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Leishmaniasis
Cutaneous, Visceral, Mucocutaneous
 
In 1988 this is a word that even tourist barely heard from
the State Department as a travel warning. A little known third 
world disease that was quite misunderstood. All the way back 
to its Scottish origin of Sir William Boog Leishman in 1903.
 
Physicians Leishman, and Donovan discovered the cause 
of a tropical disease known as Kala-Azar, caused by a 
parasite spread by sandfly bites. It was a stained slide that 
showed Leishmania donovani for the first time.
 
Even though Leishmania tropica and other variants had 
been seen before 1903, it wasn't really understood until 
the public explanation by Leishman and Donovan. 
 
Leishmaniasis is commonly seen in tropical / sub-tropical 
regions of Africa,  Mediterranean, Southern Europe, Asia,  
and South & Central America. Its estimated that 12 million 
people are currently infected. 367 million are at risk of getting 
leishmaniasis in 88 countries. 
 
During the first Gulf War, it was claimed that only 20 cases 
of L. Major ( Cutaneous Leishmaniasis ) surfaced among the 
soldiers coming back. That 12 cases of L. Tropica ( Visceral 
Leishmaniasis ) were diagnosed up to 1993. 
 
To understand the strains and types, there are a few technical 
notes that have to be spelled out. The disease has two parts in 
its lifespan, the Zoonosis and the Anthroponotic. The 
Promastigotes with tails starts in the Sandflies, and the 
small internal round amastogote version thrives in human's.
 
The three different strains listed as Cutaneous, Visceral, and
Mucocutaneous exhibit different symptoms. Cutaneous is 
skin, Visceral in internal organs, and Mucutaneous as related 
to nasal or other mucous regions of the body.  
 
At the point of contact of the sandfly in Cutaneous Leishmaniasis, 
the Sandflies saliva is ejected onto the bite - in that saliva the 
L. Tropica promastigotes burrow into the wound. From there 
they swarm in the wound until the ulceration becomes visible. 
Which becomes a long festering wound that doesn't seem to 
heal for several months. This type of external wound will heal 
in a year or so, but its uncertain if the person ever is completely 
free of the organism. Scarring is a factor, and wounds by eyes
or other sensitive areas is a serious concern. The disease can 
also lay dormant for many years before recurring in a later cut 
or infection. But most of the time it resolves in a non-threatening 
manner. The persons immune system is able to suppress it.
 
Visceral Leishmaniasis is much less understood, and a much 
darker version of this parasite. Its transmitted also by the same 
Sandflies, and in the bite wounds like Cutaneous. After that its 
different in its lifecycle. It burrows deep into the organs, bone, 
of the host. The early stages of the disease are so subtle 
that a person might not know for several years they have it. It 
so small that it doesn't show up in normal blood test, or even 
in early tissue biopsies. Then when the disease is in it latter 
stage does it start to make itself known. Once the Spleen 
becomes enlarged, and the belly extends does it start making 
it presence noticed. The strains of Leishmaniasis are usually 
noted to be L. Infantum ( Infant Syndrome ) or L. Donovani.
 
Incubation period is considered between 3 to 33 weeks. 
That diagnosis being made largely though a bone marrow 
biopsy, and or splenic asparate. ( tissue sample from bone 
marrow or spleen ). PCR ( DNA enzyme ) testing is still 
considered unreliable in confirming this disease in 2005. 
The newest test being a dry PCR to the wet PCR. Today 
its largely found as a stained gel slide where someone 
sees the amastogote in a cell, same as 1903.
 
What does a L. Donovani amastogote usually look like, a 
cell with several nucleus parts to it. The closest rough 
description would be a clear sack with multiple nucleus 
spheres in it instead of one. A clear marble with a clover 
like center. Without the features of a expected parasite, 
its often overlooked - and even missed by laboratories 
looking for it specifically. Its when the parasite is in its 
late stage at 10 to the 15th power number of parasites, 
and swarming that researchers are able to diagnose it.
 
The only American institution dealing with this disease on a 
regular basis is Walter Reed Army Hospital in Washington, 
DC. They work in conjunction with the Armed Forces Institute 
of Pathology to track, type, and treat this disease in troops 
coming back from Afghanistan and or Iraq.
 
Suspected number of current cases of Cutaneous Leishmaniasis 
in these regions in American troops from January 2003 to May 
2005 has been 848. Visceral has been 4 cases of L. Infantum 
in that same period.
 
However, more than 200,000 citizens of Kabul Afghanistan were 
diagnosed with Cutaneous Leishmaniasis in 2003 by the World 
Health Organization. So chance of contagion there is high.
 
In December 2003 the FDA held a blood banking seminar to 
discuss the possibility of contamination of the nations blood 
supply by Leishmaniasis. It was there that the FDA decided a 
lifetime ban on blood donations from persons diagnosed with 
Leishmaniasis from Iraq should be imposed. Later the Pentagon 
would make the same policy of us troops. Why a lifetime ban?
 
Because at this time there is no guarantee of a 100% sterile 
cure of any version of Leishmaniasis. That fact was eluded to 
by Barbara Herwaldt of the CDC when she presented her Power 
Point to the VA Advisory Committees on Gulf War Veterans 
that I served on in 2008-2009. ACGWV CDC 2009 presentation
 
By 2004 more than 1,500 soldierscontracted Leishmaniasis in 
Iraq that was not reported correctly. First they said 253, then 500, 
then 600, then 1,000 and the storychanged much of 2004. At this 
time the screening method wasmostly visual based on skin 
lesions. Very few had blood samplessent to Walter Reed for 
examination. 
 
At the May 2005 Institute of Medicine Infectious Disease 
meeting, Dr. Alan Magill of Walter Reed Army Hospital had 
pointed out to the committee the dark sides of Leishmaniasis. 
Part of which has been outlined in this over view. 

