Imported leishmaniasis in Germany 2001-2004 : data of the SIMPID surveillance network

• Published in: European journal of clinical microbiology & infectious diseases 2005-07, Vol.24 (7), p.471-476
• Main Authors: WEITZEL, T, MÜHLBERGER, N, BOECKEN, G, ZOLLER, T, PROBST, M, PETERS, M, WEINKE, T, GFRÖRER, S, KLINKER, H, HOLTHOFF-STICH, M.-L, JELINEK, T, SCHUNK, M, EHRHARDT, S, BOGDAN, C, ARASTEH, K, SCHNEIDER, T, KERN, W. V, FÄTKENHEUER, G
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Aged; Antibiotics. Antiinfectious agents. Antiparasitic agents; Antifungal agents; Antiparasitic agents; Biological and medical sciences; Child; Child, Preschool; Emigration and Immigration; Female; Germany - epidemiology; Health risks; Human immunodeficiency virus; Human protozoal diseases; Humans; Infant; Infectious diseases; Leishmaniasis - epidemiology; Leshmaniasis; Male; Medical sciences; Middle Aged; Parasitic diseases; Pharmacology. Drug treatments; Population Surveillance; Protozoal diseases; Risk Factors; Travel; Vector-borne diseases
• ISSN: 0934-9723; 1435-4373
• DOI: 10.1007/s10096-005-1363-1

Leishmaniasis is a rare, non-notifiable disease in Germany. Epidemiological and clinical data, therefore, are scarce. Most infections seen in Germany are contracted outside the country. The German surveillance network for imported infectious diseases (Surveillance Importierter Infektionen in Deutschland, or SIPMID) recorded 42 cases of imported leishmaniasis (16 visceral, 23 cutaneous, and 3 mucocutaneous) from January 2001 to June 2004. Although most infections were acquired in European Mediterranean countries, the risk of infection was highest for travelers to Latin America. HIV coinfection was observed significantly more often in patients with visceral leishmaniasis than in patients with cutaneous/mucocutaneous leishmaniasis (31 vs. 4%, p=0.02). The median time to a definitive diagnosis was 85 days in cases of visceral leishmaniasis and 61 days in cases of cutaneous/mucocutaneous leishmaniasis, reflecting the unfamiliarity of German physicians with leishmanial infections. Visceral leishmaniasis was treated most frequently with amphotericin B, whereas cutaneous/mucocutaneous leishmaniasis was treated with a variety of local and systemic therapies. The findings presented here should serve to increase awareness as well as improve clinical management of leishmaniasis in Germany.