Neither had the Lipmans, but they were quick studies. However, leishmania is now well-entrenched in Honduras, Belize, and other areas in Central America and appears to be spreading to islands in the Caribbean, including Hispaniola and Trinidad. Old World strongholds include Thailand and Egypt. It is considered a dynamic disease whose range is spreading, and it garnered some attention in the U.S. in recent years when several Gulf War vets brought it back as a souvenir of Operation Desert Storm. In its cutaneous form, leishmaniasis is characterized by a skin sore or sores that develop weeks or months after transmission.
Sores typically leave scars, and some forms can be severely disfiguring.
Though Pruss says chemotherapy has gotten her leishmaniasis itself under control, the lesions they left behind are another story. One sore refused to heal, and after the tissue became ischemic due to restricted blood circulation, she required hyperbaric chamber treatment to close the wound. Symptoms include fever, weight loss, cough, diarrhea, lethargy, enlargement of the spleen and liver, and anemia. Both forms require a biopsy for diagnosis. The disease itself is difficult to cure and victims are prone to recurrences.