Geographic Range
North American medicinal leeches ( Macrobdella decora ) are native to the Nearctic region. They can be found in the United States of America, Canada, and Mexico. North American medicinal leeches have been reported across multiple regions of the United States, and it is likely they are more widespread than reported. The greatest density of confirmations of these leeches within the United States is in the New England region, which includes Connecticut and Rhode Island. Maine and Massachusetts have also reported a significant number of North American medicinal leeches. The area with the second highest density of confirmations of leeches is in all five Great Lakes of North America. Other confirmed locations include North Carolina, Virginia, Maryland, Delaware, Florida, and Pennsylvania. There are occasional reports of leeches being found from the Midwest, including Illinois, Indiana, Michigan, Wisconsin, and Minnesota. New Mexico has also been reporting high numbers of discoveries of the species. The Rocky Mountains region in Colorado includes several leech reports, as well.
        In Canada, these leeches are confirmed to inhabit the eastern areas of the country
            such as the province of Alberta and the western provinces like Quebec. In Canada there
            are also numerous findings near the Great Lakes of North America. In Mexico, they
            are thought to be restricted to Nuevo Leon.
        
Habitat
        North American medicinal leeches are found in freshwater and usually live in protected
            microhabitats like underwater boulders. They inhabit rivers, streams, and lakes. Swamps
            occasionally host these leeches too. North American medicinal leeches inhabit temperate
            freshwater, usually in water temperatues between 4 °C and 24 °C. These leeches often
            inhabit water that is between one and three meters. Leeches often choose murky waters
            with a thick layer of mud and forest debris in the sediments. This microhabitat provides
            natural camouflage for leeches. The lakes and streams inhabited by North American
            medicinal leeches are often surrounded by forests.
        
- Habitat Regions
 - temperate
 - freshwater
 
- Aquatic Biomes
 - lakes and ponds
 - rivers and streams
 
- Wetlands
 - swamp
 
Physical Description
North American medicinal leeches are annelids, possessing a hydrostatic skeleton for support and flexibility. They have around 65 teeth. North American medicinal leeches exhibit orange and green on their ventral side where there are also four and a half circular annuli. These annuli run linear, exact sizes of the annuli are not recorded. The rest of North American medicinal leeches' bodies exhibit a dark green and brown patterned epithelia. This pigmentation is consistent in all life stages of these leeches. The epithelia on these leeches is smooth in appearance with numerous horizontal grooves ranging across the bodies in horizontal stripes. The suckers on the posterior and anterior end of their bodies are darker shades of the main body coloration; and the brown pigments are more prominent than the green pigments. Their bodies exhibit bilateral symmetry, and they are ectotherms. North American medicinal leeches measure between 5 cm to 9 cm in total length and their mass is between 1.5 to 4 g. North American medicinal leeches are hermaphrodites.
North American medicinal leeches hatch after four weeks; these hatchings have pale brown epithelia and lack the coloration of the four annuli on their ventral side. Instead of fully developed coloration of their annuli, the color will be a paler shade. North American medicinal leeches during their juvenile stage are typically 1 cm to 3 cm.
        North American medicinal leeches have thinner muscles compared to all other medicinal
            leeches, like European medicinal leeches (
        
         Hirudo medicinalis
        
        ). North American medicinal leeches also have horizontal stripes on their bodies while
            European medicinal leeches have longitudinal stripes. North American medicinal leeches
            are ca. 3 cm longer than European medicinal leeches.
        
