ISLAMABAD, Jan 17: A disfiguring fatal skin epidemic, Lieshmaniasis, has hit Kurram Agency with 738 cases of the disease detected in the local population and 1,500 in Afghan refugees, the World Health Organisation (WHO) reported here.

WHO spokesperson Loretta Hieber-Girardet, speaking at a news conference, said no cure for the disease was available in Pakistan.

“The drug used in treatment of Lieshmaniasis, injection Glucantime, is not available nor registered in Pakistan.”

This is a rare disease in Pakistan, but in November 2001 the NWFP Health Department had notified the WHO of a large number of cases of the disease in several villages of Kurram Agency.

The UNHCR had shifted a large population of Afghan refugees, fearing a large influx of the displaced persons after Sept 11, to the camps set up in tribal areas including in Kurram agency.

Answering a question about presence of disease in refugee camps in Balochistan, WHO Medical Officer Dr Faizullah Kakar said majority of the refugees settled in Balochistan had arrived from Kandahar where the disease was not existed. As such no incidence of disease had been detected in Balochistan, he said. Majority of the refugees settled in the NWFP and in Kurram Agency were from Kabul where the disease was present.

The spokesperson said: “The disease is caused by a parasite and is transmitted by the sand fly. When the fly bites the skin, the parasite is transmitted to blood. The type of Lieshmanisis in Pakistani population, called urban or Anthroponotic Lieshmaniasis, is transmitted from human to human.”

According to the WHO, the disease could manifest itself in two forms— Cutaneous and Systemic Lieshmanisais. Cutaneous Lieshmaniasis, which had hit majority of the population in Kurram agency, could cause a lesion anywhere on the body but the most likely sites for these lesions were the exposed parts. The lesion rapidly gave rise to a harsh looking large ulcer which frequently ate the tissue and even when the ulcer healed it led to permanent disfigurement.

WHO officials said Systemic Lieshmaniasis was more rare in Pakistan and was invariably fatal if not treated promptly. It affected the internal body organs, especially the spleen and the liver.

WHO spokesperson said the situation was complicated as very few local physicians could differentiate between Lieshmaniasis and other skin diseases that may mimic the skin lesions of Lieshmaniasis.

About measures to control the epidemic, the WFP spokesperson said the WHO had sponsored a survey in Kurram Agency to help the NWFP authorities treat the cases and prevent further spread of the disease. She said majority of the 38 cases in local population were children under the age of 15 and 72 per cent were unable to access medical treatment.