A Scary Diagnosis Hits Home

[flashl]

When a Tiny Rash Turns Out to Be Leprosy, A Teen and Her Community Learn the Modern Reality of Living With the Biblical Disease

The pink marks that appeared last summer on the back of Elizabeth "BB" Blanchard's left calf looked like three slightly raised rows. Neither the teenager nor her parents thought much about it, because they occurred where a stinging caterpillar had left similar marks a few years before. Bug bites are not unusual in Baton Rouge, where the Blanchards live.

...

In September, Blanchard tagged along when her older brother went to the dermatologist. BB's mother, Anne, asked the physician to check her daughter.

The diagnosis that ultimately resulted -- leprosy -- turned the Blanchards' world upside down and rippled through the lives of many people they knew or had contact with. It also raised issues that are often confronted when any contagious disease is diagnosed, particularly one with scary connotations: What precautions should be taken to protect the rights of the affected individual as well as the health of the community? Where can reliable information be found?

...

For the Blanchards, some of the answers lay almost literally in their back yard. Baton Rouge is home to the National Hansen's Disease (Leprosy) Clinical Center, part of the U.S. Public Health Service. Founded in 1894 as a state leprosarium in nearby Carville, La., the center is considered the premier research and treatment facility in the world for leprosy.

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Had BB Blanchard's leprosy been diagnosed 60 years ago, her life would likely have taken a far different course. But the drug therapy developed at the Baton Rouge center now effectively treats leprosy, and when the illness is diagnosed early, the terrible complications can be avoided.

Washington Post

[MrModerate]

1. Exposure to leprosy is so rare . . .

One has to ask . . . was there an accidental release or medical waste discard from the national facility?

[woodsprite]

2. My first thought too - a little too close to home to be coincidence? nt

[dropkickpa]

4. Unless you run into 9-banded armadillo's

Which are a natural resevoir for it, and anywhere from 15-30% carry it. Louisiana and Texas are the areas where US acquired cases happen (not in those traveling abroad). Of these, roughly 30-55% of these people report having contact with armadillos. The reason for the establishment of the research center in Baton Rouge is that prior to it's establishment, a regional prevalance was noted. Leprosy is very hard to transmit, and few people are actually susceptable to it.

[Warpy]

6. The bugs that cause leprosy live in the soil

and the hot spot for the country is in the deep south.

Take the tinfoil beanie off. Leprosy isn't easy to catch, but a few people will get it every year from exposure to the bug in the environment. Genetics play a part, and it's thought only 5% of the population is susceptible to infection.

Infection might have occurred in this case through the break in the skin caused by the stinging caterpillar, although it would have developed uncharacteristically fast; the usual incubation period is from 2-10 years.

Person to person transmission has not been definitively proven and waste contaminated by the bug isn't any more infectious than the local soil. This is not a highly contagious disease, no matter what the bible says.

Early diagnosis and treatment will eradicate the infection and there should be no complications.

[MrModerate]

7. What do they live on when they're not infecting people?

i.e., how do the bacteria get into the soil in the first place?

[Warpy]

8. Reservoirs in the US are people and armadilloes.

The bacilli in the soil are inert and do not grow until they enter a susceptible host. They are protected by the same thick, waxy coating that covers other bugs from the same family, the ones that cause tuberculosis.

The Wiki entry is informative, if you're particularly interested: http://en.wikipedia.org/wiki/Leprosy

[ayeshahaqqiqa]

3. Armadillos are known carriers of the disease

and anyone eating their meat could get Hansen's Disease. Don't know if they could get it from handling the squished carcases that litter the roads this time of year, but it is a thought.

[Glorfindel]

5. Armadillos are very common here in south Mississppi

but I've never heard of anyone eating one. I did pick up a dead one with a shovel once, moved it, and buried it. Thanks for the reminder about their carrying Hansen's Disease.

[hedgehog]

9. Most people are immune to Hansen's Disease. You have to have one faulty gene

to allow the bacillus to enter your body and a second faulty gene to allow the disease to develop. (If you have only the first gene, the bacillus will enter the body but will remain dormant.) As it happens, the Acadians who settled Louisiana happened to be carriers of both genes. That's why Hansen's disease is typically found in Louisiana but not Mississippi or Florida, let alone Kansas. The native Hawaiians were carriers of this gene set, which is why Hansen's disease became epidemic in the islands.

The leprosorium was built in Carville Louisiana because the disease was already present in the community.


For more information:

The Colony: The Harrowing True Story of the Exiles of Molokai by John Tayman