Cutaneous leishmaniasis: an emerging epidemic focus of Leishmania tropica in north Morocco.

Cutaneous leishmaniasis in Morocco occurs mainly in the south and is caused by Leishmania major and L. tropica. In 1995, for the first time, 4 autochthonous cases were confirmed by smear and/or culture from the province of Taza in north Morocco. An active survey revealed 128 more cases. The number had increased gradually since 1994. Most of the cases (86%) came from the suburbs of the city of Taza. All cultured and typed parasites were characterized as L. tropica MON-102. A leishmanin skin test survey among a random sample of the exposed population showed an overall positivity rate of 19.9%, with no correlation with age or gender. The spatial distribution of the cases and skin test positivity, their occurrence in all age groups, the highly variable clinical picture, the severity and large size of lesions in older patients, the slow recovery of some treated patients, and the isoenzymic monomorphism of the parasite, all suggested that cutaneous leishmaniasis caused by L. tropica is an emerging disease in Taza.