Leishmaniasis outbreak in Kurram Agency

The World Health Organisation (WHO) has reported an outbreak of the skin disease leishmaniasis in the Kurram Agency, a tribal area in Pakistan's North West Frontier Province (NWFP) bordering Afghanistan. "In addition to some 1,500 cases among the Afghan refugees, there are some 738 new cases and some 289 cured cases amongst the local population," WHO official Dr Faizullah Kakrar told IRIN in the capital Islamabad on Thursday. He dispelled the impression that Afghan refugees carried the disease. "Leishmaniasis has been present in northern Pakistan and Afghanistan for a long time," he said. The disease is transmitted by a female sandfly from one infected animal or human to another. He added that the type of disease diagnosed in Pakistan is not fatal. "Cutaneous leishmaniasis can produce skin ulcers," he said. The infected parts are left with permanent scars causing disfigurement if not treated. Precautions for preventing the further spread are similar to that of malaria. The problem is compounded by the fact that the drug needed to treat the condition is unregistered and thus not easily available in Pakistan, Kakar said, adding that WHO and UNHCR were jointly working to make enough of the medicine available in addition to training local medical staff in handling the disease. Director for the Health Department in the Tribal Areas, Dr Muhammad Iqbal told IRIN from Peshawar that the outbreak was confined to a few villages in the Mahoora area in lower Kurram agency. "In addition to Kurram Agency we are surveying other areas for possible occurrence," he said. Counting the difficulties they were facing in treating the disease he said: "Apart from the unavailability of the medicines, our staff is not trained in handling the rare disease." According to WHO the disease is mostly spread by population movements. Some 90 percent of all cutaneous leishmaniasis cases occur in Afghanistan, Brazil, Iran, Peru, Saudi Arabia and Syria.