What Every Parent Should Know About Sandfly Diseases in Children

What Are Sandflies?

Sandflies are very small flying insects, much smaller than mosquitoes. They are so tiny that they can pass through regular mosquito nets. These insects are most active during the evening and early morning hours, especially at dusk and dawn. Unlike mosquitoes that make a buzzing sound, sandflies are silent fliers, making them hard to notice.

Only female sandflies bite humans and animals because they need blood to produce eggs. Their bite is usually painless, which means your child might get bitten without even knowing it. These insects live in warm climates and are found in many parts of the world including tropical and subtropical regions.

What Diseases Do Sandflies Cause?

Sandflies can spread several diseases to children, but the most important ones to know about are leishmaniasis and sandfly fever.

Leishmaniasis - The Main Disease

Leishmaniasis is caused by tiny parasites that sandflies carry. When an infected sandfly bites your child, it can pass these parasites into their skin. According to the World Health Organization, leishmaniasis affects people in approximately 90 countries around the world. Children are particularly vulnerable to this disease.

There are three main types of leishmaniasis that can affect children:

1. Cutaneous Leishmaniasis - Skin Form

This is the most common type. It affects the skin and causes sores or ulcers, usually on parts of the body that are exposed like the face, arms, and legs. These sores can appear weeks or even months after a sandfly bite. The sores may look like:

• A small bump that slowly gets bigger
• An open sore with or without a scab
• Multiple spots or lesions on the skin
• Painless or slightly painful wounds

The concerning part is that these sores can leave permanent scars, especially on the face, which can be emotionally difficult for children as they grow up.

2. Visceral Leishmaniasis - Internal Organ Form

This is the most serious type and is also called kala-azar. It affects internal organs like the liver, spleen, and bone marrow. Children are more likely to develop symptoms from this type compared to adults. The symptoms include:

• Fever that comes and goes for weeks
• Weight loss and loss of appetite
• Enlarged belly due to swollen liver and spleen
• Tiredness and weakness
• Pale skin due to anemia

This form can be life-threatening if not treated properly. The disease weakens the immune system, making children more vulnerable to other infections.

3. Mucosal Leishmaniasis - Nose and Throat Form

This is a less common but severe form that can damage the mucous membranes in the nose, mouth, and throat. It can occur after cutaneous leishmaniasis and needs proper treatment to prevent serious complications.

Sandfly Fever

This is a viral disease also transmitted by sandflies. It is usually milder than leishmaniasis and causes flu-like symptoms including fever, headache, body aches, and tiredness. Most children recover from sandfly fever within a few days to a week without specific treatment. According to medical research, children are more commonly affected by sandfly fever than adults in areas where the disease is present.

Where Are These Diseases Found?

Sandfly diseases occur in many parts of the world. Leishmaniasis is found in approximately 90 countries across different regions. The areas where these diseases are most common include:

Which Children Are at Higher Risk?

While any child can get sandfly diseases if exposed to infected sandflies, certain children face higher risks:

• Young children: Younger children and infants are more likely to develop symptoms and severe forms of the disease.
• Children with weak immune systems: Children with conditions that weaken the immune system or those taking medicines that suppress immunity are at higher risk.
• Malnourished children: Poor nutrition makes children more vulnerable to developing severe disease.
• Children living in poor housing: Homes with inadequate screening and sanitation attract more sandflies.
• Children in rural or tropical areas: Sandflies are more common in rural settings and tropical climates.

According to the Centers for Disease Control and Prevention, children, the elderly, and people who are immunocompromised are more likely to develop symptoms when exposed to leishmaniasis.

How to Recognize Sandfly Diseases in Your Child

Signs of Cutaneous Leishmaniasis

• A bump or lump on the skin that appears weeks after being in an area with sandflies
• The bump slowly grows into an open sore
• Sores that do not heal on their own
• Usually found on exposed skin like face, arms, or legs
• May have multiple sores

Signs of Visceral Leishmaniasis

• Fever that keeps coming back
• Your child is losing weight or not gaining weight properly
• Belly appears swollen or enlarged
• Extreme tiredness and weakness
• Loss of appetite
• Pale skin or lips

How Are Sandfly Diseases Diagnosed and Treated?

