Human zoonotic cutaneous leishmaniasis and associated sand flies (Diptera: Psychodidae) in Sheikh Atiya village, southern Sinai, Egypt.

Zoonotic cutaneous leishmaniasis is endemic in Sinai Peninsula. Human cases were recorded from the northern Sinai, however little was known about the disease in southern Sinai. During entomological surveys conducted southern Sinai in summers of 1997-1999, a clinically confirmed ZCL case was encountered for the first time in Sheikh Atiya village in June 1999. The parasite was isolated and identified as L. major using cellulose acetate electrophoresis. A total of 784 phlebotomine sand flies were collected. Sand fly species composition at Sheikh Atiya village showed that P. papatasi and P. alexandri were the most abundant species in the area and each comprises about 47 % of the flies collected. P. sergenti and P. kazeruni occurred in very low numbers. All the female flies dissected (N = 304) were negative for any Leishmania-like flagellates. When the identified isolate was inoculated in the footpads of a clean laboratory colonized Acomys cahirinus dimidiatus, a lesion was developed on the site of inoculation 9 months post injection. The role of P. alexandri and A. c. dimidiatus in transmission of leishmaniasis in southern Sinai remains questionable. Environmental factors contributed to the appearance of ZCL in the area are discussed.