Cutaneous Leishmaniasis in Texas
Step 1 –Gather information and identify preliminary issues
Cutaneous Leishmaniasis causes skin lesions where the single-celled female phlebotomine sand fly bites a human and feeds on blood (Wright, Davis, Aftergut, Parrish, & Cockerell, 2008; DSHS, 2005). Over 350 million people are threatened with contracting this disease in 88 countries (DSHS, 2005; WHO, 2009). At least 1.5 million new cases are identified each year (WHO, 2009; IDRI, 2009). There are currently 12 million cases of leishmaniasis in the world (WHO, 2009). Leishmaniasis has many different forms, some of which are fatal. Cutaneous leishmaniasis, however, is not fatal. The incubation period between becoming infected and showing symptoms vary per person, but skin lesions usually occur within several weeks or months after the bite (Aftergut, 2007). The skin lesions may heal spontaneously after appearance usually within 6-12 months, meaning they do not require antiparasitic drugs (Wright et al. 2008). The skin lesions typically leave ugly scars, which may cause stigma and social withdrawal.
The sand fly is most active during the hours between dusk and dawn, peaking around twilight (Schwartz, Hatz, & Blum, 2006). The sand fly is attracted to tropical, subtropical, rural or even suburban environments that may have sanitation or waste problems. These problems attract insects such as the sand fly. The burrowing wood rat carries the Leishmania parasite, and the sand fly is infected when feeding off the rat, which in turn infects humans when bit (Aftergut, 2007). This rat is attracted to wooded environments present in rural areas in Texas, which may explain the shift from south to north incidence of the disease, as the wood rat shifted areas (Wright et al. 2008; Aftergut, 2007). Texas has limited cases and the situation is not as dire as some communities in the Middle East or South America.
Some troubling issues pertaining to leishmaniasis is evidence...