- Other Physical Features
 - ectothermic
 - bilateral symmetry
 
- Sexual Dimorphism
 - sexes alike
 
Development
North American medicinal leeches begin their development after fertilization of both the parent leeches. These leeches are hermaphroditic. Both parent leeches exchange sperm and both of their eggs are fertilized. The pregnant leeches will have multiple eggs fertilized within their ovisacs at once. Between one and one hundred eggs will be fertilized and will soon move from the pregnant leeches’ ovisacs to their clitellum. Once the eggs are moved into the clitellum the formation of a cocoon will begin, where all eggs will be packed together. The cocoon is made up of a substance that protects the eggs from exterior harm. After the completed formation of the cocoon, the pregnant leeches will secrete the cocoon out of their body, using their clitellum to push it out. It takes between one month to nine months for the pregnant medicinal leeches to secrete the cocoons. Because North American medicinal leeches live in fresh, shallow, and murky water, the cocoons are often laid in shallow areas where there are protective objects. For instance, fallen trees, rocks, or other vegetation are used to shelter the cocoons.
As the cocoons and eggs take 2 to 4 weeks develop within the sheltered areas, the eggs provide the needed nutrition for the leeches until they are ready to hatch. At hatching, they begin their intermediate life stage before they are adults. Within this intermediate stage the leeches are smaller than the adult leeches, at a length less than 5 cm and a mass less than 1 g. These juvenile leeches will feed on small amphibians like salamanders. While in the juvenile phase, North American medicinal leeches also shed their epithelium until they reach their adult sizes. The juvenile stage of North American medicinal leeches lasts around six months.
The adult stage of North American medicinal leeches is characterized by sexual maturity, the ability for these hermaphroditic leeches to mate and exchange sperm. Adult North American medicinal leeches are also significantly larger than their juvenile stage, the leeches grow to be between one and five centimeters and weigh between 1 and a half grams to five grams. Feeding habits and abilities are also key factors in separating the differences between juvenile and adult leeches. Those with the ability to prey upon and attach to large mammals successfully are adults. For successful attachment to larger prey these leeches must use fully developed anterior and posterior suckers.
        As invertebrates, these leeches exhibit indeterminate grwoth.
        
- Development - Life Cycle
 - indeterminate growth
 
Reproduction
North American medicinal leeches are hermaphroditic. These leeches search for mates that can provide them with sperm to fertilize eggs in their ovaries, so that they can both become pregnant. They are also polygynandrous, as leeches will mate with multiple partners throughout their lives. No social structures exist within the leeches as they choose multiple mating partners. These leeches will mate with one leech at a time, and year round.
North American medicinal leeches find their mates by using chemical signals. However, limited studies have examined these signals. These pheromones can be detected in the water by sexually-mature leeches. Some studies suggest that physical contact must be made for these pheromones to be detected. No other factors (visual or tactile) come into play regarding mate selection.
        Once two North American medicinal leeches have located each other for mating, the
            two bodies of the leeches will connect vertically in the water. After their bodies
            have connected using both of their male genitalia, the leeches will spin in the water
            to mate. The product of mating is a spermatophore that contains the sperm needed for
            fertilization, transferred between individuals. After mating concludes, each mate
            will not engage with their partner in any way.
        
- Mating System
 - polygynandrous (promiscuous)
 
North American medicinal leeches breed year-round. When fertilized, these leeches will cease breeding for one to nine months, during which eggs within the leeches' bodies are being covered by a cocoon. These leeches typically breed once or twice a year.
North American medicinal leeches are simultaneous hermaphrodites that breed opportunistically year-round. The act of copulation takes minutes, and fertilization can take from one hour to 23 hours. Leeches are oviparous. The 1 to 100 eggs are laid year-round, 1 to 9 months post-mating.
        Two to four weeks after the cocoon is released, the eggs will hatch, and the juvenile
            leeches are fully independent. One to 100 eggs will hatch, with the typical hatching
            mass unknown. Juvenile leeches are classified as being under 5 cm total length. These
            leeches reach sexual maturity between one and two years old. North American medicinal
            leeches are also iteroparous, as they will mate many times and produce many cocoons
            of eggs throughout their lives.
        
- Key Reproductive Features
 - iteroparous
 - year-round breeding
 - simultaneous hermaphrodite
 - sexual
 - oviparous
 
        North American medicinal leeches receive little to no parental care within their life
            stages. These leeches are hermaphroditic. The pregnant leech will act only as a vessel
            of development for cocoon formation to the offspring. This protective cocoon will
            form within the leeches’ body and then be laid in fresh water. After the cocoon is
            laid by the parental leech, the offspring are left, and the parental leech will not
            continue any involvement with the offspring.
        
- Parental Investment
 - no parental involvement
 - 
         
          pre-hatching/birth
         
         
- 
           
            provisioning
           
           
- male
 - female
 
 
 - 
           
            provisioning
           
           
 
Lifespan/Longevity
Lifespan and maximum longevity are not reported for North American medicinal leeches. Others in the genus, such as European medicinal leeches ( Hirudo medicinalis ), have an average lifespan of 1 to 3 years. These leeches are kept in captivity, specifically in clinical settings like hospitals and research settings like universities. However, captive lifespans have not been reported.
        Pollution within North American medicinal leeches’ environment can severely impact
            their lifespans. Trash within the lakes, ponds, and rivers have made attaching to
            prey more difficult because hosts are dying at higher rates. Extreme changes in the
            usual temperatures of these leeches' environments are also making it more difficult
            for these leeches to reach adulthood. Colder and warmer water temperature trends in
            the Great Lakes of the United States are causing these leeches hatch at abnormal rates.
        
