Emerging Epidemics of Cutaneous Leishmaniasis in Iran: Operational Aspects, Management and Implemented Control Approaches

Cutaneous leishmaniasis (CL) in Iran could be considered as an emerging disease that is rapidly increasing and expanding its traditional geographical range to new foci. Sixteen registered emerging epidemics have occurred since 1998 in different provinces. Various risk factors, including agricultural development, earthquake, movement to endemic areas, construction of buildings near colonies of rodents, sleeping outside, cross-border movements, and poor sanitation, play crucial roles in the expansion of the disease. The mentioned risk factors can lead to the gradual or sudden emergence of new CL epidemics, and long-lasting endemic foci can also erupt into epidemics. This paper reviews the emerging epidemics published between 1998 and 2019 in Iran with particular emphasis on the operational aspects of control and related risk factors caused by anthroponotic CL (ACL) and zoonotic CL (ZCL). The competent surveillance system should be extended to all high-risk areas to facilitate controlling the emerging epidemics of ACL and ZCL in the affected areas.