Systemic infection in children usually of begins suddenly with vomiting , diarrhea , fever , and cough . In adults, fever for 2 weeks to 2 months is accompanied by nonspecific symptoms such as fatigue , weakness , and loss of appetite . Weakness increases as the disease progresses. The skin may become grayish, dark, dry and flaky. The parasites damage the immune system by decreasing the numbers of disease fighting cells so death usually results from complications of the disease such as infection rather than from the disease itself.
Death often occurs within two years.
Infection by Leishmania have been reported on all the continents except Australia. In the Americas, Leishmania can be found from Mexico south into the South American continent. Leishmaniasis has been reported among some military personnel returning from the Persian Gulf. Public health measures to reduce the sandfly population and animal reservoirs are important. There are no preventive vaccines or drugs for leishmaniasis.