Epidemiologia i genètica del brot de leishmaniosi detectat a Madrid l’any 2009

Abstract

Leishmaniasis are a set of zoonotic diseases caused by various species of Leishmania, a group of strict parasitic protozoa with an heteroxenous cycle, alternating an invertebrate host, which acts as a vector, and a vertebrate host, usually mammal, which can act as asymptomatic reservoir. Epidemiologically, they are endemic diseases on every continent except Antarctica and affect between 700.000 and one million people each year. Their main reservoir are dogs and they are transmitted through hematophagous diptera known as phlebotomes. In humans, the infection can be presented in three forms depending on the species of Leishmania involved: cutaneous, mucocutaneous and visceral leishmaniasis. The diagnosis is made using parasitological, molecular and immunological techniques. The reference technique for the current taxonomy of leishmanias is the isoenzymatic analysis (MLEE), although it is gradually being replaced by molecular methods that are more resolutive. In 2009, one of the largest outbreaks of leishmaniasis in humans reported to date occurred in the Community of Madrid, characterized mainly by the presence of an alternative reservoir: the hare (Lepus granatensis). The aim of the present thesis is to describe the epidemiology and genetics of this outbreak. For this, a bibliographic search was carried out in the WOS database with the keywords “Leish* AND outbreak AND Madrid” including the results of the categories: articles, reviews and others. After reading the titles and abstracts, a total of 18 articles were selected. By reading all of them, it was determined that the protozoan involved in the outbreak was Leishmania infantum, transmitted through the vector Phlebotomus perniciosus. The main municipalities affected were Fuenlabrada, Getafe and Leganés, all of them located in the sorroundings of the Bosque Sur park. The clinical manifestations of those affected were both cutaneous and visceral. The works carried out on the M-407 road were responsible for a change in the transmission dynamics of L. infantum, which together with the inauguration of the Bosque Sur park in 2007, generated the ideal conditions for the reproduction of the main reservoir, the hares, giving rise to the outbreak in the Community of Madrid in 2009