Animals Involved
Wild canids and dogs are primary reservoirs, also in other mammals
Known Distributions
Asia, South America, Caribbean, Africa, the Middle East, Europe (Mediterranean
spreading north), North America
Probable Means of Spreading
Bite of sand flies Phlebotomus and Lutzomyia spp
Clinical Manifestations in People
Undulating fever, hepatosplenomegaly; some have cough, diarrhea, lymphadenopathy, weight loss, petechiae or hemorrhages on mucous membranes, nodular lesions or darkening of skin; pancytopenia; mild cases with only a few signs may resolve on their own, but most other cases fatal if untreated