Canada warns travelers on leishmaniasis risk in key hotspots

Canadian travelers planning trips to Greece, Italy, Spain and parts of China are being urged to review their health precautions, after the Government of Canada highlighted leishmaniasis as an emerging concern in several popular tourist regions.

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What Is Behind Canada’s New Travel Health Warning

The updated advisory draws attention to leishmaniasis, a parasitic disease transmitted by the bite of infected sandflies that has long been present in parts of southern Europe and Asia but is now being flagged more prominently for travelers. Publicly available information from Canadian health authorities indicates that the notice applies to specific regions in Greece, Italy, Spain and China where leishmaniasis is known to circulate.

The move comes as international health literature continues to document locally acquired cases in Mediterranean destinations frequented by North American tourists, and as China reports both cutaneous and visceral forms of the disease in some provinces. While leishmaniasis is not new, experts describe changing climate patterns, urban expansion and growing pet dog travel as factors that may increase human exposure.

Canada’s guidance does not prohibit travel to the affected countries. Instead, it emphasizes awareness of sandfly exposure, early recognition of symptoms and careful planning for medical care abroad. Travelers are being asked to treat leishmaniasis in the same way they would other vector-borne risks, such as dengue or malaria, by incorporating bite-prevention strategies into their itineraries.

How Leishmaniasis Spreads and Why Tourists Are at Risk

Leishmaniasis is caused by Leishmania parasites, which are transmitted through the bite of infected female sandflies. In the destinations highlighted by Canada, the disease occurs mainly in two forms. Cutaneous leishmaniasis affects the skin, typically producing one or more ulcers that may appear weeks or months after a bite. Visceral leishmaniasis, sometimes called kala-azar, attacks internal organs such as the spleen and liver and can be life-threatening if untreated.

Reports from European and Asian surveillance networks show that the parasite is well established around parts of the Mediterranean basin, particularly in rural and peri-urban areas. Sandflies tend to be most active from dusk to dawn, a time when many tourists are outdoors dining, walking or socializing during warm-weather vacations. This overlap in behavior increases the chance of bites, especially for visitors who are unfamiliar with local insects.

Unlike malaria, there is no widely used preventive tablet for leishmaniasis, which places more emphasis on environmental and personal protective measures. Because incubation can be long, Canadian travelers may not develop symptoms until weeks after they return home, which can make diagnosis more challenging if they do not mention their travel history.

Country Hotspots: Greece, Italy, Spain and China

In Greece, published coverage points to leishmaniasis being endemic in many mainland and island regions, with sporadic cases among residents and visitors. Popular coastal and island destinations where dogs and humans live in close proximity, combined with warm evening temperatures, create an environment in which sandflies can thrive.

Italy has recorded leishmaniasis in several central and southern regions, including areas that attract large numbers of foreign tourists. Medical journals describe both rural outbreaks and cases in suburban settings, reflecting how residential development into previously wild areas may increase human contact with infected sandflies.

Spain is also listed in international mapping studies as a country with sustained transmission, particularly in Mediterranean and central regions. Research in recent years has described clusters of infections around some urban green spaces and peri-urban zones, underlining that the disease is not limited only to remote countryside locations.

In China, leishmaniasis has historically been associated with certain inland and western provinces, although national data indicate that the pattern of disease can shift over time. Canada’s warning highlights that travelers heading beyond major coastal cities or engaging in outdoor activities in affected regions should be aware of sandfly exposure, even if they are far from the more familiar Mediterranean hotspots.

Practical Protection Steps for Canadian Travelers

Health advisories recommend that visitors to at-risk parts of Greece, Italy, Spain and China focus on reducing contact with sandflies rather than canceling travel outright. Sandflies are small and often silent, so standard mosquito precautions are relevant but need to be applied carefully, particularly in the evening and overnight hours.

Travel medicine guidance suggests using insect repellents containing ingredients such as DEET or other recognized active substances on exposed skin, and wearing long sleeves, long trousers and socks after dusk. Choosing accommodation with well-fitted screens, air conditioning or bed nets can further lower the likelihood of bites, especially in rural guesthouses or open-air lodgings.

Travelers who plan to take dogs to the Mediterranean are advised in veterinary literature to consult a veterinarian about collars, spot-on treatments or vaccines available in some countries to reduce the risk of canine infection. Since dogs are an important reservoir for certain Leishmania species, protecting pets can also indirectly reduce household exposure for humans.

Prospective visitors are also encouraged to review their travel insurance policies, checking that medical coverage applies in all four highlighted countries and that they understand procedures for seeking care if they become ill after returning to Canada. Keeping a record of destinations, including smaller towns and rural stays, can be valuable for clinicians if symptoms emerge later.

Symptoms to Watch for and When to Seek Care

According to open medical references, cutaneous leishmaniasis often begins as a small bump or nodule at the site of a sandfly bite that slowly enlarges and may ulcerate. Lesions can be painless or mildly painful and commonly appear on exposed areas such as the face, arms or legs. Because these sores can resemble other skin problems, travelers may not immediately associate them with a trip taken weeks earlier.

Visceral leishmaniasis usually presents more severely, with prolonged fever, weight loss, fatigue, enlargement of the spleen or liver and blood abnormalities. This form is considered serious and requires prompt medical treatment. While it is less common among short-term travelers, those who have spent extended periods in high-risk environments, such as long rural stays or volunteer placements, may face higher exposure.

Canadian travelers returning from Greece, Italy, Spain or China who develop unexplained skin lesions, persistent fever or other unusual symptoms are advised by public health information sources to seek medical care and to inform healthcare providers about their recent travel history. Early diagnosis can significantly improve treatment outcomes, particularly for visceral disease.

The latest Canadian advisory underscores that leishmaniasis remains a manageable risk for most tourists, provided they are informed and prepared. With thoughtful planning and attention to bite prevention, travelers can continue to enjoy Mediterranean coastlines and Chinese cultural sites while minimizing the chance of encountering this often overlooked tropical disease.