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Subject: DIARRHEAL DISEASES                                              

Unit: VAR. BUMED  

Parent Organization: BUMED       

Box ID: BX303811

Folder Title: VARIOUS NAVAL MESSAGES FOLDER 1                                                                 

Document Number:         16

Folder SEQ  #:          2










                          OLD WORLD CUTANEOUS LEISHMANIASIS

               An ulcerative skin disease caused by Leishmania major in
          Eastern Saudi Arabia and L. tropica in southwestern Saudi Arabia.

          1. Communicability
             A. Route - promastigote inoculated into skin by the bite
               of an infected sandfly.
             B. isolation of patients - not required
             C. Contact prophylaxis - not required

          II.   Incubation period, usually 2-8 weeks, but may be years
                    depending on initial inoculation size.

          III.  Diagnosis
                A.    Symptoms/signs:     Inflammatory papule that slowly
                    increases in size and ulcerates. Base will crust over
                    but the ulcer spreads under the edge of a firm and raised
                    border.   Lesions are usually on exposed skin and are
                    rarely seen in the scalp or on the palms and soles.

                B.  Demonstration of the parasite is necessary to confirm
                    diagnosis. A small full thickness skin biopsy from the
                    lesion's edge is performed and touch props made which can
                    be stained with Giemsa.     The biopsy is divided into
                    halves for culture and histology.

          IV. Duration:
               A. Treated - weeks to months.
               B. Untreated - L.malor heals spontaneously in 3-5 months; I,.
                    tropica  heals spontaneously, but takes 12 months or
                    longer.

          V. Complications
             A. Secondary   bacterial infection.

          VI. Treatment: Ulcers do not necessarily require treatment, but
               consider treating if the lesions are large, multiple, threaten
               structures like the eye, or limit function.
                    A.   Sodium stibogluconate (Pentostam), 20 mg/kg/day IV
                         x 10-20 days.

          VII. Disposition:
ere problem requiring drug treatment - EVAC.
                Minor problem and soldier is mission essential - no immediate
                    treatment required; refer for treatment on return CONUS.

          VIII. Prognosis - excellent.

          IX. Public Health Measures
               1. Sandfly control with residual insecticides.
               2. Host (gerbil) control.
               3. Personal protection with clothing, insect repellent.



   legs

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Document 28 f:/Week-37/BX303811/VARIOUS NAVAL MESSAGES FOLDER 1/diarrheal diseases:1018961450003
Control Fields 17
File Room = sep96_declassified
File Cabinet = Week-37
Box ID = BX303811
Unit = VAR. BUMED
Parent Organization = BUMED
Folder Title = VARIOUS NAVAL MESSAGES FOLDER 1
Folder Seq # = 2
Subject = DIARRHEAL DISEASES
Document Seq # = 16
Document Date =
Scan Date =
Queued for Declassification = 01-JAN-1980
Short Term Referral = 01-JAN-1980
Long Term Referral = 01-JAN-1980
Permanent Referral = 01-JAN-1980
Non-Health Related Document = 01-JAN-1980
Declassified = 18-OCT-1996