The Lost City of the Monkey God

by Douglas Preston

Leishmaniasis comes in three main varieties, each with distinct symptoms. The most common form is cutaneous (i.e., skin) leishmaniasis, which is found in many parts of the Old World, especially Africa, India, and the Middle East. It is also widespread in Mexico and Central and South America, and it recently popped up in Texas and Oklahoma. Some US troops returning from Iraq and Afghanistan contracted cutaneous leish during their deployments and nicknamed it the Baghdad boil. This kind of leish starts as a sore at the location of the bite, which grows into a weeping lesion. If left alone, it usually goes away, leaving only an ugly scar. It can usually be treated by burning, freezing, or surgically removing the ulcer. In visceral leishmaniasis, the second type—also from the Old World—the parasite invades the body’s internal organs, particularly the liver, spleen, and bone marrow. It is sometimes known as black fever, because it often turns its victim’s skin black. This variety is deadly; without treatment it is always fatal. But treatment of visceral leish is quick and reliable, requiring a single infusion of an antibiotic drug that yields a cure rate of about 95 percent. Most of the deaths in the world from leish are caused by the visceral form, among poor children who don’t have access to treatment. The final form of leish is the mucocutaneous or mucosal variety, the major New World form of the disease. It starts as a skin sore like the cutaneous kind. Months or years late...