Studies on leishmaniasis in northern Greece: Current situation

In Greece the anti-malarial vector control program in the 1940' s reduced the prevalence of leishmaniases but in the last 15 years the incidence of the diseases has been increasing (WHO 1990). Cutaneous leishmaniasis is usually caused by Leishmania tropica and visceral leishmaniasis by L. infantum. A single dermotrop isolate of L. infantum has been reported (FRANK et al., 1993). Phlebotomus neglectus has been found to be the vector for L. infantum (LEGER et al. 1988, GARIFALLOU et al. 1989) while for L. tropica it has not been identified, although the suspected vector is P. sergenti. A four year survey was conducted to evaluate the current situation of Leishmaniasis in Northern Greece (Macedonia and Thrace). This report is a part of epidemiological studies on leishmaniasis which have been started in Northern Greece in 1992, initiated by scientists from the Institute for Medical Parasitology/Bonn and the Department for Parasitic Diseases/Thessaloniki. Collection of sandflies was attempted in different places of Kassandra, Sithonia and in the Holy Mount of Athos. From June to October 1992 a total of 811 sandflies were caught by oil-traps in peridomestic places of the city of Neos Marmaras and in the year 1993 more than 4000 examples were collected by CDC miniature light traps in different parts of Chalkidiki. Traps operated all night, and were used at irregular intervals in most biotopes and in regular intervals in some biotopes were studied more extensively as potential breeding and resting sites of sandflies. Seven species of sandflies were found: Phlebotomus neglectus, P. tobbi, P. perfiliewi, P. sergenti, P. simici, Sergentomyia minuta and sporadically S. dentata. 22 out of 35 Leishmania isolates from dogs in the surroundings of Thessaloniki, Serres, Drama and Kawala were successfully cultivated and seven of them could be established in in vitro culture. Of 314 dogs from the Thessaloniki area tested by ELISA, 53 (16.9%) were positive; of 50 dogs from the Xanthi area 9 (23.7%) were positive. Leishmaniasis is endemic in Northern Greece and seems to be a zoonosis. Epidemiological significance of animal reservoirs and the role of the Leishmania vectors needs to be clarified and specific control measures against Leishmaniasis must be initiated.