Behavior
North American medicinal leeches are solitary animals, only interacting with other leeches to mate. After mating, partners will not have any contact with the other or the offspring. These leeches do not have social orders or hierarchies. There has not been recorded evidence of intraspecific aggression.
North American medicinal leeches live in murky, freshwater like rivers, ponds, and lakes. They live in shallow sections of these bodies of water sheltered by fallen trees, boulders, plants, or trash to hide from predators and to have ample opportunity to attach to their prey. There have been accounts of these leeches living close to one another in these areas if the environment is favorable.
These leeches are parasitic, as they attach to their prey to consume the blood of the host. Often, they will stay in a small area until they find their prey. If attached to prey these leeches can travel large distances in the air, water, or land. When consuming the blood of their prey they will grow as they fill up with blood. These leeches will detach from their prey when they are full of blood and become too heavy to stay attached. After becoming engorged with blood from their prey they can withstand long periods without food and will often seek prey less. These leeches can also withstand long periods without food, up to 1 year.
        These leeches have unique ways of moving within the water. Their bodies are very flexible
            for efficient water travel. When moving they bend their bodies in an up and down motion
            to move forward. They can spin and exert small bursts of motion when in danger from
            predators to swim away quickly. Despite being more active during the night than the
            day, they are not exclusively nocturnal. These leeches do not sleep but remain inactive
            for rest periods.
        
Home Range
The home range of North American medicinal leeches is very small, between one and fifteen square meters within a freshwater environment including ponds, rivers, and lakes.They do not defend a territory.
        As parasites, hosts may move these leeches large distances in air, water, or on land.
        
Communication and Perception
        North American medicinal leeches have little research done on their communication.
            However leeches do communicate chemically utilizing their anterior sucker to release
            pheromones from their saliva. Their saliva will then travel within the body of water
            they inhabit and reach other leeches. Utilizing these pheromones aids in communication
            for reproduction. Leeches will not seek out conspecifics for reproduction unless their
            bodies are full of blood. North American medicinal leeches sense vibrations in the
            water that alerts them about possible incoming hosts. North American medicinal leeches
            are also able to feel when other organisms brush against their epithelium which enables
            them to attach to their prey. These leeches also have 5 pairs of eyespots to sense
            the differences in light and dark in their environment.
        
- Other Communication Modes
 - pheromones
 - vibrations
 
- Perception Channels
 - visual
 - tactile
 - vibrations
 - chemical
 
Food Habits
        North American medicinal leeches are classified as sanguivorous, feeding on blood.
            Blood is consumed from their prey by their anterior sucker while the posterior sucker
            holds onto prey. Blood consumed by these leeches provide a variety of nutrition including
            proteins, carbohydrates, and irons. Their primary food sources include amphibians
            such as frogs and salamanders. Leeches opportunistically consume eggs and tadpoles
            of green frogs (
        
         Lithobates clamitans
        
        ). 
            These leeches consume fish eggs from smallmouth bass (
        
         Micropterus dolomieu
        
        ) and brook trout (
        
         Salvelinus fontinalis
        
        ). North American medicinal leeches will often attach to the body of the fish host’s
            gills or pharynx. These leeches will opportunistically feed upon birds in rare cases.
            Often when these leeches attach to birds they attach when the birds walk, fly, or
            are wading into the water and brush upon the leeches’ bodies. Their flexible epithelia
            and invertebrate bodies aid them with wind resistance and the rapid movements when
            feeding on these birds. There have been reports of North American medicinal leeches
            attaching to ducks such as the American black duck (
        
         Anas rubripes
        
        ). They also attach to mammalian hosts, including humans (
        
         Homo sapiens
        
        ) and other large mammals when opportunity arises. North American medicinal leeches
            also successfully attach to prey more during the night compared to morning or afternoon
            hours. The activity of these leeches decreases during daytime, thus affecting successful
            attachment and feeding.
        
