Abstract
Visceral leishmaniasis (VL) caused by Leishmania (L.) infantum is a public health threat in the Emilia-Romagna region, northeastern Italy, but its epidemiology has not been fully elucidated in this area. The objective of this study was to characterize Leishmania infection in sand flies collected in a re-emerging focus of VL in the Bologna province. During the summer of 2016, 6114 sand flies were collected, identified, and tested for Leishmania detection. Of the identified sand flies, 96.5% were Phlebotomus (P.) perfiliewi and 3.5% were P. perniciosus. Detected parasites were characterized by biomolecular methods (multilocus microsatellite typing and characterization of repetitive region on chromosome 31), and quantified by real-time PCR. The prevalence of Leishmania infection in individually-tested P. perfiliewi sand flies varied from 6% to 10% with an increasing trend during the season. Promastigotes of L. infantum were isolated by dissection in one P. perfiliewi female; the isolated strain (Lein-pw) were closely related to Leishmania parasites from VL cases in northeastern Italy, but differed from strains isolated in dogs from the same area. Our findings strongly support the vector status of P. perfiliewi for human VL in the study area.
Highlights
In the Mediterranean basin, Leishmania infantum is the causative agent of visceral leishmaniasis (VL), a zoonotic parasitic disease affecting humans; dogs, susceptible to canine leishmaniasis, are considered the main reservoirs in this nosogeographical entity [1,2]
Promastigotes of L. infantum were isolated by dissection in one P. perfiliewi female; the isolated strain (Lein-pw) were closely related to Leishmania parasites from Visceral leishmaniasis (VL) cases in northeastern Italy, but differed from strains isolated in dogs from the same area
The sand fly, P. perfiliewi, is largely predominant in this area, reaching high density in the sylvatic environment in the central-eastern part of the region, while P. perniciosus is present at considerably lower density [9], this particular proportion between the two species is confirmed by samplings dating back to the 70s [10,11]
Summary
In the Mediterranean basin, Leishmania infantum is the causative agent of visceral leishmaniasis (VL), a zoonotic parasitic disease affecting humans; dogs, susceptible to canine leishmaniasis, are considered the main reservoirs in this nosogeographical entity [1,2]. In Italy, the primary vector of VL is Phlebotomus (P.) perniciosus, a sand fly widely distributed across the country and abundant in the Tyrrhenian and Southern regions [3]. The sand fly, P. perfiliewi, more abundant in Central Italy [4], is considered a less relevant vector of L. infantum in restricted foci of leishmaniasis [5,6]. After the VL epidemic in 1971–1972 with 60 cases [7], recrudescence of human leishmaniasis was recorded in 2012–13 in the hilly part of the Bologna province (Emilia-Romagna region, northeastern Italy), with more than 30 cases [8] (Figure 1). The sand fly, P. perfiliewi, is largely predominant in this area, reaching high density in the sylvatic environment in the central-eastern part of the region, while P. perniciosus is present at considerably lower density [9], this particular proportion between the two species is confirmed by samplings dating back to the 70s [10,11]
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