It is possible but very unlikely that you would get leishmaniasis in the United States. Very rarely, people living in rural southern Texas have developed skin sores from cutaneous leishmaniasis. No cases of visceral leishmaniasis are known to have been acquired in the United States. Leishmaniasis is spread by the bite of some types of phlebotomine sand flies. Since sand flies do not make noise when they fly, people may not realize they are present.
Sand flies are less active during the hottest time of the day.
However, they will bite if they are disturbed, such as when a person brushes up against the trunk of a tree where sand flies are resting. Rarely, leishmaniasis is spread from a pregnant woman to her baby. Leishmaniasis also can be spread by blood transfusions or contaminated needles. People of all ages are at risk for leishmaniasis if they live or travel where leishmaniasis is found. The risk for leishmaniasis is highest from dusk to dawn because this is when sand flies are the most active.