Control of zoonotic visceral leishmaniasis: is it time to change strategies?

Zoonotic visceral leishmaniasis (ZVL) is an important emerging parasitic disease. This article reviews the recommended control methods for the disease and concludes that they have only been partially effective. The continued endemicity of ZVL, its recent appearance in urban areas of Latin America, and its increasing importance as an opportunistic infection among persons infected with human immunodeficiency virus indicate that present control methods for the disease are ineffective and that new control strategies are needed. Prevention of the disease in dogs appears to be the best approach for interrupting the domestic cycle of ZVL. The most feasible approach would seem to be a canine vaccine that protects dogs from developing parasitemia and from becoming peridomestic reservoirs of the parasite.