Prevention should include the application of a long-acting topical insecticide throughout the period of sand fly activity. Additionally, vaccination should be considered as a multimodal approach*.
Long-acting topical insecticides applied to dogs living in or travelling to endemic areas should be maintained during the entire period risk of potential exposure to/or activity of sand flies:
- Spot on formulations
Treatment with permethrin spot-on formulations provides repellent (anti-feeding) activity against sand flies for 3-4 weeks. In the case of dogs travelling to endemic areas, the product should be applied at least 2 days before departure. - Collars
Deltamethrin-impregnated collars prevent phlebotomine sand fly b ites. The efficacy of this collar preventing Leishmania infection has been demonstrated in several field trials. The duration of efficacy of this collar is 5-6 months.A flumethrin-containing collar, with demonstrated variable repellent efficacy against sand flies, has shown in clinical field studies, a reduction of the risk of infection with L. infantum via transmission by sand flies for up to 8 months. Collars shoul d be applied at least 1-2 weeks before travelling.
*Based on a risk-benefit assessment (or in endemic areas), a multimodal approach combining the use of repellents and vaccination should be considered for an optimal prevention against both infection and development of clinical disease. Repellents reduce the risk of infection but do not prevent the appearance of clinical signs once the dog has been infected. Vaccination reduces the risk of the progression of the disease and the probability of developing clinical signs but does not prevent infection.
Preventative recommendations based on different level of risk for L. infantum infection (Miró et al., 2017)
| NON ENDEMIC AREAS | ||||
| Level of risk (0 low – 4) |
Travel History | Lifestyle | Preventative Applications | Additional Recommendations |
| 0 | Local (negligible) | Any | None | Avoid breeding with, or blood transfusion from dogs belonging to risk levels 3-4 or seropositive dogs (and 1-2, if possible) |
| 1 | Occasional travel to fringe or endemic areas | Any | Repellents: Cover the entire period of travelling/exposure including the delay for activity | See risk level 0 If travel once for less than 3 weeks, use topical insecticide spot-on formulations applied at least 2 days before travelling/exposure. For longer periods of travel, use repeated spot-on or collars. Test for L. infantum infection 6 months post travel (via quantitative serology) |
| 2 | Frequent/long travel to fringe or endemic areas | Any | Repellents: Cover the period of travel including the delay for repellent activity Vaccination (optional) |
See risk level 0 For long and/or frequent trips preventative and additional recommendations should be the same as for risk level 4 Test for L. infantum infection 6 months post last travel (via quantitative serology) |
| 3 | Re-homing from an endemic area | Any | See additional recommendations | Test for L. infantum infection via quantitative serology. If positive, do not breed and do not use as blood donor, consider treatment (staging) Repellents all year round Testing of other household dogs |
| ENDEMIC AREAS | ||||
| Level of risk (0 low – 4) |
Serology Results (IFAT/ELISA) | Lifestyle | Preventative Applications | Additional Recommendations |
| 4 | Seronegative | Outdoors (high exposure) | Repellents all year round or during the known sand flies season. Vaccination (strongly recommended) |
Domperidone could be considered (if not vaccinated) Periodic testing (via quantitative serology) if breeding or blood donor (at least once a year) |
| 4 | Seronegative | Indoors (low exposure) | Repellents all year round or during the known sand flies season. Vaccination (optional) |
Periodic testing if breeding or blood donor |
| None applicable | Seropositive (Healthy*/Sick**) | Any | Repellents all year round | Do not use for breeding or as blood donor Staging for treatment as needed Test other household dogs |
*Healthy: a dog without any clinical sign or clinicopathological abnormality
**Sick: a dog with clinical and/or clinicopathological abnormalities
Female Phlebotomus perniciosus feeding
on the muzzle of a dog (© Guadalupe Miró)