Importation of visceral leishmaniasis in returning Romanian workers from Spain

• Published in: Travel medicine and infectious disease Vol. 7; no. 1; pp. 35 - 39
• Main Authors: Neghina, Raul, Neghina, Adriana-Maria, Merkler, Carmen, Marincu, Iosif, Moldovan, Roxana, Iacobiciu, Ioan
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier Ltd 01-01-2009; Elsevier Limited
• Subjects: Adult; Amphotericin B - therapeutic use; Antiprotozoal Agents - therapeutic use; Bone marrow; Bone marrow biopsy; Climatic conditions; Diagnosis, Differential; Fatal Outcome; Female; Giemsa-stained blood smears; Hospitalization; Humans; Infectious Disease; Leishmaniasis, Visceral - diagnosis; Leishmaniasis, Visceral - drug therapy; Leishmaniasis, Visceral - epidemiology; Male; Mediterranean countries; Retrospective Studies; Romania - epidemiology; Spain; Time Factors; Travel; Travel history; Travel medicine; Treatment Outcome; Vector-borne diseases; Romania; Spain; Bone marrow biopsy; Travel history; Giemsa-stained blood smears; Mediterranean countries
• ISSN: 1477-8939; 1873-0442
• DOI: 10.1016/j.tmaid.2008.10.002

Summary Background Over the past two decades visceral leishmaniasis cases and foci have increased in Romania, where the disease has also become a medical concern. The following study aimed to provide essential knowledge on early diagnosis and management of visceral leishmaniasis cases in Romania acquired especially by traveling and working in the Mediterranean countries. Method Retrospective analysis of the medical records of the patients diagnosed with imported visceral leishmaniasis in a western Romanian county. Results Three patients with visceral leishmaniasis imported from Spain were admitted to hospital in Timisoara in 2005. Detailed case histories along with clinical and laboratory features are presented. In all the patients the final laboratory confirmation of the disease was by Giemsa-stained blood smears obtained by bone marrow biopsy. Conclusions Since 2004, many Romanian citizens left their homeland looking for a better job in the Mediterranean region. Unaware of the risks of outdoor labor in warm climatic conditions, they accepted to live and work in improper sanitary conditions. Late identification of the disease resulted mainly from failure of the physicians to diagnose and associate the syndrome with travel.