Settlements, security fence and emergence of leishmaniasis

Preparing a presentation on leishmaniasis for a medical meeting which was held at the end of last November near Bethlehem (National Palestinian Authority), I came across this article published in Emerging Infectious Diseases : “Ecoepidemiology of Cutaneous Leishmaniasis Outbreak, Israel” by Singer et al. (1). This interesting paper reported 161 cases of cutaneous leishmaniasis caused by Leishmania tropica which occurred in the Jerusalem district during 2004–2005. These cases occurred in Ma’ale Adumim, a town just outside Jerusalem. In fact, Ma’ale Adumim is a new Israeli settlement and a city in the West Bank, on the edge of the Judean desert and cannot be considered, according to international laws (though disputed by the Israeli government) as part of Israel as stated in the title of the paper. Moreover, the discussion evoked the role of global warming in this outbreak without emphasizing on the consequences of the construction of the security wall, the building of bypass roads and the establishment of new settlements on hyrax populations, the small mammal reservoir host for Leishmania (2). This point was mentioned by Agenda item 14 presented at the 2007 WHO health assembly (3). The picture below, shot near Bethlehem, illustrates quite well the ecological damages caused by Israeli settlements and the possible consequences on the epidemiology of leishmaniasis.



Nasereddin & Jaffe (4), as soon as 2004, pointed out the possible consequences of the security fence on the incidence of visceral leishmaniasis by this premonitory sentence: ““it is certain that this manmade barrier will change the dynamics of zoonotic infectious disease transmission in Israel and the West Bank. It may be true that diseases do not respect borders, but governmental decisions can disrupt local ecologies thus changing epidemiological patterns of diseases in both Israel and Palestine, and such changes may have important ramifications for public health”.