Over 180 children have been affected with Baghdad boil disease, or leishmaniasis, in Iraq's southern province of Qadissiyah, about 130km south of Baghdad, local officials said. Leishmaniasis is known by different local names, including oriental sore, Aleppo button, Jericho boil and Delhi boil. In its most unpleasant form - visceral leishmaniasis - organ failure and death can result. The disease's incubation period is up to six months, so thousands could have the disease without knowing it. "It is a dangerous disease which hits mostly children and could lead to death or leave skin deformities if no appropriate treatment is available," said Fatih Abdul-Salam, a dermatologist at Qadissiyah General Hospital. He said leishmaniasis is transmitted by the bite of the midge-like female phlebotomine sandflies - tiny sand-coloured blood-sucking flies. "The disease has spread because of the lack of medical measures in the province and the lack of medicines, as most of those available have expired," Abdul-Salam said.
According to the World Health Organization (WHO), the currently-used drugs are in any case toxic, and have severe adverse reactions. They are also very costly. Nearly half of the current cases are in the Siniya area, about 15km west of Qadissiyah's provincial capital, Diwaniyah. "About a month ago, we informed the provincial officials about the spread of this disease in our area and that we did not have enough medicines for it," said Farhan Mohammed, the head of Siniya local council. "But no one responded in a serious way and that contributed to the spread of this disease, as our modest efforts in the area's medical centre were not enough," Mohammed said. According to WHO, the 20 or so infective species or subspecies of the parasite cause a range of symptoms, some of which are common (fever, malaise, weight loss, anaemia) - and swelling of the spleen, liver and lymph nodes in its visceral form. Cutaneous leishmaniasis - the most common form - causes 1-200 simple skin lesions which self-heal within a few months but which leave unsightly scars. Mucocutaneous leishmaniasis begins with skin ulcers causing massive tissue destruction, especially of the nose and mouth.