de Higiene e Medicina Tropical (IHMT), Lisbon, Portugal.
§Instituto de Salud Carlos III (ISCIII), Madrid, Spain.
¶Université de Montpellier (UMON), data from Centre National de Référence des Leishmania, Montpellier, France.
#Source: retrospective canine leishmaniasis database, Centre National de Référence des Leishmania.
**Istituto Superiore di Sanità (ISS), Rome, Italy.
††Hellenic Pasteur Institute (HPI), Athens, Greece.
‡‡National Reference Laboratory for Animal Health (VS), Nicosia, Cyprus.
§§Ege University (EUMS-DP), Izmir, Turkey.

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