Steve Wooler wrote:Hi Steph
Nobody's treating my wood with linseed oil!
Leaving the subject (and inuendo) of the application of linseed oil to Steve and Steph
I came across a sand fly bourne illness called leishmaniasis on
http://www.traveldoctor.co.uk/stings.htm
Lurking on the beaches of many of our favourite holiday and diving resorts is a disease that can do more than just ruin your holiday. It's a disease that can haunt you for months after you return home, and even ruin your life. Though it's not as widely known as malaria, it can be every bit as painful, tenacious, and dangerous. Worse yet, the source of the infection is nearly invisible - the ubiquitous no-see-um, the disease it transmits - Leishmaniasis.
If you've never heard of leishmaniasis, you're hardly alone. The culprits that spread the disease, commonly referred to as no-see-ums (because you hardly ever see them), are minute insects of the genus Phlebotomus often called "sand flies" and like mosquitoes, the gestating female no-see-ums hungry for protein go in search of a "blood meal". It is during the process of feeding that they transmit the protozoan parasites responsible for the disease.
It is also possible for a fever and rash to develop after receiving several no-see-um bites as a reaction to the toxins in the bites themselves, and multiple no-see-um bites can cause death from their toxins alone.
Leishmaniasis currently affects around 12 million people in 88 countries (with 2.5 million new infections annually). It is considered a dynamic disease whose range is constantly spreading which is now well entrenched in the Mediterranean, North Africa, The Middle East, South East Asia, Central America and the Caribbean.
In its cutaneous form, leishmaniasis is characterised by a skin sore or sores that develop weeks or months after transmission. Sores typically leave scars, and some forms can be severely disfiguring.
Visceral leishmaniasis, traditionally known as kala-azar may take months and even years to develop and is fatal if untreated. Symptoms include fever, weight loss, cough, diarrhoea, lethargy, enlargement of the spleen and liver, and anaemia. Both forms require a biopsy for diagnosis.
Though leishmaniasis only accounts for a small percentage of tropical infections, unless the victims consult physicians specialising in tropical medicine, diagnosis is often inaccurate. The disease is quite difficult to cure and victims are prone to recurrences.
For decades the most effective treatment has been considered to be sodium stibogluconate, but the three-week intravenous regimen is relatively toxic, and the parasite is reportedly becoming antimony-resistant in some areas so there is no guarantee that it will not recur. Other treatments are available, but no cure is 100% effective, and there are currently no vaccines available.
With no certain cure, prevention is definitely the key. No-see-ums are usually more of a problem at night and when the wind dies down on the beach. The first line of defence is to cover yourself with insect repellents containing DEET. Wear long-sleeved shirts, long trousers, and socks in the evenings.
While the odds of bringing home leishmaniasis are probably too small to allow it to influence travel plans, the consequences of infection are so unpleasant that it makes good sense to take aggressive steps to avoid becoming the main course for a hoard of hungry no-see-ums.
If on return from an endemic area, you develop persistent sores that you fear may be indicative of leishmaniasis, ask for a referral to a tropical medicine specialist.
On second thoughts - maybe a liberal dosing of linseed oil to the nether regions is a precaution worth taking!
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