Leishmaniasis in Pennsylvania

• Cutaneous Leishmaniasis: Skin sores or ulcers, often appearing weeks to months after the bite, which can heal but leave scars.
• Mucocutaneous Leishmaniasis: Destructive lesions of the mucous membranes of the nose, mouth, or throat, leading to disfigurement.
• Visceral Leishmaniasis (Kala-azar): Prolonged fever, weight loss, enlargement of the spleen (splenomegaly) and liver (hepatomegaly), and anemia.

Leishmaniasis is primarily transmitted through the bite of an infected female phlebotomine sandfly. These sandflies become infected by feeding on an infected human or animal (such as rodents or dogs) and then transmit the *Leishmania* parasites to a new host during a subsequent blood meal. Direct human-to-human transmission is rare, but vertical transmission (mother to child) and shared needle transmission have been reported.

• Avoid sandfly bites, especially during peak activity (dusk to dawn), by staying indoors.
• Use insect repellent containing DEET or picaridin on exposed skin.
• Wear long-sleeved shirts, long pants, and socks when outdoors.
• Sleep under insecticide-treated bed nets if in an endemic area.
• Ensure windows and doors have fine-mesh screens.