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There are two forms of VL transmission. Zoonotic with animal reservoirs mainly dogs and rodents in the Mediterranean basin and Latin America regions where the etiologic agent is L infantum; and anthroponotic – human to human transmission by the vector without other animals in between which occurs in India and East Africa where the etiologic agent is L donovani.

Very rare forms of transmission include transfusion of infected blood, needle sharing, congenital and laboratory accidents.