Diagnosis

Doctors diagnose leishmaniasis through several methods:

• Examining skin sores and taking small tissue samples
• Blood tests to check for the parasites
• Testing samples from bone marrow for visceral leishmaniasis
• Asking about travel history to areas where sandflies are found

Treatment

Treatment depends on the type of leishmaniasis and how severe it is. Some skin sores may heal on their own over time, but many cases need treatment to prevent complications and scarring. Doctors may use:

• Special medicines that fight the parasites
• Creams or injections applied directly to skin sores
• Oral medications for more serious cases
• Hospital care for severe visceral leishmaniasis

The good news is that with proper treatment, most children recover well. However, treatment can take several weeks, and it is important to complete the full course of medicine even if your child starts feeling better.

How to Protect Your Children from Sandfly Diseases

There is currently no vaccine available to prevent leishmaniasis. The best protection is to avoid sandfly bites. Here are practical steps you can take:

At Home

• Use fine mesh nets: Regular mosquito nets have holes too large for sandflies. Use bed nets with very fine mesh, smaller than 1.5 millimeters
• Treat nets with insecticide: Insecticide-treated bed nets provide extra protection
• Install proper window screens: Make sure windows and doors have fine mesh screens
• Use air conditioning: Air-conditioned rooms are safer as sandflies prefer still air
• Spray living areas: Use approved insecticides in sleeping and living areas
• Keep surroundings clean: Remove garbage and organic waste that attract sandflies

When Going Outdoors

• Limit outdoor time at dusk and dawn: Sandflies are most active during these hours
• Cover up: Dress children in long-sleeved shirts, long pants, and socks
• Use insect repellent: Apply repellent containing DEET or picaridin on exposed skin and clothing
• Treat clothing: Consider treating clothes with permethrin insecticide
• Avoid sandfly habitats: Stay away from areas with lots of vegetation, animal burrows, and damp places

For Travelers

If you are traveling with children to areas where sandfly diseases are common:

• Check if your destination is in a risk area before traveling
• Book accommodations with air conditioning and good screening
• Carry insect repellent, treated bed nets, and protective clothing
• Educate older children about avoiding outdoor activities at dusk and dawn
• Know the symptoms to watch for after returning home

Prevention Checklist for Parents

Myths and Facts About Sandfly Diseases

Living in Areas Where Sandflies Are Common

If your family lives in a region where sandflies are present, make protection part of your daily routine:

• Keep your home well-maintained with proper screens on all openings
• Make sure children sleep under treated bed nets every night
• Educate older children about the importance of protection
• Create awareness among family members about symptoms to watch for
• Know where to seek medical help if needed
• Participate in community efforts to control sandfly populations
• Support good sanitation and waste management in your community

Community efforts are important in controlling sandfly populations. This includes proper waste disposal, eliminating standing water, and keeping vegetation trimmed around homes.

Key Takeaways for Parents

• Sandflies are very small insects that can transmit serious diseases to children
• Leishmaniasis is the main concern, with forms affecting either skin or internal organs
• Children are more vulnerable than adults, especially young children and those with weak immune systems
• Early recognition and treatment are crucial for good outcomes
• Prevention focuses on avoiding sandfly bites through physical barriers, repellents, and timing outdoor activities
• Fine mesh is essential as sandflies are smaller than mosquitoes
• No vaccine exists yet, making prevention the primary defense
• If your child develops unexplained skin sores or prolonged fever after potential exposure, seek medical attention

Additional Resources

For more information about sandfly diseases, you can refer to:

• World Health Organization - Leishmaniasis fact sheets
• Centers for Disease Control and Prevention - Leishmaniasis information
• Your local health department for region-specific guidance
• Medical textbooks such as Nelson Textbook of Pediatrics and Red Book: Report of the Committee on Infectious Diseases