GOATS AND SODA – Back in 2014, dermatologist Bridget McIlwee saw a 3-year-old patient in central Texas with unusual bumps on his ear.
“They looked a little bit like almost kind of a benign mole that you would see in a child, except that you wouldn’t expect something like that to come up quickly and then multiply,” she says.
McIlwee sent off a sample for laboratory testing, and the results came back pointing to a surprising culprit:
The boy had tested positive for cutaneous leishmaniasis, a neglected tropical disease.
Most of the infections reported are in Texas
The World Health Organization says between 600,000 and 1 million new infections happen worldwide every year, mostly in tropical regions of the Americas, the Mediterranean basin, the Middle East and Central Asia — not in Texas. These illnesses can be disfiguring, even if they are rarely fatal.
“I was shocked, because in medical school, we’re taught that this is a tropical disease, something that you see in immigrants, military returning from deployment, people who went on vacation to South America or Asia or Africa,” McIlwee says.
But this boy hadn’t traveled anywhere, meaning he must have picked up the cutaneous leishmaniasis parasite at home in the United States.
That led McIlwee and her colleagues to investigate whether the parasite could be living and spreading in North America. They published their results in 2018, arguing that cutaneous leishmaniasis is, in fact, endemic to the United States.
Now the Centers for Disease Control and Prevention is reinforcing those findings via new research presented in October at the American Society of Tropical Medicine and Hygiene’s conference, suggesting that a specific strain of the Leishmania parasite has likely been living in the U.S. for years.
Mary Kamb, a medical epidemiologist at the CDC who worked on the new research, says cutaneous leishmaniasis is known to be endemic in almost 90 countries but “wasn’t thought to be a problem among people living here in the United States until recently.”
This disease is spread by sand flies, which Kamb says are tiny. “They’re about a quarter of the size of a mosquito … ”