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What is Black fever?

Black fever (visceral leishmaniasis) is a slowly progressing, highly contagious chronic disease, which is characterized by recurrent and irregular fever, significant weight loss, swelling of the liver and spleen, and anaemia. It is transmitted through the bite of infected female sand-flies (phlebotomine).

What are its main signs and symptoms?

There are several forms of leishmaniasis based on the organ that is affected. Most common types are of the skin and visceral (affecting the liver and spleen). The signs and symptoms of black fever include:

  • Loss of appetite
  • Pallor and substantial weight loss
  • Weakness
  • Fever
  • Skin – becomes dry, thin and scaly
  • Anaemia
  • Splenomegaly – Enlargement of the spleen, usually soft and non-tender.
  • Liver – enlargement- soft, smooth surface, sharp edge

What are the main causes?

Black azar is a disease that spreads through vector-infected sand flies (Female Phlebotomus argentipes). The infected fly transmits the parasite called Leishmania into the bloodstream which produces the symptoms.

How is it diagnosed and treated?

There are 2 approaches for the diagnosis of black azar

  • Symptomatic: The symptoms mentioned above are closely diagnosed and monitored.
  • Laboratory: this includes serological tests to look for antibodies produced against the parasite and parasite demonstration in bone marrow/spleen/lymph node  tissue sample collected via a biopsy or in culture medium. This is considered as confirmatory diagnosis.

Anti-parasite drugs can help to kill the parasite in the patient’s body. First oral medication against black fever is miltefosine. It is 95% effective in patients. Vaccines or preventive drugs for black fever are not available so precautions should be taken when in endemic areas like sub-Saharan countries, Asia, southern Europe and America.

Self-care includes wearing full sleeved shirts and pants while travelling to these endemic areas. Use insect repellent sprays and avoid stepping outdoors during evening and night when the sand flies are most active.

  1. Medicines for Kala Azar (Black Fever, Visceral Leishmaniasis)
  2. Doctors for Kala Azar (Black Fever, Visceral Leishmaniasis)
Dr. Neha Gupta

Dr. Neha Gupta

Infectious Disease
16 Years of Experience

Dr. Lalit Shishara

Dr. Lalit Shishara

Infectious Disease
8 Years of Experience

Dr. Alok Mishra

Dr. Alok Mishra

Infectious Disease
5 Years of Experience

Dr. Amisha Mirchandani

Dr. Amisha Mirchandani

Infectious Disease
8 Years of Experience

Medicines for Kala Azar (Black Fever, Visceral Leishmaniasis)


  1. American International Medical University. Kala-azar/ Leishmaniasis : Symptoms, Causes, Diagnosis, Management& Prevention. Saint Lucia [Internet]
  2. World Health Organization [Internet]. Geneva (SUI): World Health Organization; New therapy for "Black fever" is 95% effective.
  3. World Health Organization [Internet]. Geneva (SUI): World Health Organization; Access to essential antileishmanial medicines and treatment.
  4. MedlinePlus Medical Encyclopedia: US National Library of Medicine; Leishmaniasis
  5. Center for Disease Control and Prevention [internet], Atlanta (GA): US Department of Health and Human Services; Parasites - Leishmaniasis
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