“We cannot eradicate this disease worldwide”

It is one of the oldest diseases in the world. And yet, after believing in its eradication in the 2000s, experts agree that we will still have to live with leprosy for some time: 200,000 new cases are still found every year in the world, especially in India and Brazil.

For several years, the American states of Florida and Louisiana have also been affected by the resurgence of the disease. Should we fear his return to France? To mark World Leprosy Day this Friday to Sunday, 20 minutes A former surgeon specializing in leprosy with the Raoul Folereau Foundation, a historic player in the fight against the disease, Dr. Michel-Yves Grouvin (see box) was asked for his opinion.

Does leprosy still portray a certain image?

Of course. The imagination is still very present and the patients are very stigmatized. They often suffer social exclusion due to misconceptions and ignorance surrounding the disease. However, it is not very contagious, and if it is detected very early, at the stage of a simple rash on the skin, it can be completely treated with three recognized antibiotics. On the other hand, if we do not intervene quickly, the dermatological disease becomes neurological and can lead to paralysis of the eyes, arms and legs.

Why can’t we eradicate it with these antibiotics?

It is a disease that affects the poorest people, who have difficulty accessing care, as is the case with half the population in Madagascar, for example. Additionally, the Hansen’s bacillus – which causes leprosy – is a bacteria that we breathe in the air. Incubation is very long and therefore difficult to monitor.

Today, there are fewer than one case per 10,000 inhabitants in African countries, but the fewer patients there are, the better they should be cared for. The World Health Organization envisioned the disease being able to be eradicated in the 1980s with the advent of new laboratory-produced antibiotics. But there is a high level of impact.

We are also seeing a resurgence in one Western country, the United States. Is this alarming?

Worryingly, the approximately 150 annual cases reported there were not linked to importation of the disease from a tropical country. Today, the hypothesis of zoonosis, i.e. transmission by animals, has been confirmed. We know that the bacillus is hosted by animals: it is found on squirrels and armadillos. And in fact, one study showed that cases discovered in Florida and Louisiana were linked to armadillos. People suffering from leprosy ate this animal. Naturally, this is a habit in this region of the United States.

Without armadillos on its territory, is France safe from the return of leprosy?

In our country, leprosy has disappeared, and there is no reason for its return. The only and very rare cases detected in France come from travel or migration. I have personally encountered it on very few occasions. A few years ago, I had to operate on a Burkinabe who arrived in Lille with leprosy. In Bastia, I also advised the foreign legion established in Calvi for the Brazilian Legionnaires. Furthermore, if antibiotic treatment is prescribed early, there is no risk of disability.

Collected Comments by Gilles Durand