Swiss and US researchers have identified a strain of leprosy found in armadillos in dozens of people in the southern United States, indicating the skin disease can be transmitted directly from animals to humans.

"/> Swiss and US researchers have identified a strain of leprosy found in armadillos in dozens of people in the southern United States, indicating the skin disease can be transmitted directly from animals to humans.

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HEALTH

Swiss researchers link armadillos to leprosy

Swiss and US researchers have identified a strain of leprosy found in armadillos in dozens of people in the southern United States, indicating the skin disease can be transmitted directly from animals to humans.

The team of researchers, including a team from the Ecole Polytechnique Federale de Lausanne, looked at 50 leprosy patients in the United States and 33 wild armadillos with the disease.

The findings are the first to confirm a long-suspected link between the disease in armadillos and humans, but are not a sign that a new epidemic is underway, researchers said.

Rather, the report published Wednesday in the New England Journal of Medicine suggests that the disease, most often found in India, can originate in the United States and infect humans who hunt armadillo and butcher the meat.

“I’m sure it is not new. I am sure it has been there for really quite some period of time. It does not change the risk,” lead study author Richard Truman of Louisiana State University told AFP.

“What we are really doing right now is being able to recognize and prove it does occur.”

Leprosy, sometimes called Hansen’s disease after the Norwegian doctor who discovered it in 1873, is a bacterial infection that causes lesions on a person’s extremities.

About 249,000 new cases were reported globally in 2008, and about 150 cases arise in the United States each year.

Left untreated, it can lead to blindness and nerve damage that cripples the hands and feet, but it is usually curable with antibiotics.

“There is general perception that leprosy is not an important disease anymore,” said co-author Pushpendra Singh of the Ecole Polytechnique Federale de Lausanne in Switzerland.

“No effective vaccine is available, and we should remember that no infectious disease has ever been eradicated without a very effective vaccine.”

In the latest findings, the researchers were able to identify a never-before-seen armadillo genotype of the bacterium, Mycobacterium leprae – a new strain named – in 28 animals and 22 people who had not gone abroad and could not have contracted the disease elsewhere.

“It became clear that leprosy patients who never traveled outside the US but lived in areas where infected armadillos are prevalent were infected with the same strain as the armadillos,” said the study.

The armadillo genotype of leprosy was found in human patients in the five Gulf Coast states – Texas, Louisiana, Mississippi, Arkansas and Alabama.

The study data was collected from 2000 to 2007 and patients’ ages ranged from the teens to the 80s, said Truman.

Not all patients whose leprosy was traced back to armadillos admitted having contact with the animals, he said.

“We only had contact history available to us from 15 of those patients and only half of those said they had contact with armadillos and the other half indicated they had not,” he said.

Scientists have puzzled over exactly how the disease passes on ever since it was first isolated in 1873. It can have an incubation period of two to 10 years. Some research has suggested it could be transmitted by nasal secretions.

But contrary to popular myth, it is not a highly contagious disease, and about 95 percent of the human population is naturally immune.

“We think people have to have pretty close contact with the organism and that would likely be contact with blood or fresh flesh of the animal,” Truman added.

“So just touching an armadillo, you are not going to get leprosy.”   According to James Krahenbuhl, director of the National Hansen’s Disease Program in Baton Rouge, Louisiana, about 3,600 patients in the United States are living with leprosy.

About 70 percent of those people have lived or worked in countries where the infection is prevalent. The rest acquire it in the United States.

“These findings will increase the awareness of physicians in this part of the country, in the south, in the Gulf Coast area, that leprosy does indeed exist,” said Krahenbuhl.

“They should consider the diagnosis if they have a patient in their office with a suspicious skin lesion.”

According to the World Health Organization, most countries where leprosy was once endemic have been able to reduce the rate of infection to fewer than one person per 10,000.

However, the disease remains an affliction, mainly of the poor, in parts of Brazil, India, Nepal and several countries in Africa.

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HEALTH INSURANCE

What isn’t covered by Switzerland’s compulsory health insurance?

