Leishmaniasis - Treatment and Prevention
Leishmaniasis is a sandfly-borne infection that US travelers to tropical and subtropical regions should know about, including how to stay safe and what to do if symptoms appear.
Leishmaniasis travel
Leishmaniasis is an infection caused by a tiny parasite spread through the bite of infected sandflies. It affects travelers who visit tropical, subtropical, and some Mediterranean regions, especially those spending time outdoors in rural or forested areas. US travelers heading to parts of Latin America, Africa, the Middle East, or South Asia face the greatest risk and should take steps to protect themselves before and during their trip.
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There is currently no approved vaccine for leishmaniasis, and no preventive medication (prophylaxis) is available for travelers. Prevention depends entirely on avoiding sandfly bites. Sandflies are small, silent, and most active from dusk to dawn. They can bite through thin fabric, so clothing choice matters.
The most effective steps travelers can take include applying an EPA-registered insect repellent containing DEET or picaridin to exposed skin, wearing long sleeves and long pants in the evenings, and treating clothing and gear with permethrin. Sleeping under a fine-mesh bed net (with holes smaller than standard mosquito nets) adds extra protection, since sandflies are much smaller than mosquitoes. Staying in well-screened or air-conditioned accommodations also reduces exposure significantly.
Travelers heading to high-risk areas, particularly those on adventure trips, doing fieldwork, or staying in rural settings, should discuss their specific itinerary with a travel health provider before departure. According to the CDC, bite avoidance is the primary defense against leishmaniasis. The WHO fact sheet on leishmaniasis confirms that no vaccine is currently available for human use.
WayPax Health recommendation
Because there is no vaccine or preventive medication for leishmaniasis, the WayPax approach focuses on making sure every at-risk traveler leaves home fully informed and equipped for bite avoidance. This is especially important for adventure travelers, backpackers, field researchers, and anyone spending nights outdoors in endemic regions. A WayPax provider will review your full itinerary, identify your specific risk level, and discuss all available protection strategies with you in a real online consultation. If other travel health needs come up during your review, such as malaria prophylaxis or vaccines for your destination, WayPax providers can write those prescriptions and arrange those vaccinations entirely online, without you ever visiting a clinic in person. Getting a full travel health review through WayPax before your trip is one of the easiest ways to make sure you are genuinely prepared.
Get your Leishmaniasis prescription and other travel medicines online today.
What is leishmaniasis?
Leishmaniasis is a disease caused by Leishmania parasites, a group of more than 20 related species. The parasites are passed to people through the bite of infected female phlebotomine sandflies. The disease takes three main forms, each affecting the body differently.
Cutaneous leishmaniasis (skin form) is the most common type seen in travelers. It causes skin sores, mainly ulcers (open wounds), on exposed parts of the body. These sores can leave permanent scars. According to the WHO, about 95% of cutaneous cases occur in the Americas, the Mediterranean basin, the Middle East, and central Asia. Visceral leishmaniasis (also called kala-azar) is the most serious form. It affects internal organs and is fatal in over 95% of cases if left untreated. Mucocutaneous leishmaniasis damages the mucous membranes of the nose, mouth, and throat. Symptoms vary by form but can include skin ulcers, fever, weight loss, and swelling of the spleen and liver. The CDC notes that only a small fraction of people exposed to the parasite will develop the disease. Research published on PubMed confirms that the clinical range runs from no symptoms at all to life-threatening visceral disease.
Where is leishmaniasis a risk?
Leishmaniasis is found across a wide band of tropical, subtropical, and some temperate regions. The disease is not evenly distributed, and the type of leishmaniasis a traveler might encounter varies by region.
In the Americas, risk is concentrated in parts of Central and South America, where forested and rural environments support the sandfly populations that carry the parasite. This region accounts for a large share of cutaneous leishmaniasis cases worldwide. According to the WHO, most cases of visceral leishmaniasis occur in Brazil, east Africa, and India, making these areas of particular concern for travelers spending extended time in rural communities.
East Africa and the broader sub-Saharan African region carry significant visceral leishmaniasis risk, particularly in areas affected by conflict, displacement, or poor housing conditions. The Indian subcontinent, especially India, is one of the highest-burden areas for visceral leishmaniasis globally.
