In the ongoing conflict between the Israel Defense Forces (IDF) and Hamas in Gaza, a sandfly-borne parasitic disease, cutaneous leishmaniasis, has affected at least 100 IDF troops. Contracted in southern Israel before entering Gaza, the disease leads to deep and unsightly skin lesions. Although it doesn’t significantly impact a soldier’s ability to fight, the number of affected individuals may be higher, with smaller lesions potentially going untreated due to the urgent nature of their duties.
Prof. Eli Schwartz, head of the Molecular Lab for Tropical Diseases at Sheba Medical Center, mentioned that determining the exact number during wartime is challenging. Soldiers were likely bitten by disease-carrying sandflies before entering Gaza, as cutaneous leishmaniasis is endemic to Israel, not Gaza. The appearance of skin lesions occurs about a month after being bitten.
The sandfly population surged in October, biting troops along the Gaza border as they prepared for the ground invasion on October 27. Cutaneous leishmaniasis is also found in other regions, such as South America, where aggressive strains require systemic treatments.
There are two types of the disease in Israel, caused by different parasite species and hosts. The leishmania tropica parasite, hosted by rock hyraxes in rocky areas, causes one type, while the leishmania major parasite, hosted by various rodents in sandy regions, causes the other.
Sandflies, seeking a blood meal, transmit the parasite to humans, leading to skin lesions at the bite site. The disease is more prevalent in warmer months, and the crowded conditions of soldiers along the border likely contributed to the increase in cases.
Preventive measures include using mosquito repellent, covering exposed skin, and employing netting and screens from sundown to sunrise. While cutaneous leishmaniasis causes temporary disfigurement and potential scarring, it is less severe than visceral leishmaniasis, which can be fatal.
Prof. Schwartz emphasized the need for better treatment for leishmaniasis, noting that IDF doctors can generally diagnose and treat soldiers in the field. Risky systemic drug treatment is reserved for severe cases, and alternative treatments, like injecting drugs directly into the ulcer, are available.
Despite challenges, IDF soldiers with leishmaniasis can typically continue fighting, with the military adapting to the recent unavailability of a key topical ointment by sourcing a similar preparation from a local pharmacy.
