The south coast of Rio de Janeiro State, in Brazil, is endemic for cutaneous and visceral leishmaniases and is frequently visited by tourists from different parts of the world. Since the complex epidemiology of leishmaniases demands local studies, the goal of this study was to investigate the phlebotomine sand fly fauna and leishmaniases transmission in Ilha Grande, an ecotourism area of Angra dos Reis municipality.
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During 15 consecutive months of sand fly monitoring, 1093 specimens from 16 species were captured. The potential leishmaniases vectors found were Lutzomyia (Nyssomyia) intermedia, L. migonei, L. (N.) flaviscutellata, L. (Psychodopygus) ayrozai and L. (Lutzomyia) longipalpis. Five species were new records in Ilha Grande: L. (Sciopemyia) microps, L. termitophila, L. firmatoi, L. rupicola and L. (P.) ayrozai. Higher species richness was found inside forest areas, although potential leishmaniases vectors were present in deforested areas, peridomiciles and inside houses. Lutzomyia (N.) intermedia and L. migonei were the most abundant species. Females of L. migonei showed a high rate (10.3%) of natural infection by Leishmania (Viannia) sp., probably Leishmania (V.) braziliensis.
Since Ilha Grande is an ecotourism area that receives travelers from many parts of the world, it is important to study the local transmission of infectious diseases. Therefore, the goal of this study was to investigate the phlebotomine sand fly fauna and leishmaniases transmission in the island, which has records of human cases of both CL and VL.
The island has a population of 9,000 residents, spread in small villages near beaches. The Atlantic Forest cover is in different regeneration levels due to human occupation and use in the past for agriculture through crops of sugar cane, coffee and corn [18]. Four Environmental Preservation Areas exist on the island to protect the natural ecosystems and have restrictive rules for land use, so touristic activities are considered ecotourism. In fact, ecotourism is the main economic activity of the island, which attracts people from different parts of the world [19].
The detection of L. migonei in high abundance also corroborates with previous studies of Atlantic Forest areas of Southeast Brazil, where it is usually found as the second-most abundant species and it is considered CL secondary vector [2, 7]. It was first found naturally infected with flagellates by Pessoa & Coutinho [45] in São Paulo State. Afterwards, in Baturité, Ceará State, Azevedo et al. [46] also detected promastigotes in 0.2% of dissected L. migonei females, which were later identified as Leishmania (V.) braziliensis [47]. Pita-Pereira et al. [24], using the same molecular method as the present work, detected a 2% infection rate of L. migonei with Leishmania (V.) braziliensis in Jacarepaguá, Rio de Janeiro. In contrast with these low Leishmania natural infection rates, the high rate of Leishmania (Viannia) sp. infection detected in L. migonei in Praia Vermelha (10.3%) suggest the role of this sand fly species in CL transmission in this locality. These results complement the previous study of Araújo Filho et al. [11, 12], who commented about L. migonei importance as CL vector in this locality.
Recently, L. migonei was found naturally infected with Leishmania (L.) infantum chagasi in São Vicente Férrer, Pernambuco State, suggested by the authors to be a potential VL vector in the locality [48]. Guimarães et al. [49] later detected, in the same locality, L. migonei naturally infected with Leishmania (V.) braziliensis. These findings demonstrate the capacity of L. migonei to maintain infection with two different species of Leishmania, although more studies are necessary to investigate the possibility of mixed infection and its role in VL transmission.
The present study demonstrates the occurrence of CL and VL vectors even after major environmental impacts (such as the landslides of 2010). This suggests that leishmaniases transmission profiles in the area may have shifted from essentially sylvatic to impacted and peridomestic areas, highlighting the need for constant epidemiologic and entomologic surveillance. In addition, Ilha Grande is an ecotourism area with tourists frequently trekking inside forests, where they may be exposed to vector contact. This can easily be reduced with use of insect repellents. People who live on the island need to have access to information about leishmaniases transmission, so that peridomestic cleaning can be carried out, to reduce establishment of vector breeding areas. Health education practices with the native population and information for tourists are suggested control actions that can be taken in Ilha Grande to reduce the burden of leishmaniases.
