Health

sl8

(16,169 posts) Fri Oct 20, 2023, 08:32 AM Oct 2023

A Nasty Tropical Skin Disease Is Now Endemic in the U.S.

Last edited Sat Oct 21, 2023, 09:41 AM - Edit history (1)

https://www.scientificamerican.com/article/a-nasty-tropical-skin-disease-is-now-endemic-in-the-u-s/

EPIDEMIOLOGY

A Nasty Tropical Skin Disease Is Now Endemic in the U.S.

A unique U.S. strain of leishmaniasis has just been reported

By Simon Makin on October 19, 2023

Cutaneous leishmaniasis is one of the “neglected tropical diseases,” a disparate group of conditions that affect some of the world’s poorest people and receive relatively little global attention. Caused by parasites spread by sand fly bites, the disease is not fatal, but skin lesions, the main symptom, can bring about all sorts of issues relating to depression and stigma. “You get facial scarring for life, which causes all sorts of issues relating to depression and stigma,” says parasitologist David Molyneux of the Liverpool School of Tropical Medicine in England.

The disease is endemic in the Middle East, Asia, Africa and Latin America. Until recently, it was not widely believed to be native to the U.S. Cases have long been seen in Texas, but most were presumed to have been contracted by travelers returning from Mexico. Over the past decade or so, reports started cropping up of cases in people with no history of travel outside the U.S., suggesting that they may have caught the illness locally.

A U.S. Centers for Disease Control and Prevention team has now found nontravelers who were infected with a form of the parasite that is genetically different from those sometimes brought back from overseas, suggesting that cutaneous leishmaniasis is endemic in the U.S. The researchers hope to improve detection of cases across the country by raising awareness that this is no longer a parasitic disease that is only picked up abroad.

During a presentation at the annual meeting of the American Society of Tropical Medicine and Hygiene (ASTMH) on October 19, the researchers described their analysis of 2,133 tissue samples sent to the CDC for testing between 2005 and 2019. In their study, which has not yet been published, they found that most of the positive samples came from people who had traveled to countries where cutaneous leishmaniasis was endemic, but 86 people who were infected had not traveled outside the U.S.

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4 replies

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A Nasty Tropical Skin Disease Is Now Endemic in the U.S. (Original Post) sl8 Oct 2023 OP

And it never ends. samplegirl Oct 2023 #1

Well, if they happen to be COVID antivaxxers taking Ivermectin, they've STUMBLED on an effective hlthe2b Oct 2023 #2

I saw a lot of it in Boston, of all places Warpy Oct 2023 #3

Treating the ulcers does not rid the body of the parasites. Ivermectin would be necessary regardless hlthe2b Oct 2023 #4

samplegirl

(11,983 posts)

1. And it never ends.

Reply to sl8 (Original post)

Fri Oct 20, 2023, 08:35 AM

Oct 2023

hlthe2b

(105,662 posts)

2. Well, if they happen to be COVID antivaxxers taking Ivermectin, they've STUMBLED on an effective

Reply to sl8 (Original post)

Fri Oct 20, 2023, 08:36 AM

Oct 2023

treatment. Ivermectin is and always has been a very effective anti-parasite drug and even with this somewhat genetically distinct form of Leishmaniasis, it has been shown to be effective.

So too is DEET to prevent sandfly bites and sleeping/camping under permethrin-treated nets, tents.

Warpy

(113,000 posts)

3. I saw a lot of it in Boston, of all places

Reply to hlthe2b (Reply #2)

Fri Oct 20, 2023, 12:14 PM

Oct 2023

between globe trotters and new immigrants. I rarely saw the early stage, which is raised bumps around a bug bite. People came in for treatment when the area ulcerated and it became clear something worse was going on. It isn't passed person to person by social contact. The ulcers are ugly and produce scarring, so people generally kept them covered up.

It's a nasty, persistent little parasite that can recur after the original lesion has healed, especially in people who haven't come in for treatment. It can turn into systemic lieshmaniasis and the systemic form is life threatening.

If the low dose ivermectin that antivax kooks were taking works on it, that's great. Still, it's better to seek treatment before you need something like that, the ulcers are treated with heat or cold. I understand now they're using lasers on them to kill the bugs.

I'm not surprised it's showing up in Texas, that was only a matter of time.

hlthe2b

(105,662 posts)

4. Treating the ulcers does not rid the body of the parasites. Ivermectin would be necessary regardless

Reply to Warpy (Reply #3)

Fri Oct 20, 2023, 01:22 PM

Oct 2023

or another antiparasitic drug. If visceral Leishmaniasis is present, a slightly less toxic form of amphotericin B is the treatment of choice. At that point, liver damage is typically extensive, and quite obviously amphotericin B is not an easy drug on the liver and kidneys--actually quite toxic, albeit this newer formulation a bit less so.

And no, Ivermectin is not given in a low "throw-away" dose--even for early infection with Leishmaniasis parasites. Despite the COVID-related idiocy, Ivermectin is actually quite a useful drug--just not for viral infections. What even the typical physician with little infectious disease-- much less virology-- background misses, is that invitro, nearly any drug, and one hell of a lot of ubiquitous substances can deter viral replication for many enveloped viruses. Of course that does not play out in the body--something that seems to be possible to differentiate for some.

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