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DALLAS-When Dr. Kent Aftergut saw a patient with a couple of sores on his back resembling boils, the dermatologist immediately thought of an infection caused by a parasite usually found in South America, the Middle East, Mexico and South Texas.But his patient, a 58-year-old from the North Texas town of Waxahachie, hadn't recently traveled far. Tests, though, confirmed that Weldon Hatch's two sores below his left shoulder blade were indeed leishmaniasis."It's an ugly thing," Hatch said.Aftergut said the ailment-called "Baghdad Boil" by soldiers in the Middle East-is rare in the US for someone not a foreign traveler.A search by a team of doctors at the University of Texas Southwestern Medical Center, where Aftergut is on the faculty, found nine similar cases in North Texas in the last two years.It's something that the Texas Department of State Health Services has noticed as well. After hearing about a couple of leishmaniasis cases last year in northeast Texas and southeastern Oklahoma, the health department made the condition one of the diseases that doctors must report to them when diagnosed.So far this year, the health department has confirmed four cases in people in Texas who had not traveled to places where the parasite is usually found.In North Texas, doctors say patients are likely becoming infected when a sand fly bites a burrowing wood rat, which carries the parasite, and then bites a human. The disease can't be spread by human contact.Tom Sidwa, manager of the zoonosis control branch for the health department, said they're trying to determine what could be causing the move north."It was thought that the range of the sand flies didn't extend that far," Sidwa said. "Seeing it much farther north was surprising."Aftergut said either the wood rat or sand flies could be moving, although he doesn't know why.Luckily, the leishmaniasis cases identified by the medical center's doctors have been Leishmania mexicana, a less dangerous form of the parasite that is not life-threatening. Unlike other forms, the infection doesn't spread to the whole body.In those with a normal immune system, Leishmania mexicana sores usually heal within a year and won't make the patients sick.Aftergut said that treatment can include anti-fungal medications or removing the sores, which is what Hatch had done.Hatch-an avid hunter, hiker and naturalist who spends a lot of time outdoors-first noticed the two tiny red dots on his back in February. As they began to grow to the size of a quarter, looking blistery and itching, he headed to the doctor.Since his experience with leishmaniasis, he said he's been heeding doctors' advice and spraying on a little insect repellent when he heads outside.As in the days of Noah...
