Two cases of visceral leishmaniasis in U.S. military personnel--Afghanistan, 2002-2004.

Visceral leishmaniasis (VL), a sand fly-borne parasitic disease also known as kala-azar (Hindi, for black sickness or fever), is a risk for persons who travel to or live in areas of the tropics, subtropics, and southern Europe where the disease is endemic. The World Health Organization estimates that approximately 500,000 new cases of this potentially fatal disease occur each year, >90% of which are acquired in parts of the Indian subcontinent, Sudan, and Brazil. A total of 21 cases of VL acquired in Afghanistan, all in the 1980s, have been reported previously. This report provides preliminary data about two cases of VL that have been diagnosed in U.S. military personnel deployed to Afghanistan in support of Operation Enduring Freedom, which began in 2001. U.S. health-care providers should consider VL in persons who were deployed to Southwest/Central Asia (or were in other areas where VL is endemic) who have persistent febrile illnesses, especially if associated with other clinical manifestations suggestive of VL (e.g., splenomegaly and pancytopenia).