Calls have been made for specific guidelines for the public health response to patients with leprosy after a recent case involving a rare form of the disease in the south-west of Ireland
There have been calls for specific public health guidelines to be established in response to patients with leprosy, following a recent case of the rare disease in south-west Ireland that posed significant challenges to healthcare staff. A report on the 2024 case, recorded by HSE South-West, highlighted the complex issues it presented, particularly regarding contact tracing, managing close contacts and the stigmatising nature of the disease.
This is only one of five cases of leprosy reported in the Republic in the last decade, and the first recorded in the south-west of the country. Leprosy, a chronic infectious disease caused by bacteria that affect nerve endings and destroy the body’s ability to feel pain and injury, is curable.
However, the stigma associated with the physical impairments it can cause often deters people from seeking diagnosis and treatment, increasing the risk of transmission. The report expressed concern that the difficulties in dealing with the case in Ireland were due to the lack of specific guidelines at both national and EU level.
The infected individual was a person in their 30s who lived with eight other adults in Ireland. They were born and raised in a Caribbean country where leprosy is endemic and had moved to Ireland in 2022 from southern Brazil, an area with a high incidence of leprosy, where they had lived for 10 years.
An individual who initially showed up in late 2023 with symptoms of pain and numbness in their right arm and hand, along with several raised, light-coloured skin lesions on various parts of their body, has made a full recovery.
According to a report published in Eurosurveillance – a medical journal focusing on infectious diseases – the patient was diagnosed in the summer of 2024 and successfully treated with multi-drug therapy, reports the Irish Mirror.
Due to the lack of specific guidelines for managing close contacts of such infections, medical staff conducted a rapid scoping review of international guidelines to devise a contact tracing strategy and public health risk assessment.
The report highlighted the absence of a universally accepted definition of a ‘close contact’ in leprosy cases, but HSE staff chose to define it as anyone who had been in contact with the patient for at least 20 hours per week over a minimum of three months in the previous year.
After thorough questioning, it was determined that only one housemate, the patient’s partner, and a work colleague qualified as close contacts. “No credible source of infection was identified among their Irish contacts,” the report stated.
Ten other adults were also considered potential close contacts, including two who had since left Ireland.
The report revealed that HSE staff believed extensive contact tracing of all household members could harm the patient and potentially jeopardise their housing and employment status, both described as “informal or precarious.”
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