The Hindu : Kerala / Thiruvananthapuram News : Case of Kala Azar reported at MCH

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Thursday, Mar 17, 2005

Kerala

Kerala - Thiruvananthapuram

Case of Kala Azar reported at MCH

By C. Maya

THIRUVANANTHAPURAM, MARCH 16. Even as the Health authorities are grappling with the control of malaria, another vector-borne disease seems to have surfaced, with the reporting of an indigenous case of Kala Azar or visceral Leishmaniasis at the Medical College Hospital (MCH) here.

An infectious disease usually seen only in Bihar, West Bengal and Uttar Pradesh, this is a rare instance of Kala Azar being reported here, doctors at the MCH said. The few reported cases of Leishmaniasis were of a different form, which affect only the skin.

Diagnosis

The disease was diagnosed in a 68-year-old man from Thenmala some three weeks ago during evaluations prior to a surgery. Though he did not have the typical symptoms of Kala Azar such as recurrent fever, weight loss or fatigue, his blood count was very low.

It was the enlargement of the spleen that led the General Medicine Department to do extensive investigations. Diagnosis of Kala Azar through blood tests is very difficult but a bone marrow biopsy done by the pathology department confirmed the diagnosis. Lab results seemed to indicate that the case is an indigenous one.

Infectious

Kala Azar affects the internal organs such as spleen, liver and the bone marrow. The disease could be fatal if left untreated. Just as mosquito is the vector for malaria, Kala Azar is spread by tiny sandflies. The female sandfly transmits the Leishmania parasite from one infected person to another through its blood-sucking bites.

The reporting of Kala Azar has much public health importance as the disease is infectious and vector control measures are called for, U. Farooq, Associate Professor of Entomology, MCH, said. The patient was administered drugs intravenously and discharged after three weeks. However, follow-up would be required for a year.

Sandflies are seen mostly in rural areas, in the cracks and crevices on mud walls or inside cattle sheds. In the strain of Leishmaniasis that affects the skin, open sores are formed on the skin. These spread throughout the body and can often be mistaken as leprosy sores.

Public health issue

The disease, which had been eradicated in India in the late 1950s, resurfaced after 20 years and by the late 80s manifested again as a major public health problem. The disease is concentrated in five countries - India, Bangladesh, Nepal, Brazil and Sudan. Kala Azar is endemic to many districts in Bihar and West Bengal. It has also been reported in some parts of Tamil Nadu.

The fact that the disease has been reported from Thenmala would mean that there are unreported or undiagnosed cases of Kala Azar in the area.

Entomological surveys in the area are required to confirm the presence of the vector. As there is a threat that the disease could spread in the community, control measures such as indoor residual spraying of insecticides would be required in the area, doctors said.

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