- Primary Diet
 - carnivore
 
- Animal Foods
 - birds
 - mammals
 - amphibians
 - fish
 - eggs
 - blood
 
Predation
North American medicinal leeches have three main predator types: birds, reptiles, and fish. All the leeches’ predators hunt for them in freshwater habitats such as rivers, streams, and lakes. Most predators feed opportunistically on these leeches. The only recorded bird species that consume North American medicinal leeches are northern shovelers ( Spatula clypeata ).
Among the fish that eat the leeches are smallmouth bass ( Micropterus dolomieu ). These fish inhabit the freshwater rivers and also serve as leech hosts. Bluegill ( Lepomis macrochirus ) and redear sunfish ( Lepomis microlophus ) consume leeches, the latter eat large quantities of these leeches.
Common snapping turtles ( Chelydra serpentina ) and eastern painted turtles ( Chrysemys picta ) consume North American medicinal leeches, as do eastern garter snakes ( Thamnophis sirtalis ).
        Leeches avoid predators by successful escape in water and camouflage – they are a
            mix of dark green and dark brown with colorful orange spots. The areas in which these
            leeches inhabit are often under or around rocks, fallen trees, and mud which the leeches
            will dig into to camouflage against their predators.
        
- Anti-predator Adaptations
 - cryptic
 
Ecosystem Roles
North American medicinal leeches are opportunistically preyed upon by birds, reptiles, and fish. These leeches are parasites that attach to fish, frogs, large mammals, birds, salamanders, and fish eggs. There is no report of North American medicinal leeches having parasites.
North American medicinal leeches act as parasites that attach externally to hosts. The main fish these leeches attach to are smallmouth bass ( Micropterus dolomieu ) and brook trout ( Salvelinus fontinalis ). These leeches will also eat the eggs of these fish when they encounter them in the water. Occasionally, these leeches will attach to birds such as American black ducks ( Anas rubripes ) when physical contact occurs. These leeches also attach to large mammals if encountered. North American medicinal leeches are used in medical practice by humans ( Homo sapiens ) which is a role that these leeches have acquired more commonly recently.
        Primarily these leeches act as predatory parasites within rivers, ponds, lakes, and
            steams. In most cases these leeches will remove toxins from their hosts as they feed
            on them.
        
- Ecosystem Impact
 - parasite
 
- smallmouth bass ( Micropterus dolomieu )
 - brook trout ( Salvelinus fontinalis )
 - American black duck ( Anas rubripes )
 - humans ( Homo sapiens )
 
Economic Importance for Humans: Positive
North American medicinal leeches have a variety of economic importances for humans. These leeches are mainly used in medicine for blood treatments and post-surgical treatment. European medicinal leeches ( Hirudo medicinalis ) have been used for centuries, North American medicinal leeches have only been used within the past 200 years. The usage of these leeches in modern medicine is performed with well-researched procedures in hospitals and clinics, where physicians use lab-grown North American medicinal leeches. Lab-grown leeches provide patients with sterile and safe leeches for their treatments. These leeches provide profits to many hospitals and clinics worldwide. The United States of America is the country that records the greatest use of these leeches and these leeches are considered a medical device therein medicine. In many other countries, North American medicinal leeches are also commonly used with European medicinal leeches. European countries' use of medicinal leeches is on the rise.
These leeches are used to treat blood ailments because North American medicinal leeches contain an enzyme called thrombin that prevents the coagulation of blood. It should be noted that North American medicinal leeches are better at feeding on blood than European medicinal leeches because North American medicinal leeches contain more thrombin than European medicinal leeches. Historically, North American medicinal leeches were used in a medical practice called blood letting, where they would be attached to a patient to drain their blood to get rid of toxins in the body and to balance what physicians believed to be the four humors of the body.
        North American medicinal leeches are profitable and important in scientific research,
            mainly in universities, hospitals, and private companies. The research efforts to
            find more effective leeches for medical use is ongoing and some researchers aim to
            breed leeches to find variants with larger amounts of the two histamines: hyaluronidase
            and bdellin within the leech’s bodies. Other researchers are focused on cultivating
            larger sized North American medicinal leeches. The current price of a singular North
            American medicinal leech is twelve dollars; however these leeches are often used in
            bulk to treat humans in the medical setting which increases the price for consumers,
            thus making them more expensive. The price for bulk use in the medical setting usually
            starts at one thousand dollars if patients do not have insurance.
        
