Division of Epidemiology, Health Promotion and Prevention Subdirectorate, Primary Care Directorate, Madrid, Spain.
Euro Surveill. 2013 Jul 25;18(30):20546. doi: 10.2807/1560-7917.es2013.18.30.20546.
Since July 2009, there has been a community outbreak of leishmaniasis in the south-west area of the Madrid autonomous community, Spain, affecting residents from four towns that are geographically close together and share extensive park areas. As of December 2012, 446 cases were reported (6 in 2009, 97 in 2010, 196 in 2011 and 147 in 2012), a mean incidence rate of 22.2 per 100,000 inhabitants during July 2009 and December 2012. The mean age was 44 years (range: 2 months to 95 years); 61.0% were male. A total of 68 (15.2%) had immunosuppressive conditions; 160 (35.9%) had visceral leishmaniasis and 286 (64.1%) cutaneous. A total of 421 (94.4%) cases were confirmed. Leishmania infantum was identified as the agent. Monitoring revealed high densities of the vector Phlebotomus perniciosus. The surveillance system for canine leishmaniasis did not detect any increase in prevalence during the period. Environmental control measures have been taken, such as improvements in sanitation and disinsection in the risk areas and control of the overpopulation of Leporidae, as xenodiagnosis studies have shown that hares play a role as active reservoirs. This is the largest reported community outbreak of leishmaniasis in Europe. The discovery of the new reservoir stands out in the multifactorial aetiology of the outbreak. Epidemiological research and environmental intervention measures are continuing.
自 2009 年 7 月以来，西班牙马德里自治区西南部地区爆发了利什曼病疫情，受影响的居民来自四个地理位置相邻、拥有广泛公园区域的城镇。截至 2012 年 12 月，共报告了 446 例病例（2009 年 6 例，2010 年 97 例，2011 年 196 例，2012 年 147 例），2009 年 7 月至 2012 年 12 月期间的平均发病率为每 10 万人 22.2 例。平均年龄为 44 岁（范围：2 个月至 95 岁）；61.0%为男性。共有 68 例（15.2%）患有免疫抑制性疾病；160 例（35.9%）患有内脏利什曼病，286 例（64.1%）患有皮肤利什曼病。共确诊 421 例（94.4%）。鉴定出的病原体为婴儿利什曼原虫。监测发现，传播媒介白蛉属的密度很高。犬利什曼病监测系统在该期间未发现流行率增加。已采取环境控制措施，例如在风险地区改善卫生和消毒，并控制兔科动物的过度繁殖，因为动物媒介检测研究表明野兔发挥了主动储存宿主的作用。这是欧洲报告的最大规模的社区利什曼病疫情。新储存宿主的发现是疫情多因素病因学的一个显著特点。正在继续开展流行病学研究和环境干预措施。
