Leishmaniasis in Panama

The following background data on Leishmaniasis in Panana are abstracted from Gideon www.GideonOnline.com and the Gideon e-book series. [1,2]

Time and Place:
- Most cases are reported from western Panama – Bocas del Toro, Cocle, Colon, Chiriqui and Panama Provinces.
- Children and new settlers to forest areas are at highest risk.

Infecting species:
- Leishmania mexicana amazonensis and L. braziliensis panamanensis are implicated.
- L. colombiensis is also encountered.
- L. naiffi has been identified in sand flies the region of the Canal Zone.

Reservoirs:
- Leishmania braziliensis has been identified in the two-toed sloth (Choloepus hoffmanni) and three-toed sloth (Bradypus infuscatus.
- The two-toed sloth has also been identified as a reservoir for Leishmania panamensis and L. colombiensis.
- Parasites have also been demonstrated in the night monkey (Aotus trivirgatus).
- Dogs may also act as natural reservoirs in this country. 3% of dogs in forest settlements are infected (1968 to 1973).

Vectors:
- The principal local vector for L. panamensis is Lutzomyia (Nyssomyia) trapidoi.
- Additional species of anthropophilic sandflies have been implicated, including Lu. (N.) ylephiletor, Lu. (Ps.) panamensis, Lu. ovallesi, Lu. (Ps.) shannoni, and Lu. gomezi.
- The predominant vectors in Gamboa (central Panama) are Lu. (Ps.) panamensis and Lu. gomezi.

Notable outbreaks:
1984 – An outbreak (15 cases) was reported among Puerto Rican National Guard personnel conducting exercises in Panama.

References:
1. Berger SA. Infectious Disases of Panama, 2012. 378 pp, 79 graphs, 1290 references. Gideon e-books, http://www.gideononline.com/ebooks/country/infectious-diseases-of-panama/
2. Berger SA. Cutaneous and Mucosal Leishmaniasis: Global Status, 2012. 106 pp, 92 graphs, 837 references. Gideon e-books, http://www.gideononline.com/ebooks/disease/cutaneous-and-mucosal-leishmaniasis-global-status/

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