- Positive Impacts
 - source of medicine or drug
 - research and education
 
Economic Importance for Humans: Negative
North American medicinal leeches have not been recorded to cause any adverse effects to humans. However, when they are used in the medical setting they do attach to the skin of the patient through piercing through the skin, leaving an incision millimeters in length. The attachment of these leeches is not painful to humans.
        Verriere et al. (2016) found that some leeches used in European medicinal therapy
            were infected with a harmful bacterium in the genus
        
         Aeromonas
        
        . Post-treatment infections are rare, but should be monitored to reduce negative human
            interactions. McClure et al. (2021) confirmed that this bacterium is present in North
            American medicinal leeches, and therefore poses the same threat.
        
- Negative Impacts
 - 
         
          injures humans
         
         
- bites or stings
 - carries human disease
 
 
Conservation Status
North American medicinal leeches are not evaluated by the IUCN red list, and have no special status on the US federal list, CITES appendices, or the state of Michigan list.
Threats to these leeches include overharvesting from the wild to meet a rising demand for their use in medicinal treatments. Once removed from the wild, these leeches are grown in sterile lab conditions. Threats in the wild also include predators and droughts, which reduce suitable aquatic habitats.
        Currently, North American medicinal leeches are lab grown for medicinal use in hospital
            and clinical settings. The captive breeding, raising, and distribution of these leeches
            is one of the only conservation efforts today. North America BioPharma is a large
            private company that sells medicinal leeches to the public. This company currently
            sells European medicinal leeches (
        
         Hirudo medicinalis
        
        ) but is expanding to include North American medicinal leeches.
        
Additional Links
Contributors
Fiona Steinour (author), Radford University, Natalie May (editor), Radford University, Alexander McVicker (editor), Radford University, Karen Powers (editor), Radford University, Tanya Dewey (editor), University of Michigan-Ann Arbor.
- Nearctic
 - 
          
living in the Nearctic biogeographic province, the northern part of the New World. This includes Greenland, the Canadian Arctic islands, and all of the North American as far south as the highlands of central Mexico.
           
- native range
 - 
          
the area in which the animal is naturally found, the region in which it is endemic.
 
- temperate
 - 
          
that region of the Earth between 23.5 degrees North and 60 degrees North (between the Tropic of Cancer and the Arctic Circle) and between 23.5 degrees South and 60 degrees South (between the Tropic of Capricorn and the Antarctic Circle).
 
- freshwater
 - 
          
mainly lives in water that is not salty.
 
- swamp
 - 
          
a wetland area that may be permanently or intermittently covered in water, often dominated by woody vegetation.
 
- ectothermic
 - 
          
animals which must use heat acquired from the environment and behavioral adaptations to regulate body temperature
 
- bilateral symmetry
 - 
          
having body symmetry such that the animal can be divided in one plane into two mirror-image halves. Animals with bilateral symmetry have dorsal and ventral sides, as well as anterior and posterior ends. Synapomorphy of the Bilateria.
 
- indeterminate growth
 - 
          
Animals with indeterminate growth continue to grow throughout their lives.
 
- polygynandrous
 - 
          
the kind of polygamy in which a female pairs with several males, each of which also pairs with several different females.
 
- iteroparous
 - 
          
offspring are produced in more than one group (litters, clutches, etc.) and across multiple seasons (or other periods hospitable to reproduction). Iteroparous animals must, by definition, survive over multiple seasons (or periodic condition changes).
 
- year-round breeding
 - 
          
breeding takes place throughout the year
 
- sexual
 - 
          
reproduction that includes combining the genetic contribution of two individuals, a male and a female
 
- oviparous
 - 
          
reproduction in which eggs are released by the female; development of offspring occurs outside the mother's body.
 
- natatorial
 - 
          
specialized for swimming
 
- diurnal
 - 
          
- active during the day, 2. lasting for one day.
 
 
- parasite
 - 
          
an organism that obtains nutrients from other organisms in a harmful way that doesn't cause immediate death
 
- motile
 - 
          
having the capacity to move from one place to another.
 
- sedentary
 - 
          
remains in the same area
 
- solitary
 - 
          
lives alone
 
- visual
 - 
          
uses sight to communicate
 
- tactile
 - 
          
uses touch to communicate
 
- chemical
 - 
          
uses smells or other chemicals to communicate
 
- pheromones
 - 
          
chemicals released into air or water that are detected by and responded to by other animals of the same species
 
- vibrations
 - 
          
movements of a hard surface that are produced by animals as signals to others
 
- visual
 - 
          
uses sight to communicate
 
- tactile
 - 
          
uses touch to communicate
 
- vibrations
 - 
          
movements of a hard surface that are produced by animals as signals to others
 
- chemical
 - 
          
uses smells or other chemicals to communicate
 
- cryptic
 - 
          
having markings, coloration, shapes, or other features that cause an animal to be camouflaged in its natural environment; being difficult to see or otherwise detect.
 
