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06/07/2013

In war-torn Syria, the 'Aleppo Evil' rears its ugly head

Leishmaniasis
A displaced child eats a sandwich inside a house in al-Zanbaqi village in the Idlib countryside in Syria. The child is showing symptoms of Leishmaniasis, a disease transmitted by sand flies. MUZAFFAR SALMAN/REUTERS

Earlier this week, the above picture was published with a story I wrote about the troubling rise of infectious diseases in Syria -- everything from typhoid and measles to cases of acute watery diarrhea. But also spreading is cutaneous leishmaniasis, or CL, a parasitic disease transmitted by sandfly bites that can cause facial lesions like the ones on this young boy's face.

The World Health Organization says it is hearing reports of increased cases of CL in Syria, as well as amongst refugees who have fled to neighbouring Jordan, Lebanon, Iraq and Turkey.

According to Dr. Peter Hotez, who recently posted about Syria's cutaneous leishmaniasis problem on PLOS Medicine's community blog, CL has existed in Aleppo for centuries. And over hundreds of years, the disfiguring disease has earned itself a collection of stigmatizing sobriquets such as the "Aleppo Evil," "Aleppo ulcer," "Aleppo boil" and "Aleppo button."

These nicknames obviously refer to what Syrians call the "one-year sore" -- unsightly facial lesions caused by CL that can take one or even two years to heal.

Hotez writes that the lesions can cause permanent scarring and stigmatization. Citing experts in Afghanistan, he explains that some girls and women with CL are marked as unmarriageable and mothers are sometimes forbidden from touching their children (even though leishmanisasis can't be spread through human contact).

Over the last century, the prevalence of CL in Syria has waxed and waned. But Hotez points out that like other neglected tropical diseases, it tends to resurge when infrastructure and health care systems break down -- which, sadly, is exactly what has happened in Syria.

Jennifer Yang is the Star’s global health reporter. She previously worked as a general assignment reporter and won a NNA in 2011 for her explanatory piece on the Chilean mining disaster. Follow her on Twitter: @jyangstar


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