Spatial Relationship between a Regional Outbreak and a Higher-than-Expected Incidence of Leishmaniasis in Urban Southern Madrid, Spain

Jesús Alonso-Carrillo Unit of Infectious Diseases, Hospital Universitario “12 de Octubre”, Instituto de Investigación Sanitaria Hospital “12 de Octubre” (imas12), Madrid, Spain;

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Ana Pérez Ayala Department of Microbiology, Hospital Universitario “12 de Octubre”, Instituto de Investigación Sanitaria Hospital “12 de Octubre” (imas12), Madrid, Spain;

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Mario Fernández-Ruiz Unit of Infectious Diseases, Hospital Universitario “12 de Octubre”, Instituto de Investigación Sanitaria Hospital “12 de Octubre” (imas12), Madrid, Spain;
Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III (ISCIII), Madrid, Spain;
Department of Medicine, School of Medicine, Universidad Complutense, Madrid, Spain

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José Tiago Silva Unit of Infectious Diseases, Hospital Universitario “12 de Octubre”, Instituto de Investigación Sanitaria Hospital “12 de Octubre” (imas12), Madrid, Spain;

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Sara Castaño-Pérez Unit of Infectious Diseases, Hospital Universitario “12 de Octubre”, Instituto de Investigación Sanitaria Hospital “12 de Octubre” (imas12), Madrid, Spain;

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Mónica Prieto Unit of Infectious Diseases, Hospital Universitario “12 de Octubre”, Instituto de Investigación Sanitaria Hospital “12 de Octubre” (imas12), Madrid, Spain;

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Nuria Valdeolivas Unit of Infectious Diseases, Hospital Universitario “12 de Octubre”, Instituto de Investigación Sanitaria Hospital “12 de Octubre” (imas12), Madrid, Spain;

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María Asunción Pérez-Jacoiste Asín Unit of Infectious Diseases, Hospital Universitario “12 de Octubre”, Instituto de Investigación Sanitaria Hospital “12 de Octubre” (imas12), Madrid, Spain;

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Manuel Lizasoain Unit of Infectious Diseases, Hospital Universitario “12 de Octubre”, Instituto de Investigación Sanitaria Hospital “12 de Octubre” (imas12), Madrid, Spain;
Department of Medicine, School of Medicine, Universidad Complutense, Madrid, Spain

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José María Aguado Unit of Infectious Diseases, Hospital Universitario “12 de Octubre”, Instituto de Investigación Sanitaria Hospital “12 de Octubre” (imas12), Madrid, Spain;
Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III (ISCIII), Madrid, Spain;
Department of Medicine, School of Medicine, Universidad Complutense, Madrid, Spain

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Francisco López-Medrano Unit of Infectious Diseases, Hospital Universitario “12 de Octubre”, Instituto de Investigación Sanitaria Hospital “12 de Octubre” (imas12), Madrid, Spain;
Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III (ISCIII), Madrid, Spain;
Department of Medicine, School of Medicine, Universidad Complutense, Madrid, Spain

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ABSTRACT.

The largest outbreak of human leishmaniasis in Europe took place in Fuenlabrada, Spain, between 2009 and 2017. The University Hospital “12 de Octubre” in Madrid serves the population residing in three districts of Madrid located just north of the outbreak area (Villaverde, Usera, and Carabanchel). Villaverde and Usera are connected by rail to the outbreak area, unlike Carabanchel. We performed a retrospective study including all cases of leishmaniasis diagnosed between 2011 and 2020. Fifty-one cases were documented. In the districts connected by rail to the outbreak area, a higher-than-expected incidence was observed (13.45–15.55 versus 5.2 per 100,000 inhabitants). Apart from the linear distance from the place of residence to the railway tracks, no differences in terms of demographics or risk factors were detected between the populations of the districts. We hypothesize that the direct connection with the outbreak area by rail could explain the higher incidence observed in Villaverde and Usera.

Author Notes

Financial support: This work was supported by Instituto de Salud Carlos III, Spanish Ministry of Science and Innovation, cofinanced by the European Development Regional Fund (ERDF) and the European Social Fund (ESF) “A way to achieve Europe—The ESF invests in your future.” M. Fernández-Ruiz holds a research contract “Miguel Servet” (CP18/00073) from the Instituto de Salud Carlos III, Spanish Ministry of Science and Innovation.

Current contact information: Jesús Alonso-Carrillo, José Tiago Silva, Sara Castaño-Pérez, Mónica Prieto, Nuria Valdeolivas, and María Asunción Pérez-Jacoiste Asín, Unit of Infectious Diseases, Hospital Universitario “12 de Octubre”, Instituto de Investigación Sanitaria Hospital “12 de Octubre” (imas12), Madrid, Spain, E-mails: jesusalonsocarrillo@gmail.com, j.tiago.silva@hotmail.com, sarcaspe@gmail.com, monica.prieto@live.com, nuria.valdeolivas.hidalgo@gmail.com, and mperezja82@hotmail.com. Ana Pérez Ayala, Department of Microbiology, Hospital Universitario “12 de Octubre”, Instituto de Investigación Sanitaria Hospital “12 de Octubre” (imas12), Madrid, Spain, E-mail: apayalabalzola@salud.madrid.org. Mario Fernández-Ruiz, José María Aguado, and Francisco López-Medrano, Unit of Infectious Diseases, Hospital Universitario “12 de Octubre”, Instituto de Investigación Sanitaria Hospital “12 de Octubre” (imas12), Madrid, Spain, Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III (ISCIII), Madrid, Spain, and Department of Medicine, School of Medicine, Universidad Complutense, Madrid, Spain, E-mails: mario_fdezruiz@yahoo.es, jaguadog1@gmail.com, and flmedrano@yahoo.es. Manuel Lizasoain, Unit of Infectious Diseases, Hospital Universitario “12 de Octubre”, Instituto de Investigación Sanitaria Hospital “12 de Octubre” (imas12), Madrid, Spain, and Department of Medicine, School of Medicine, Universidad Complutense, Madrid, Spain, E-mail: manuel.lizasoain@salud.madrid.org.

Address correspondence to Francisco López-Medrano, Unit of Infectious Diseases, Hospital Universitario “12 de Octubre,” Centro de Actividades Ambulatorias, 2a planta, bloque D. Avda. de Córdoba, s/n, 28041 Madrid, Spain. E-mail: flmedrano@yahoo.es
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