Thursday, April 28, 2011

Hint: Don’t Order The `Possum On the Half Shell’




# 5529


Nine-banded Armadillo -wikipedia



Armadillo and road kill jokes abound in the south (Why did the chicken cross the road?  . . .  To prove to the armadillo it can be done). But apparently some people actually do indulge in that cliché of a southern delicacy – known in finer rural dining establishments as `possum on the half shell’.


I’ll not bother to debate the culinary merits of armadillo stew, since I’m fully aware that tastes (of people, and presumably armadillos) vary. A lesson learned after I once futilely tried to explain `grits’ to friend from the UK while she countered with vividly told tales of `the haggis’.  


Neither of us gained much ground with the other.


Different strokes, I guess.


But it is worth noting today that an article in the NEJM is reporting that some of the roughly 150 cases of Leprosy in the United States each year may arise from the consumption of, or more likely - contact with - armadillos.


This is not exactly a new idea, since it has been known since the 1960s that armadillos can carry the etiological agent responsible for leprosy;  Mycobacterium leprae.


Establishing a link between strains carried by humans, and carried by armadillos, has only recently  been accomplished.


Below is the link to the NEJM article, but for more details I have the HRSA press release as well.



Probable Zoonotic Leprosy in the Southern United States

Richard W. Truman, Ph.D., Pushpendra Singh, Ph.D., Rahul Sharma, Ph.D., Philippe Busso, Jacques Rougemont, Ph.D., Alberto Paniz-Mondolfi, M.D., Adamandia Kapopoulou, M.S., Sylvain Brisse, Ph.D., David M. Scollard, M.D., Ph.D., Thomas P. Gillis, Ph.D., and Stewart T. Cole, Ph.D.

N Engl J Med 2011; 364:1626-1633April 28, 2011



Wednesday, April 27, 2011

Leprosy in U.S. may be transmitted by armadillos, study finds

A new genetic study on leprosy bacteria reports that armadillos may be a source of infection in the Southern United States. The collaboration between scientists at the Health Resources and Services Administration’s (HRSA) National Hansen’s Disease Program (NHDP) in Baton Rouge, La., the Ecole Polytechnique Federale de Lausanne and Institute Pasteur in Europe, and the Instituto de Biomedicina in Venezuela sheds light on the potential risk of transmission of leprosy bacteria between armadillos and humans. The risk of transmission is extremely low.


The study, led by Richard W. Truman, Ph.D., Research Scientist at NHDP, and published in the April 28 issue of the New England Journal of Medicine, was partially supported by the National Institute of Allergy and Infectious Diseases (NIAID), part of the National Institutes of Health.


“Leprosy has been feared throughout human history, and there are still regions in several countries, including in the southern United States, where new cases of this disease continue to occur,” said Dr. Truman.  “The results of this study will help us better understand where some of these infections originate.”


Caused by the bacterium Mycobacterium leprae, leprosy, also known as Hansen’s disease, primarily affects the skin and peripheral nerves. It is a chronic infection that afflicts more than 2 million persons worldwide with nerve damage, deformity or disability. Today, leprosy is found mostly in tropical regions of the world; at least 250,000 new cases are reported globally every year, with 150-250 cases occurring in the United States. Leprosy is treatable with antibiotics but is easily misdiagnosed, and delays in therapy increase the likelihood of disability and deformity.


Leprosy was thought to be spread only between humans via respiratory droplets. Armadillos are the only other known natural hosts of leprosy bacteria. These data confirm a long-suspected link between armadillos and the 30 to 40 new cases of leprosy seen each year in U.S.-born Americans who have never traveled abroad to regions where the disease is prevalent.


The new study, scientists compared the gene sequences of M. leprae samples taken from humans and armadillos in the United States.  They found that 64% of the human samples had a particular genotype that had never been seen before, and 85% of samples from armadillos shared that same genotype.


“These findings do not change the risk of acquiring leprosy from armadillos, which remains extremely low,” said Dr. James Krahenbuhl, director of NHDP.  “Armadillos have been suspected as a source of human infection in the Gulf Coast area for 40 years.”


“Genetics and genomics have become important tools for studying how diseases behave in natural settings,” said Christine Sizemore, Ph.D., chief of the Tuberculosis and Other Mycobacterial Diseases Section at NIAID. “The data and methods used in this study can be applied in other areas of the world to monitor leprosy transmission and identify other possible environmental reservoirs.”


The NHDP is a center of excellence comprising an outpatient clinic and referral center for treatment and rehabilitation, training and research, all focused on leprosy. The NHDP outpatient clinic and 11 contract clinics in the U.S. manages 3000 cases. An additional 600 cases are managed by private sector physicians with services and consultation provided by NHDP physicians.  The NHDP is the only provider of these services in the United States:  Visit the National Hansen's Disease Program or the NIAID Leprosy website for more information about leprosy.



While the risks of contracting leprosy (Hansen’s Disease) for the discriminating diner are exceedingly low, this is a fascinating bit of medical detective work.

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