Another jump in the “Jericho Rose” outbreak – the treatments in Israel have run out

The scourge of the Jericho ringworm continues with a spike in cases, mainly among soldiers serving in the south of the country, and the treatments for the disease have run out: “Maariv” has learned that every month dozens of Israelis, most of them soldiers, are diagnosed with skin lesions suspected of being the “leishmania” virus that causes the Jericho ringworm disease, as a result of bites of the sand fly. In recent years, there has been a dramatic increase in cases of infection all over the country, apparently due to the acceleration of construction. The main problem Israel faces: the treatments have run out, and the medical teams are forced to treat with drugs that are of low effectiveness.

Already about a year ago we published about the jump in the Jericho rose outbreak. The updated Ministry of Health data indicate a double number of cases in the past year: from 120 infected during the year 2023 to over 220 cases in 2024. Most of the infected are soldiers who suffered from prolonged lesions, and the laboratory tests indicated infection with a parasite transmitted by the sand fly.

“Israel has been plagued by leishmania for years with hundreds of cases a year,” explains Prof. Eli Schwartz, an expert in internal medicine and travel medicine from the Sheba Medical Center and the president of the Israel Association for Tropical Diseases, who has been researching and treating leishmania patients for years. “The area surrounding Gaza is endemic to leishmania and due to the presence of soldiers there in high numbers From before, there is undoubtedly an increase in the incidence. The conditions of the war also lead to an increase in the number of infected animals and sandflies.”

According to Prof. Schwartz, the treatment for the disease has run out: there has been a shortage in the last year of the drug gluconate used to treat lesions by injection. “Imbido” pills, which are also used for treatment, are also not available for a long time. In the past, “Lishkoten” ointment was also used, the production of which was stopped by the Teva company.

The Leishmania parasite is transmitted to humans through the bite of the tiny fly. Any insect may sting a person several times, usually at night, and each bite leaves an inflamed and painful lesion that does not heal. In some cases, the treatment requires the shutdown of operational activity due to the complex treatment that is carried out in hospitals only. Lesions that are not treated will not be life-threatening, but will leave scars on the skin for life. “Israel is a record high for leishmania and the Ministry of Health and the Ministry of Environment are not doing enough to prevent infection and to treat patients. Unfortunately, we will continue to see leishmania spread, with a partial response to patients.”

What is the prevalence of Jericho rose in Israel?

In Israel, there has been an increase of about 300 percent in the rate of infection with Jericho rose disease. As mentioned, the disease is transmitted by the sand fly and causes very painful inflammatory wounds that cause great suffering to the patient for many months. The treatment is also complex and sometimes includes side effects.

Why did the disease break out in Israel in the first place?

The reason for the general increase in the incidence of the disease in Israel is apparently changes in ecosystems, construction and development that caused the breeding of rock rabbits or psammen rodents that host the leishmaniasis parasite until it is transmitted by biting and sucking blood to the sand fly and from there to humans.

What is the course of the disease?

Rose of Jericho is caused by two Leishmania parasites that cause two types of lesions: the “Leishmania major” parasite causes skin lesions that heal within six months to a year, while lesions caused by the “Leishmania tropica” parasite will heal in about two years. Sometimes the lesions are inflamed and very painful requiring hospitalization under intravenous treatment, or laser and electrotherapy treatments. Leishmania in the Gaza Envelope is of the major type.

How do you get the disease?

The route of infection with Leishmania begins with the Leishmania parasite that passes to rodents – psammens that transmit the species Leishmania major in the south of the country through the bite of the sand fly or the rock monkeys that transmit the species Leishmania tropica in Samaria and the north of the country. The fly bites, sucks the blood and in the process injects Leishmania parasites into the rodent so that the rodent becomes a reservoir. The parasite multiplies in the rock rabbit’s body. The fly stings the rock rabbit again, extracts parasites from it, stings the humans and injects them with the parasite.

When should you see a doctor?

Most of the insect bites in Israel are not from the sand fly and they heal within a few days. If there is a lesion that does not heal within about 3 weeks, or if it is painful – consult a doctor.

How is the diagnosis made?

In the case of a suspected leishmaniasis lesion, a doctor takes a sample from the lesion that is sent to a laboratory to identify the parasite, for a sensitive and accurate test called PCR that locates the parasite’s genetic load. The aforementioned test is carried out in several skin departments of medical centers in Israel and the answer is received within a few days.

How is the disease treated?

In the past, the treatment was given with Lishkotan ointment, but its production and marketing was stopped in Israel.