Kala Azar: What is visceral leishmaniasis, symptoms, its preventions and all you need to know

All patients with a diagnosis of Visceral Leishmaniasis or Kala Azar need immediate and thorough therapy.

Liposomal AmB is the medicine of choice for immunocompetent patients for the treatment of Kala Azar.
Liposomal AmB is the medicine of choice for immunocompetent patients for the treatment of Kala Azar.

Health News: Union Health Ministry recently shared a data stating that India contributes 11.5 per cent of total cases of Visceral Leishmaniasis or Kala Azar reported globally. When we talk about India, more than 90 per cent of the Kala-azar cases currently are contributed by Bihar and Jharkhand. Uttar Pradesh (2019) and West Bengal (2017) states have achieved their elimination targets at the block level.

Health Wire spoke to Dr. R R Dutta – HOD, Internal Medicine, Paras Hospitals, Gurugram – to understand more about the disease, its symptomps and preventions. Here are excerpts:

What is Visceral Leishmaniasis or Kala Azar?

  1. Sandfly bites can cause visceral leishmaniasis. Internal organs are typically impacted by this kind of leishmaniasis, including the spleen, liver, and bone marrow.

2. A parasite migrates to internal organs like the liver, spleen (thus “visceral”), and bone marrow in kala azar, also known as visceral leishmaniasis. The host will nearly invariably die if the condition is not treated.

3. Additionally known as “black fever,” it is transmitted by contagious sand flies and brought on by parasitic infection with leishmania.

4. The primary route is by a female phlebotomine sand fly bite. By suckling on the blood of an infected animal or person, sand flies catch the disease. Because of: People might not be aware that sand flies are present.

5. They don’t make any noise; they’re small—on average, they’re even smaller than mosquitoes; and their bites might not be felt (the bites can be painless or painful).

Types of Visceral Leishmaniasis or Kala Azar

Cutaneous leishmaniasis is a different type of Kala-azar that causes skin lesions, primarily ulcers on exposed body areas, which leaves scars and causes major disability. The lesions are often harmless but can be uncomfortable, especially if open sores develop a bacterial infection.

Cutaneous leishmaniasis types:

Leishmaniasis of the Mucosa: In this form of Cutaneous leishmaniasis, infection is brought on by the spread of parasites from the skin to the mucosa of the naso-oropharynx.

Kala Azar: Symptoms

1. A quiet infection affects some people, leaving them symptom- and sign-free. Clinical evidence of infection typically manifests as fever, weight loss, splenic and liver enlargement (swelling), abnormal blood tests, and a fever. Low blood counts in individuals can include anemia (low red blood cells), leukopenia (low white blood cells), and plateletemia (low platelets) (thrombocytopenia).

2. A quiet infection affects some people, leaving them symptom- and sign-free.

3. Within a few weeks or months following the sand fly bite, the skin lesions associated with cutaneous leishmaniasis typically appear.

4. Visceral leishmaniasis patients typically develop symptoms months (and perhaps years) after being bitten.

Kala Azar: Preventions

1. Avoiding sand fly bites is the most effective strategy to avoid infection.

2. Avoid being outside, especially between dusk and early when sand flies are typically most active.

3. Reduce the amount of skin that is exposed (uncovered). Wear long sleeves, long pants, socks, and, to the extent that the weather permits it, tuck your shirt into your pants.

4. Insect repellent should be applied to exposed skin, as well as the ends of sleeves and pant legs. Observe the directions on the repellent’s label. Typically, repellents that include the chemical DEET are the most effective (N,N-diethylmetatoluamide).

5. Keep to air-conditioned or well-screened spaces.

6. Remember that sand flies may squeeze through narrower openings since they are smaller than mosquitoes.

7. To get rid of bugs, use an insecticide to spray living and sleeping places.

8. Use a bed net and tuck it beneath your mattress if you are not sleeping in an area that is well-screened or air-conditioned. Use a bed net that has been treated with a pyrethroid-containing insecticide, if at all possible. The same procedure can be used on garments, screens, curtains, and linens (clothing should be retreated after five washings).

How to treat Visceral Leishmaniasis (Kala Azar)

1. When diagnosing visceral leishmaniasis, parasitological or serological testing are combined with clinical symptoms (such as rapid diagnostic tests). All patients with a diagnosis of visceral leishmaniasis need immediate and thorough therapy.

2. Early detection and timely, efficient treatment lower illness prevalence and avoid disability and death. As well as monitoring the prevalence and burden of disease, it aids in reducing transmission.

3. Liposomal AmB is the medicine of choice for immunocompetent patients for the treatment of Kala Azar. There are further treatment alternatives, including miltefosin, paromomycin, and multidrug therapy.

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