A Case of Zoonotic Domestically Acquired Hansen Disease (Leprosy) in the State of Georgia
Main Article Content
Keywords
Hansen Disease, Leprosy, Case Report, Georgia, Armadillo
Abstract
Introduction: Hansen Disease (HD) is an infection of the bacteria Mycobacterium leprae causing rash and anesthesia of the skin. It is endemic to many developing countries, where it is spread by direct contact. Zoonotic transmission through the 9-banded armadillo (Dasypus novemcinctus) has been documented in North America. HD is rare in the state of Georgia and most cases are from individuals travelling from HD endemic regions.
Case Report: The patient developed red, infiltrated, anesthetic plaques covering 20% of her body. Fite staining revealed mycobacterial organisms suggesting lepromatous HD. The patient had no relevant history of travel or personal health history. The patient gardened outdoors in Southern Georgia. She knew armadillos were present in the area, but she did not have direct contact with one. The suspected mode of transmission was through feces of an infected armadillo in the soil. The patient is being treated with a 2-year course of rifampin, clofazimine, and dapsone, and reports improvement.
Discussion: Domestically acquired HD is generally seen in other Southern states with greater armadillo populations. The range of the 9-banded armadillo is expanding, which potentially puts a greater area of the country at risk for exposure to HD. Therefore, increasing resources for treatment of HD is important.
Conclusion: This case report presents a case of HD with indirect zoonotic transmission.
References
2. Schreuder, P. A., Noto, S., & Richardus, J. H. (2016). Epidemiologic trends of leprosy for the 21st century. Clinics in dermatology, 34(1), 24-31.
3. World Health Organization. (2021). Towards zero leprosy: global Leprosy (Hansen’s disease) Strategy 2021–2030. World Health Organization.
4. Truman, R. W., Singh, P., Sharma, R., Busso, P., Rougemont, J., Paniz-Mondolfi, A., ... & Cole, S. T. (2011). Probable zoonotic leprosy in the southern United States. New England Journal of Medicine, 364(17), 1626-1633.
5. McCormick, C. D., Lea, J., Stryjewska, B. M., Thompson, A., & Fairley, J. K. (2019). Trends of leprosy and multibacillary infection in the state of Georgia since the early 1900s. PLoS Neglected Tropical Diseases, 13(10), e0007713.
6. Feng, X., & Papeş, M. (2015). Ecological niche modelling confirms potential north‐east range expansion of the nine‐banded armadillo (Dasypus novemcinctus) in the USA. Journal of Biogeography, 42(4), 803-807.
7. Kar, H. K., & Gupta, R. (2015). Treatment of leprosy. Clinics in dermatology, 33(1), 55-65.
8. Franco-Paredes, C., Garcia-Creighton, E., Henao-Martínez, A., Kallgren, D. L., Banjade, R., Dyer, J. A., ... & Stryjewska, B. (2022). Novel approaches in the treatment of Hansen’s disease (Leprosy): a case series of multidrug therapy of monthly rifampin, moxifloxacin, and minocycline (RMM) in the United States. Therapeutic advances in infectious disease, 9, 20499361221135885.
9. Atkin, N. J. (2018). From isolation to prosperity: rediscovering the Carville leprosarium. Clinics in Dermatology, 36(3), 421-425.