Leishmaniasis
 

A friedn and me spent last year a week riding in Morocco, also visited the dunes at Merzouga. After a while we both developed nasty sores. After a lot of tests diagnosis was set: Leishmaniasis. Luckily, not the really dangerous variety.
Leishmaniasis is a parasite transferred by the bite of a sandfly. There are several variants ranging from just ugly and impractcal to outright dangerous. Treatment is difficult, normally with injections of antimone-based medecine into muscles while monitoring liver and kidney functions (antimone has been forbidden as insecticide in Europe since the 50's.

Prevention is the same as malaria: keep skin covered, avoid being bitten. Avoid sitting down on blankets of dubious cleanliness (Merzouga dunes teashop ....).

We are both OK, no worries.

Auke

Aukeboss,

Very glad to hear that you are OK.

That's an important warning IMO.
About the sandfly, a couple of aspects that I have been told:

There are species of sandfly that can get through mosquito nets - they are smaller than mosquitos basically.
They are not much of a threat above about 1/2 metre from ground level - they don't fly and cannot "jump" higher than that.

Also, the L disease can be encountered in water courses contaminated with rats piss - I used to carry a warning card for this, because my work involved watercourses and not all doctors would recognise the symptoms.
The advice is not to have open wounds near potentially contaminated water - bathing, washing, swimming.

Been there and have the scar to prove it
 

Dave and Auke,

I grew up in the Amazon, so my chances were pretty good to hook up with some desease or infection. Leismeniasis can really be nasty, and usually it is on the face near the nose. It eats away the flesh leaving everything exposed!

In my case (at age 16), I had a mosquito bite on my shin that I had scratched open, then the fly must have zeroed in on that. Regular infections were common, so I was just treating it normally, but it continued to grow. The local clinic did a culture and determined it was leishmeniasis and showed me some nasty pictures of it fully developed from a medical journal (GROOOOSSS !!).

That was enough for me! I stuck to the discipline of daily visits to the clinic where they shot me with anti-biotics (in the bum of course), then scraped and cleaned the wound, then dried it under a lamp, before dousing it with sulfa power and covering it. No getting it wet!

Took 30 days of this treatment to heal (you think long rides makes your bum sore... try a shot a day in that there spot for 30 days!). It left me with a 3 inch diameter, 1/4 inch deep scar. Doesn't give me any problems, but does hurt like hell when I bang it!

I'm going into detail because riders need to become aware. The MOST IMPORTANT THING about self-care in the tropics is to attempt to be clean and dry at least once a day! IMMEDIATELY care for the most minor scratch! Then you should be good. PLEASE don't avoid the tropics for fear of things like this.. (in the Andes there is a small brown spider that leaves the Black Widow looking like a pussy cat!)

When I was younger, I would be embarrassed about the scar until my older sister pulled me aside and said: "Wear it with honor,.. it means you've 'been' places and 'done' things that others only dream about....