Infection of urban dwellers that report contact with contaminated water associated with ecotourism represents a new pattern of disease transmission and dissemination. The infection with the disease at these occasions finds its expression in outbreaks of acute schistosomiasis among internal tourists to rural areas. Therefore, epidemiological surveillance in endemic areas should be aware of this schistosomiasis transmission pattern, and a multidisciplinary approach, most of all sanitation and health education measures, is required in order increase the efficiency of control strategies.
The Epidemiological Surveillance Service of the Ribeirão das Neves municipality again was informed about the occurrence of another six cases of acute schistosomiasis among members of a single family with ages ranging between 16 and 80 years. The family members showed symptoms similar to those in the first outbreak and were diagnosed, treated and followed up as described above. They reported contact with a water in small stream that is often used for recreational activities in the city of Santana do Riacho, an important ecotourism resort in the Serra do Cipó National Park in Minas Gerais, Brazil. In response to this cluster, 24 snails from the area of exposure were collected and identified as B. glabrata. Exposition to artificial light for detection of infection with S. mansoni confirmed that two (8.3 %) of the snails were eliminating cercariae.
It is noteworthy that infection dynamics of these two outbreaks shows similarity, involving urban family households that travel for leisure purposes to ecotourism areas with natural water source contact exposure. In the first outbreak, autochthonous infection, by way infection within the municipality, was observed in a water collection system which is contaminated with untreated human waste and showed the presence of vector competent water snails. The contamination of the aquatic environment with human feces in combination with the presence of the intermediate host snails provides the ideal environment for disease transmission and consequently infection of visitors to this area who may have leisure and recreational water contact.
The second outbreak calls attention to the encounter of infected snails in a well-known tourist area. This region receives thousands of visitors (both local and outside) involving ecotourism associated with natural water activities. Schistosomiasis cases and infected snails in the region have previously been reported [6, 10], and our findings corroborate and document continued active transmission of schistosomiasis in this area and risk to tourists. This region is part of a mountainous complex do Espinhaço and is considered a natural reserve of extreme hydrographic importance to the State of Minas Gerais. The government in partnership with the private sector has initiated specific programs to stimulate international tourism growth to the region [11]. Although there is general knowledge that this area is endemic for schistosomiasis, little is done to sensitize the local community to the problem and to report on the risks of disease transmission to tourists [6]. This situation reveals the need for a coordinated planning effort in the development of the tourism sector, including mainly reorganization and restructuring of sanitation measures, such as waste disposal and sewage treatment, as well as the implementation of integrated health educational programs for the local community and visiting tourists regardless of the country of origin.
Given that the costs and benefits of ecotourism cannot be meaningfully assessed without understanding the human context, particular attention is given to how ecotourism has been used as part of community development. In closing, the book synthesizes the current state of knowledge regarding best practices for reducing human impacts on wildlife. The final chapter highlights key research questions that must be addressed to provide more evidence-based guidelines and policy.
Generally, ecotourism deals with interaction with biotic components of the natural environments.[4] Ecotourism focuses on socially responsible travel, personal growth, and environmental sustainability. Ecotourism typically involves travel to destinations where flora, fauna, and cultural heritage are the primary attractions. Ecotourism is intended to offer tourists an insight into the impact of human beings on the environment and to foster a greater appreciation of our natural habitats. Ecotourism aims at minimal environmental impact on the areas visited. Besides fostering respect towards the natural environment, ecotourism also helps in creating socio-economic benefits for the communities of the area visited.
Responsible ecotourism programs include those that minimize the negative aspects of conventional tourism on the environment and enhance the cultural integrity of local people. Therefore, in addition to evaluating environmental and cultural factors, an integral part of ecotourism is the promotion of recycling, energy efficiency, water conservation, and creation of economic opportunities for local communities.[5] For these reasons, ecotourism often appeals to advocates of environmental and social responsibility. 2ff7e9595c
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