- parasite
 - 
          
an organism that obtains nutrients from other organisms in a harmful way that doesn't cause immediate death
 
- drug
 - 
          
a substance used for the diagnosis, cure, mitigation, treatment, or prevention of disease
 
- carnivore
 - 
          
an animal that mainly eats meat
 
- sanguivore
 - 
          
an animal that mainly eats blood
 
References
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GBIF, 2025. "Macrobdella decora (Say, 1824) in GBIF secretariat" (On-line). GBIF Backbone Taxonomy. Accessed February 03, 2025 at https://doi.org/10.15468/39omei .
Kennedy, N. 2023. A Phylogeographic Analysis of the North American Medicinal Leech, Macrobdella Decora (Master’s Thesis) . Toronto, Canada: University of Toronto.
Kirk, R., N. Pemberton. 2013. Leech . London, England: Reaktion Books.
Kornreich, L., A. Kleinhaus. 1999. Postingestive chemosensation and feeding by leeches. Physiology & Behavior , 67/5: 635-641.
McClure, E., M. Nelson, A. Lin, J. Graf. 2021. Macrobdella decora: Old world leech gut microbial community structure conserved in a new world leech. Applied and Environmental Microbiology , 87/10: e02082-20. Accessed February 03, 2025 at https://doi.org/10.1128/AEM.02082-20 .
Meyer, M., R. Sawyer. 1972. North American freshwater leeches, exclusive of the Piscicolidae, with a key to all species. The Journal of Parasitology , 58/4: 773.
Min, G., N. Sarkar, M. Siddall. 2010. Salivary transcriptome of the North American medicinal leech, Macrobdella decora. Journal of Parasitology , 96/6: 1211–1221.
Munro, R., M. Siddall, S. Dessert, R. Sawyer. 1991. Bleeding in human volunteers from the bite of the American medicinal leech Macrobdella decora compared with its European counterpart Hirudo medicinalis. Comparative Haematology International , 1: 214–216.
NatureServe, 2025. "Macrobdella decora a freshwater leech" (On-line). Nature Serve Explorer. Accessed February 03, 2025 at https://explorer.natureserve.org/Taxon/ELEMENT_GLOBAL.2.841852/Macrobdella_decora .
Olsen, L., J. Sunesen, B. Pederson. 2001. Small Freshwater Creatures . Oxford, England: Oxford University Press.
Phillips, A., F. Goetz. 2023. Comparative reproductive morphology of two species of Macrobdella (Hirudinea: Arhynchobdellida: Macrobdellidae). Zoomorphology , 142: 153-168.
Phillips, A., R. Montiel, S. Kvist, A. Oceguera-Figueroa. 2019. Phylogenetic position and description of a new species of medicinal leech from the eastern United States. Journal of Parasitology , 105/4: 587-597.
Poly, W. 2018. Range extension for the elusive New England medicinal leech, Macrobdella sestertia Whitman, 1886 (Hirudinida: Macrobdellidae), in South Carolina, U.S.A., with notes on morphology, coloration, and biology. Proceedings of the California Academy of Sciences , 64/12: 347–359.
Schalk, G., M. Forbes, P. Weatherhead. 2002. Developmental plasticity and growth rates of green frog (Rana clamitans) embryos and tadpoles in relation to a leech (Macrobdella decora) predator. Copeia , 2002/2: 445–449.
Verriere, B., B. Sabatier, E. Carbonnelle, J. Mainardi, P. Prognon, I. Whitaker, L. Lantieri, M. Hivelin. 2016. Medicinal leech therapy and Aeromonas spp. infection. European Journal of Clinical Microbiology & Infectious Diseases , 35: 1001–1006.
Wenning, A. 1987. Salt and water regulation in Macrobdella decora (Hirudinea: Gnathobdelliformes) under osmotic stress. Journal of Experimental Biology , 131/1: 337–349.
iNaturalist Community, 2025. "North American medicinal leech" (On-line). iNaturalist. Accessed February 03, 2025 at https://www.inaturalist.org/taxa/244696-Macrobdella-decora .