Dogs, jackals, foxes, and rats are the potential reservoirs. It is transmitted by sandflies. Humans are the only known reservoir. Leishmaniasis occurs in Central America, South America, Africa, India, the Middle East, Mediterranean countries, and Asia. In mucocutaneous leishmaniasis, death usually occurs from secondary infection.
Visceral leishmaniasis is progressive.
Males are infected more than females, most likely as a result of increased exposure to sandflies. Otherwise, occurrence is proportional to sandfly exposure. After the bite of an infected sandfly, the incubation period ranges from weeks to months. Systemic symptoms generally are absent. Skin trauma can result in activation of cutaneous infection long after the initial bite.