Switzerland’s basic health insurance is among the most expensive in the world, but there are certain services it doesn’t pay for. Here are some of the benefits the scheme won’t cover in full.

What isn't covered by Switzerland’s compulsory health insurance?

Basic insurance — KVG in German and LaMal in French and Italian —  is compulsory in Switzerland. It doesn’t come cheap, but it is quite comprehensive and includes coverage for illness, medications, tests, maternity, physical therapy, preventive care, and many other treatments.

It also covers accidents for those who do not have accident insurance through their workplace.

Basically, whatever the doctor orders is covered by KVG / LaMal, at least partially.

READ MORE: Everything you need to know about health insurance in Switzerland

However, there are some treatments the basic insurance won’t pay for.

Experimental treatments

Any experimental treatments or drugs — that is, those not approved by the Swissmedic regulatory agency or the Federal Office of Public Health (FOPH) will not be covered.

This exclusion is not specifically Swiss; insurance schemes is most countries won’t cover unauthorised medical treatment either.

Dental care

In most cases, services such as teeth cleaning, dental fillings, root canals, tooth extractions, and orthodontic braces, are not included under basic insurance.

The only exceptions, according to the Federal Office of Public Health (FOPH), are dental interventions “necessitated by a serious disorder of the masticatory system, or if such treatment is required to support and ensure the success of medical treatment for a severe general disorder (e.g. leukaemia, heart-valve replacement)”.

Most dental treatments are not covered. Photo by Pixabay

Eyeglasses and contact lenses

Compulsory health insurance will contribute up to 180 francs per year towards glasses and contact lenses prescribed by an ophthalmologist for children up to the age of 18.

No such benefit exist for adults. However, “in the case of serious visual impairment or certain illnesses (e.g. disease-related refraction abnormalities, postoperative alterations or corneal disease), compulsory health insurance will, regardless of age, make higher contributions towards medically prescribed spectacle and contact lenses”, FOPH says.

READ MORE: Reader question: Can Swiss health insurance exclude me if I have pre-existing conditions?

Ambulance

Emergency vehicles that transport you to a hospital can be quite expensive — depending on the canton, the costs can range from 900 to 2,000 francs per trip. 

Basic health insurance will contribute a certain amount  to the cost of emergency transportation, but only if it is a medical necessity — a serious accident, an illness, or a life-threatening situation. But if the patient could have travelled by private car or public transport, basic health insurance policies will pay nothing.

Insurance will cover some of the cost of ambulance transport only in emergency. Photo by Fabrice COFFRINI / AFP

Private hospital room

While the cost of your hospitalisation will be fully covered, the basic insurance does not pay for a private room.

You will be accommodated in a room with other patients.

Depending on a medical facility — whether it’s a small hospital or a large, university medical centre, you could end up with just one other person or possibly four or five, the latter being common in teaching hospitals.

If you insist on a private accommodation, you will have to pay for it out of your own pocket.

Reader question: Can Swiss health insurance exclude me if I have pre-existing conditions?

Vaccines

Immunisations outlined by FOPH  will be paid for by insurance, as will the Covid vaccine.

Not covered, however, are travel-related vaccinations or preventive measures, such as against yellow fever or malaria.

Treatment abroad

Outside Switzerland, only emergency care is covered  — double the amount that the same treatment would cost in Switzerland.

Usually, basic health insurance will not cover transportation costs back to Switzerland, except in case of emergency, when it will cover 50 percent of the total cost of transportation to the nearest hospital abroad — but no more than 500 francs per year. 

If you only have a basic insurance policy and travel abroad often, especially to the United States, you should take out a travel insurance that will cover you for illness and accidents in foreign countries above and beyond what your Swiss carrier will pay.

And if you want to upgrade your treatment options, consider taking out a supplemental insurance or, if you can afford it, private one.

READ MORE: Should you buy supplemental health insurance in Switzerland?

You can find out more about what KVG / LaMal will and will not cover here.

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