1. VC1B VC WASH Cluster – Emergency Training 1 Vector Control Module 1B Leishmaniasis

2. VC1B VC WASH Cluster – Emergency Training 2 Leischmaniasis Phlebotomine sandfly 500 species, 30 carry Leischmaniasis Small (2-3 mm long)

3. VC1B VC WASH Cluster – Emergency Training 3 CutaneousSkin lesions (oriental sore) Deformities of mouth/nostrils (espundia) 1–1.5 million cases/year Visceral (Kala Azar) Infection in the lymphatics, fever, substantial weight loss, swelling of the spleen and liver and anemia and death if untreated, 500,000 cases/year RecidivansRelapsing, tuberculoid form of cutaneous leishmaniasis Lesions usually on the face Chronic can last for decades Leishmaniasis symptoms by type

4. VC1B VC WASH Cluster – Emergency Training 4 Live in inter-tropical and temperate regions Female’s feed on blood to mature eggs Larvae need organic matter, heat and humidity to develop Eggs laid in burrows of specific rodents, bark of old trees, cracks in walls animal shelters and rubbish Female sandfly covers a radius of several hundred meters Only suck blood at night

5. VC1B VC WASH Cluster – Emergency Training 5

6. VC1B VC WASH Cluster – Emergency Training 6

7. VC1B VC WASH Cluster – Emergency Training 7 Begins as papules or nodules Progresses to ulcers at the site of a vector bite Cutaneous Leishmaniasis : Appears 2-3 weeks after infective bite

8. VC1B VC WASH Cluster – Emergency Training 8

9. VC1B VC WASH Cluster – Emergency Training 9 Visceral leishmaniasis (kala-azar) Incubation period is 2-6 months Presents with fever, massively enlarged spleen and pancytopenia Progresses to weakness, emaciation and death

10. VC1B VC WASH Cluster – Emergency Training 10 Vulnerability Young age (infants and children) and malnutrition predispose to development of disease HIV sufferers also at increased risk Overall death rate = 11%

11. VC1B VC WASH Cluster – Emergency Training 11 Control Long lasting insecticide treated nets (LLINs)to protect from sandfly bites Indoor residual treatment Outdoor space spraying