The infantile visceral leishmaniasis: could it attack Egyptian north coastal region again?

Visceral leishmaniasis is caused by three species of the L. donovani complex: L. donovani, L. infantum, and L. chagasi. Infections with these organisms are often asymptomatic or very mild, but in a minority of individuals there is progression to severe symptomatic disease. This is associated with spread of the infection throughout the reticuloendothelial system. L. infantum typically affect children below the age of 5 years. However, IVL can also occur in immunosuppressed adults, such as transplant recipients and patients receiving immunosuppressive chemotherapy or patients suffering from chronic intestinal schistosomiasis. IVL was encountered in Al-Agamy, Alexandria on 1983 with Phlebotomus langeroni. This vector is still abundant with low density away from Al-Agamy. Urbanization of the north coastal area in the vicinity of Alexandria changes the ecological status but how does it affect the behavior of sandflies; mainly the IVL vector Phlebotomus langeroni? Many employees and their families return home from Libya with fever with or without other accompanying symptoms. Fever can be a manifestation of a minor, self-limited process or can herald a progressive, life-threatening illness. The detection of Phlebotomus langeroni in El-Hamam City, Sedi Barany City, and Matrooh City and the abundance P. papatasii in these three cities in addition to Al Agamy must be taken into consideration of the Public Health Authority.