The Mediterranean basin, including parts of southern Europe and North Africa, as well as the Middle East and central Asia, are known risk zones for cutaneous leishmaniasis. Sandflies thrive in dry, sandy, and rocky environments and are most active in warm months, so risk tends to peak in summer and early autumn in these regions.
Treatment: what to do if you get leishmaniasis
If you develop a skin sore that does not heal, or experience unexplained fever, weight loss, or fatigue after traveling to a risk area, see a doctor promptly. Leishmaniasis requires a confirmed diagnosis before treatment can begin, and the right treatment depends on which form of the disease you have and which species of parasite caused it.
According to the CDC Yellow Book, liposomal amphotericin B (AmBisome) is FDA-approved to treat visceral leishmaniasis and is generally the preferred option for US patients. Other treatments include miltefosine, an oral medication used for certain forms of the disease. Research in PubMed Central notes that treatment choices depend on the specific parasite species involved. Seek care from a travel medicine or infectious disease specialist, as leishmaniasis is not commonly treated in general practice settings in the US.
Frequently asked questions
What are the symptoms of leishmaniasis in travelers?
The most common form seen in travelers is cutaneous leishmaniasis, which causes a slow-healing skin sore or ulcer, usually on an exposed area like the arm, leg, or face. Visceral leishmaniasis causes fever, weight loss, fatigue, and swelling of the spleen and liver. Symptoms can appear weeks to months after the sandfly bite, so travelers should mention their travel history to any doctor they see after returning home.
How can I prevent leishmaniasis when I travel?
There is no vaccine or preventive medication for leishmaniasis, so bite avoidance is the only protection available. Use a DEET or picaridin-based insect repellent on exposed skin, wear long sleeves and pants at dusk and dawn, treat clothing with permethrin, and sleep under a fine-mesh bed net. Staying in screened or air-conditioned rooms also reduces your risk significantly.
Can leishmaniasis be treated while traveling abroad?
Treatment for leishmaniasis requires a confirmed diagnosis and specialist care, which may be difficult to access in remote areas. If you develop a non-healing skin sore or feel seriously ill while traveling in a risk area, seek medical attention as soon as possible. It is generally safer to return home and see a travel medicine or infectious disease specialist in the US, where the appropriate medications are available.
Where is leishmaniasis most common for travelers?
Travelers most commonly encounter cutaneous leishmaniasis in parts of Latin America, the Middle East, and central Asia. Visceral leishmaniasis, the most serious form, is most prevalent in Brazil, east Africa, and India. Adventure travelers, backpackers, and anyone spending time outdoors in rural or forested areas in these regions face the highest risk.
How do people get leishmaniasis while traveling?
Leishmaniasis spreads through the bite of an infected female phlebotomine sandfly. Sandflies are tiny, quiet insects that are most active from dusk to dawn. They are found in sandy, rocky, and forested environments and can bite through thin clothing. You cannot get leishmaniasis from another person or from a mosquito.
Is there a vaccine for leishmaniasis?
No. There is currently no approved vaccine for leishmaniasis for human use. Research into vaccines is ongoing, but none are available to travelers at this time. The only way to protect yourself is to prevent sandfly bites through repellents, protective clothing, and bed nets. A WayPax provider can help you build a full bite-avoidance plan and address any other travel health needs for your trip, all online without a clinic visit.
What types of travelers are most at risk for leishmaniasis?
Travelers who spend time outdoors in rural, forested, or sandy environments in endemic regions face the greatest risk. This includes hikers, campers, ecotourists, field researchers, military personnel, and volunteers working in remote communities. Short-stay tourists staying in urban hotels with air conditioning face a much lower risk than those sleeping outdoors or in basic accommodations.
Explore by region
Latin America
East Africa
West and Central Africa
North Africa and the Middle East
South and Southeast Asia
Related diseases
- Malaria, a mosquito-borne parasitic disease found across many of the same tropical and subtropical regions where leishmaniasis is present
- Dengue, a viral infection spread by mosquitoes in Latin America, Africa, and Asia that shares many of the same high-risk travel destinations
- Chagas disease, a parasitic infection found in Latin America that is also transmitted by an insect vector in rural and forested areas
- Schistosomiasis, a parasitic infection common in sub-Saharan Africa and parts of South America that affects travelers with freshwater exposure in endemic regions
- Rickettsial diseases, tick and mite-borne bacterial infections found across Africa, the Middle East, and Asia that share overlapping geographic risk zones with leishmaniasis
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