Colombia’s efforts to combat visceral leishmaniasis are another model for fighting the disease in and around cities, where it is increasingly common as a result of the insect that disseminates it adapting to the urban environment, and the presence of infected dogs inside and outside of dwellings.
In May 2012, seven cases of visceral leishmaniasis were found in the municipality of Neiva (department of Huila), a location distinctive for harboring some 25,000 stray dogs. After the outbreak was detected, the national authorities, with the support of PAHO/WHO, led an investigation of the focus, defined the risk zone, and determined what actions to take. These efforts confirmed that the disease had been present in the infected individuals for an average of 17 months. The disease can be fatal if not treated in time; in this case the patients suffered from fever, enlarged livers and spleens, prostration, and diarrhea. All sick individuals were hospitalized and given proper treatment. Despite the complications and strong side effects of the treatment, the patients did well, were monitored for their medical progress, and, over the following months, were cured.
In the 2012 outbreak, 72% of cases involved women living in houses with precarious conditions, such as crowding, lack of water, and lack of garbage disposal services. To help solve these problems, traps were set to catch the vector. In addition, more than 1,000 canine blood samples were collected in the area, of which 4% proved positive for visceral leishmaniasis. These strategies were complemented with vector control efforts that employed insecticides, pruning of shrubs, removal of organic material, and activities to help educate the community about the disease and how to prevent it.
Thanks to this comprehensive package of measures, and the active participation of the population of Neiva, the outbreak was controlled and no new cases emerged in the following year.