Autochthonous Leishmaniasis in the United States of America.

Leishmaniasis is endemic in 99 countries worldwide, including the USA where it has low endemicity. The disease is emerging but likely underdiagnosed due to its historical absence in the diagnostic differentials of American physicians. Additionally, the public seems to have little knowledge about this disease. Here, a comprehensive literature review was carried out on autochthonous leishmaniases in humans in the USA, including their associated Leishmania spp., capable sand fly vector, transmission route, and risk to the parasitic infection. All 89 cases were cutaneous leishmaniasis reported in Texas, Oklahoma, Arizola, and North Dakota. The collective information should serve to mitigate both autochthonous and imported leishmaniasis by expanding reservoir and vector surveillance and improving physician training in diagnosis in the USA.