The average American has never heard of this disease and general 
medicine is not prepared to deal with foreign diseases. So as 
these people developed symptoms that had no recourse. I heard 
from one person who approached Walter Reed for blood testing 
only to find them disinterested in identifying it. You need a genome 
type of the strain to identify which species as there are several
in Iraq. L. Tropica and L. Major are the dominate ones. Oddly enough 
we introduced L. Mexicana from troops that brought it to Iraq. It 
seems Walter Reed doesnt want to know the exact strains, maybe 
because identifying its point of origin would make the Pentagon 
responsible for its spread. 
 
Here is a snippet of a 2006 WRAMC publication:
 
Transfusion. 
2006 Sep;46(9):1641-5.
Leishmania: risk to the blood supply.
Cardo LJ1.
Author information
1Walter Reed Army Institute of Research, Silver Spring, Maryland 20910, USA. Lisa.Cardo@us.army.mil
Operation Iraqi Freedom and Operation Enduring Freedom 
present a much greater Leishmania threat than did Operation 
Desert Storm. Because most transmission by transfusion 
occurs in endemic areas, and visceral infection is asymptomatic 
in healthy individuals such as blood donors, it is difficult to 
determine the absolute risk of transmission by transfusion, but 
review of the literature provides many clues as to the appropriate 
measures to be taken for blood donor deferral.

 
We at DSBR believe there are many more cases of Leishmaniasis
undiagnosed in America. That American contractors serving 
in Iraq are coming home with it, soldiers, tourist. That the 
diagnostic system in place across America are missing this 
outbreak, and that in time it will be spread here through 
transfusion, intimate contact, and possibly mosquito vectors. 
Further, between troops from Iraq and Afghanistan that served
upwards of 5 tours - how many of those might have been infected
with any form of this parasite that was never seen by any medic
or reported. Could it be for every case there was one that didnt
report? 3, 5 or more. These people are donating blood any time
they want the rest of there lives. Meaning every time is like adding
another person to mix. Thousands of possible tainted blood
samples randomly mixed with health and no screening system
in place to detect this.
 
Once infected the medical system wont point back to tainted
blood but imply some other vector. Leishmaniasis positive people
in America are treated the same as third world individuals, and
have no rights under the current system. Once you have it, they
dont care how you got it. You pay out of your own pocket to
treat it, live with it, and even be mocked you claim to have it. This
is a orphan disease and why its ignored in America.
 
The Pentagon simply is hoping it will resolve itself when the
small number of infected people in America die off. Exceptable
loses versus owning up to the infiltration. But, there is no public
tracking system or effort to follow this so the number spreading
are uncertain for up to 40 years.
 
Testing can be done for the military at Walter Reed Army 
Hospital, through Peter Weina at 301.319.9956 or email
peter.weina@na.amedd.army.mil http://www.pdhealth.mil/downloads/Leishmaniasis_DS_04272004.pdf 
 
There is also the Armed Forces Institute of Pathology, 
which has a Leishmaniasis Registry. Point of Contact 
is Colonel Peter McEvoy mcevoy@afip.osd.mil
http://www.afip.org/leishsurvey.html
 
If you are a civilian contractor, you can go through 
Parasitic Disease Consultants 
http://parasiticdiseaseconsultants.com
A Clinical Laboratory for the Diagnosis of Parasitic, 
Viral and Other Infectious Diseases. 
IRVING G. KAGAN, Ph.D, Director
Mailing Address:
P.O. Box 616
Tucker, GA 30085

Laboratory Address:
2177-J Flintstone Drive
Tucker, GA 30084
Phone # (770) 496-1370 / (770) 496-5848
Fax # (770) 938-7189
 
The CDC has a Leishmaniasis testing department, which you 
will go through Mr. Frank Steurer at 770-488-4475. http://www.cdc.gov/ncidod/dpd/parasites/leishmania/factsht_leishmania.htm 
 
This is the VA protocol for dealing with Leishmanisis:
http://www1.va.gov/environagents/docs/USHInfoLetterIL10-2004-013.pdf

 


 
At the IOM May 2005, Dr. Alan Magill said he did not know a 
Arvid Brown of Michigan. Here is a copy of the July 12th 1998 
WRAMC letter to VAMC Ann Arbor Michigan of the first ELISA
test results on Arvid Brown. From the book: 
"Bloodmeal: ignored to death"
 
The independent lab "Parasitic Disease Consultants" 
confirmation of Arvid Browns Leishmaniasis in 1998
"Bloodmeal: ignored to death" page 2
 
IOM:
Gulf War and Health: Infectious Diseases
Project Identification Number: HPDP-H-04-06-A
http://www.gulflink.org/iom4/iom4.htm
Slides of Richard Reithinger, Craig Hyams,
Mike Kilpatrick, Alan Magill
 
CDC:
Barbara Herwaldt slides to
December 2003 FDA Blood bank committee
CDC Leishmaniasis Slides
 
Kirt Love slides to the
December 2003 FDA Blood bank committee
Kirt Love Leishmaniasis Slides
 
Letters to DHSD from DSBR before the was 
in Iraq of March 2003
 
August 3rd, 2002
Response to Kirt Love on Leishmaniasis - page 1
Response to Kirt Love on Leishmaniasis - page 2
 
September 20th, 2002
Janyce Brown to DHSD, 3 pages
 
November 15th, 2002
response letter from DHSD
DHSD response letter
May 2003
response from DHSD
Response to Kirt Love May 2003 page 1
Response to Kirt Love May 2003 page 2
 
Freedom Magazine
Volume 35 issue 1
Desert Storm Blows Back with a Fury
 
Deployment Quarterly Spring 2005 
Quick Testing Approved For Leishmania Parasite