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has recently been observed in Rio de Janeiro City, the Middle Paraiba Valley and the Costa Verde Fluminense. This has exposed the contiguous Paraiba Valley (Vale do Paraiba) and the North Coast (Litoral Norte), in the neighboring Sao Paulo State, to new infections. Although a similar situation occurred in the 1990s in western Sao Paulo State, during which the infection traversed highways and railways connecting the region to Mato Grosso do Sul State, the latter was already endemic for VL.The current complexity of urban VL transmission poses new challenges, and there is an urgent need for new strategies to control the spread of infection. The increased circulation of human populations and infected dogs, and greater distribution of the sand fly vector, which is also influenced by human activities, need to be considered

Visceral leishmaniasis in Southern Rio de Janeiro State and the risk of propagation to São Paulo State, Brazil