{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T23:07:10Z","timestamp":1789081630785,"version":"build-2803163510"},"reference-count":16,"publisher":"Public Library of Science (PLoS)","issue":"5","license":[{"start":{"date-parts":[[2026,5,8]],"date-time":"2026-05-08T00:00:00Z","timestamp":1778198400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosntds.org"],"crossmark-restriction":false},"short-container-title":["PLoS Negl Trop Dis"],"abstract":"<jats:p>Cutaneous leishmaniasis (CL), once considered a travel-associated tropical disease, is increasingly transmitted within the United States, particularly in southern regions. Despite mounting evidence of local transmission, public health recognition and preventive infrastructure remain limited. This Viewpoint highlights the urgent need to shift the U.S. CL response from questioning endemicity to preventing transmission. We review ecological, clinical, and surveillance data demonstrating the presence of competent vectors, animal reservoirs, and autochthonous human cases. Diagnostic delays, underreporting, and insufficient provider training contribute to missed prevention opportunities. Climate change and peri-urban rodent-human contact data further heighten future risk. A coordinated response is essential, including national notifiability, expanded diagnostics, integrated vector and reservoir surveillance, clinical education, and One Health\u2013focused research. Without immediate action, CL risks becoming an entrenched, neglected zoonosis in the United States.<\/jats:p>","DOI":"10.1371\/journal.pntd.0014297","type":"journal-article","created":{"date-parts":[[2026,5,8]],"date-time":"2026-05-08T23:12:09Z","timestamp":1778281929000},"page":"e0014297","update-policy":"https:\/\/doi.org\/10.1371\/journal.pntd.corrections_policy","source":"Crossref","is-referenced-by-count":1,"title":["Hiding in plain sight: A call to prevent cutaneous leishmaniasis transmission in the United States"],"prefix":"10.1371","volume":"20","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1344-9312","authenticated-orcid":true,"given":"Juan David","family":"Ram\u00edrez","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah M.","family":"Gunter","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Megan","family":"Coffee","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Norman","family":"Beatty","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dawn M.","family":"Wetzel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2026,5,8]]},"reference":[{"issue":"9","key":"pntd.0014297.ref001","doi-asserted-by":"crossref","first-page":"1032","DOI":"10.1001\/jamadermatol.2018.2133","article-title":"Incidence of endemic human cutaneous leishmaniasis in the United States","volume":"154","author":"BE McIlwee","year":"2018","journal-title":"JAMA Dermatol"},{"issue":"3","key":"pntd.0014297.ref002","doi-asserted-by":"crossref","DOI":"10.1128\/msphere.00814-23","article-title":"Cutaneous Leishmania mexicana infections in the United States: defining strains through endemic human pediatric cases in northern Texas","volume":"9","author":"B Nepal","year":"2024","journal-title":"mSphere"},{"issue":"8","key":"pntd.0014297.ref003","first-page":"999","article-title":"Leishmania in Texas: a contemporary one health scoping review of vectors, reservoirs, and human health","volume":"14","author":"MH Jibowu","year":"2025","journal-title":"Biology (Basel)"},{"key":"pntd.0014297.ref004","article-title":"Genomic characterization of a locally transmitted Leishmania mexicana isolate from Texas","author":"JD Ram\u00edrez","year":"2026","journal-title":"Am J Trop Med Hyg"},{"issue":"1","key":"pntd.0014297.ref005","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pntd.0000585","article-title":"Climate change and risk of leishmaniasis in north america: predictions from ecological niche models of vector and reservoir species","volume":"4","author":"C Gonz\u00e1lez","year":"2010","journal-title":"PLoS Negl Trop Dis"},{"issue":"4","key":"pntd.0014297.ref006","doi-asserted-by":"crossref","first-page":"160","DOI":"10.1007\/s40475-022-00267-4","article-title":"Possibility of Leishmania transmission via Lutzomyia spp. sand flies within the USA and implications for human and canine autochthonous infection","volume":"9","author":"EA Beasley","year":"2022","journal-title":"Curr Trop Med Rep"},{"key":"pntd.0014297.ref007","doi-asserted-by":"crossref","first-page":"57","DOI":"10.1051\/parasite\/2025039","article-title":"A review of Leishmania infections in American Phlebotomine sand flies - 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