A Newly Emerged Cutaneous Leishmaniasis Focus in Northern Israel and Two New Reservoir Hosts of Leishmania major

In 2006/7,18 cases of cutaneous leishmaniasis (cl) were reported for the first time from sde eliyahu (pop. 650),a village in the beit she'an valley of israel. between 2007-2011,a further 88 cl cases were diagnosed bringing the total to 106 (16.3% of the population of sde eliyahu). the majority of cases resided in the south-western part of the village along the perimeter fence. the causative parasite was identified as leishmania major yakimoff & schokhor,1914 (kinetoplastida: trypanosomatidae). phlebotomus papatasi (scopoli),1786 (diptera: psychodidae) was found to be the most abundant phlebotomine species comprising 97% of the sand flies trapped inside the village,and an average of 7.9% of the females were positive for leishmania its1 dna. parasite isolates from cl cases and a sand fly were characterized using several methods and shown to be l. major. during a comprehensive survey of rodents 164 levant voles microtus guentheri danford & alston,1880 (rodentia: cricetidae) were captured in alfalfa fields bordering the village. of these 27 (16.5%) tested positive for leishmania its1 dna and shown to be l. major by reverse line blotting. a very high percentage (58.3% - 21/36) of tristram's jirds meriones tristrami thomas,1892 (rodentia: muridae),found further away from the village also tested positive for its1 by pcr. isolates of l. major were successfully cultured from the ear of a wild jird found positive by its1 pcr. although none of the wild pcr-positive voles exhibited external pathology,laboratory-reared voles that were infected by intradermal l. major inoculation,developed patent lesions and sand flies became infected by feeding on the ears of these laboratory-infected voles. this is the first report implicating m. guentheri and m. tristrami as reservoirs of leishmania. the widespread co-distribution of m. guentheri and p. papatasi,suggests a significant threat from the spread of cl caused by l. major in the middle east,central asia and southern europe. © 2013 faiman et al.