Ecology and attempted control of cutaneous leishmaniasis around jericho, in the jordan valley

Cutaneous leishmaniasis is hyperendemic in the Jordan Valley near Jericho. Of the soldiers stationed in the area for 1 month, 50% were found, by clinical and laboratory methods, to be infected. For the first time a local natural reservoir was found; 40% of Psammomys obesus, a wild rodent captured in the area, were infected with the same strain of Leishmania tropica as were the humans. The insect vector is identified as Phlebotomus papatasii. Control measures used (health education, topical application of insect repellents, and spraying with DDT) were followed by a reduction in the number of lesions per person. Complete protection was observed 2-3 months after intradermal inoculation of leishmaniads. Partial protection was observed 3 weeks after such inoculation. Differences in efficacy were observed in the use of 2 different strains of L. tropica. A summary of 2 years of experience with different measures of control is discussed.