If you’ve never heard of leishmaniasis, you’re lucky — and you probably live in a developed country.
It’s an illness caused by parasites that are carried by tiny blood-sucking insects called sandflies. The painful, hard-to-treat sores it leaves on skin and internal organs can be disfiguring and even sometimes deadly.
And while leishmaniasis mostly occurs in Central and South America, Africa, the Middle East, and Asia for now, it’s moving north into the United States, as Maryn McKenna reports in a blog post.
In a story for National Geographic News, McKenna describes how about half of the members of an expedition to the Honduran jungle returned to the US with an “unwelcome souvenir” that left them with fevers, chills, fatigue, and weeping sores that wouldn’t heal.
Even once these five well-funded expedition members started to receive treatment directly from the Laboratory of Parasitic Diseases at the National Institutes of Health, they were still on a rough road. The only treatments are toxic, potentially causing intense pain, and kidney damage. The side effects for one riskier drug include vomiting, diarrhoea, and liver damage, along with the aforementioned problems.
As McKenna notes in her blog post, a “trickle of cases” in the American Southwest — mostly in South and Central Texas — indicate that the illness is moving north, having already established a foothold in the US, and in isolated cases, patients have acquired the infection as far up as North Dakota.
In 2011, Lisette Hilton described leishmaniasis as a “growing threat” within the US in the trade publication Dermatology Times.
“For the last dozen years or so, we’ve been finding more cases of leishmaniasis that presumably were transmitted within the [US] borders,” Dr. Scott Norton, a dermatologist at Georgetown University Hospital, told Hilton.
These numbers are still small. Researchers talk about finding 13 confirmed cases in Texas and Oklahoma between 2000 and 2007. Not a lot.
The risk of contracting this disease currently in the US is very low.
But this disease can survive anywhere that the various types of sandflies that carry it can live, and researchers have found that their range is expanding as the planet gets warmer.
One study predicts that by 2080, these vector species could be living as far north as Canada.
Why this could actually lead to a cure to a devastating illness
Right now, the CDC estimates that there are between 700,000 and 1.2 million new cases of cutaneous leishmaniasis, which causes lesions on the skin, every year. There are between 200,000 and 400,000 new visceral leishmaniasis cases, which are even more dangerous since they can cause potentially deadly damage to internal organs.
One researcher told McKenna that last year, this form of the disease killed ten times as many people in South Sudan as died in the entire 2014-2015 Ebola outbreak.
But for the most part, there isn’t much research into a cure for leishmaniasis, which can leave people with scars that can ruin lives. And the treatments that do exist so far are hard to get and potentially debilitating.
This illness fits into the category of neglected tropical diseases (NTD), serious illnesses that together affect more than a billion mostly poor people around the world every year. They include many diseases that Americans tend not to worry about, like leprosy, rabies, and chikungunya. Limited interest by pharmaceutical companies means that there isn’t much work done to find a cure for them — it wouldn’t be a particularly profitable venture.
As Bill Gates pointed out in a recent discussion of preventative care and resilient health systems at the Clinton Foundation meeting, we spend more on trying to cure baldness than we do on trying to cure malaria, which is not technically a NTD but affects similar a similar population.
More cases of leishmaniasis affecting people in the US and other more developed countries may be the thing that spurs the interest necessary to develop a cure or a vaccine.
McKenna writes that the challenges the expedition members faced should be a wake up call for the rest of us that it’s time to come up with a way to fight this illness.
“Their experience, and their difficulty finding affordable, effective, safe treatment, should serve as warnings that we ought to heed while we can,” she writes.
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