In recent days, the attention of European health authorities has focused on a disease that now seemed relegated to the medical history books. In Romania e Croatia Some cases of leprosy have been reported, an infectious disease that has been rare on the continent for several decades. The situation is under control and is not considered alarming, but brings the issue of the global circulation of diseases back to the center. Virgilio Notizie explored the issue in depth with the epidemiologist Massimo Ciccozzi, from the Campus Bio-Medico University of Rome.
What is leprosy and what parts of the body does it affect
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Also known as Hansen’s disease, leprosy is a chronic granulomatous infection caused by the bacterium Mycobacterium leprae or the related Mycobacterium lepromatosis. It mainly affects the skin and peripheral nerves, but can also affect the mucous membranes of the respiratory tract. The most exposed areas are the extremities, face and joints. The course is very slow and can last years: if left untreated, the pathology can become disabling and disfiguring, but is not considered lethal.
Cases reported between Romania and Croatia
The first reports came from Romania, where no cases of leprosy had been recorded for 44 years. In Cluj-Napoca, Transylvania, four women of Asian origin employed in a massage center were found to be involved: one with a confirmed diagnosis, the other three still under observation. The authorities ordered the immediate closure of the business and started an epidemiological investigation.
Shortly after, a case was also identified in Croatia, in Split. This is a man of Pakistani origin who has been living in the country for about two years. Here too, according to the health authorities, similar episodes have not been recorded for over 30 years.
Prophylactic procedures and reassurance
In both countries the planned prophylactic measures were promptly activated. In Croatia, the patient’s contacts are monitored and the situation is defined as “under absolute control”. The director of the Croatian Institute of Public Health, Bernard Kaić, explained that the man had turned to health services about ten days earlier with symptoms compatible with the disease. The Romanian Minister of Health also reassured on the absence of an epidemic risk, underlining the low contagiousness of leprosy.
Modes of transmission and treatments available
Leprosy is transmitted mainly through respiratory droplets, emitted by coughing and sneezing. However, as experts explain, prolonged exposure is necessary for contagion to occur. Symptoms include skin lesions, loss of sensation, weakness, and possible peripheral nerve damage.
The disease is now treatable thanks to a combined therapy of antimicrobial drugs. The treatment, which can last from six to twelve months, allows in most cases a complete recovery, if started in time.
Massimo Ciccozzi’s analysis
Interviewed by Virgilio Notizie, the epidemiologist Massimo Ciccozzi explains that it is “a travel disease” and “it is difficult to think that leprosy is endemic in Croatia or Romania”. Therefore “they are isolated cases, recognized quickly, and therefore there is no risk of epidemics. But today there are no longer any borders when it comes to health”.
According to the epidemiologist, any pathology present in an area of the world can manifest itself even at a great distance, due to the rapidity of international movements. Even Italy, although it has not recorded cases for a long time, would be ready to deal with any reports: «We have excellent facilities such as the Spallanzani in Rome and the Sacco hospital in Milan, with professionals capable of recognizing and managing the disease promptly».
Finally, Ciccozzi reminds us that one of the most insidious aspects is the pre-symptomatic phase, during which numerous infections can occur without the patient being aware of it. Precisely for this reason, he concludes, international monitoring remains a fundamental tool for preventing the spread of rare but still present diseases in the world.
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