ISIS is now facing off against perhaps its deadliest enemy yet a flesh eating disease spread by sand flies. The disease, called Leishmaniasis, is estimated to cause about 2 million infections per year, and somewhere between 20,000 to 50,000 deaths.

As recently as last year Doctors Without Borders was working in Syria to prevent the spread of the disease, but as the Islamic State advanced, doctors were forced to essentially evacuate. Now all medical care is being left to local doctors and medics, but supplies are scare and it’s estimated that about 64% of Syrian hospitals have been damaged, destroyed, or abandoned.

ISIS Dying: Where Bombs May Fail, Flesh Eating Disease May Succeed

ISIS: Poor hygiene conditions

Poor hygiene conditions, and the fact that many if ISIS’s soldiers have essentially refused treatment is allowing the disease to spread at a rapid rate. Add in the fact that ISIS’s ground troopers are often forced into cramp and tight living conditions, and it’s a perfect recipe for a medical disaster.

Of course, one’s disaster could turn out to be another’s miracle. If the flesh eating disease is able to even slow down ISIS, it could prove to be a tipping point in the battle against the extremist group. Bombs and advances from competing armies have pushed the group back, but so for the Islamic State has proven to be difficult to outright defeat.

The Islamic State has found itself under pressure from essentially all sides. A disease spreading from the inside out could turn out to be the straw that breaks the proverbial camel’s back. Facing assaults on nearly every front, a disease could prove to be nearly impossible to contains.

Disease Is Easily Treatable

Despite its gruesome nature, Leishmaniasis is actually quite easy to treat, assuming, of course, you have access to the right materials and the right training. For Doctors Without Borders the disease was a hassle, but an easily treatable one.

The few medics and trained professionals left in Syria and ISIS controlled Iraq, however, aren’t trained to treat the disease. The disease is generally caused by poor hygiene and poor living conditions. With Syria having descending essentially into failed state status, conditions are ripe for the spread of the disease.

The disease can result in open flesh wounds, ulcers, an enlarged spleen and liver, and death. It’s estimated that 100,000 cases have been reported in the region, though it’s difficult to determine how many of these cases are of Islamic State supporters.