It’s easy to get hung up on odd ball reports, since they’re interesting and novel. Their overall impact is pretty low, but they often have some reasonable take-home messages.

So, here’s another odd ball report: leprosy in a Canadian who had never traveled beyond Canada and the US (Bonnar et al, 2018 Emerging Infectious Diseases).

Leprosy is a nasty disease, caused by the bacterium Mycobacterium leprae, that many people think of only in historical terms (see photo). Yet, it continues to cause problems in some regions of the world.

The reported case involves a man from Atlantic Canada who was diagnosed with Hansen disease (leprosy). It took some time to arrive at the diagnosis, not surprisingly, since he had no history of travel to an area where leprosy is common, so it wasn’t likely high on the list of potential causes of disease. His travel history only consisted of annual trips to Florida.

Molecular analysis of M. leprae from the man found that it was consistent with a zoonotic strain of the bacterium that is found in armadillos (or, more specifically, 9-banded armadillos). No contact with armadillos was reported, but indirect transmission is suspected to have occurred, such as through contact with environmental sites.

This doesn’t mean people should avoid travel to Florida. However, it highlights a few issues:

• Travel history is important for diagnosis of some infectious diseases. Physicians need to ask, patients need to offer the information, and, importantly, physicians need to know (or have good resources for) what diseases to suspect in different areas. (Leprosy risk from armadillos probably isn’t commonly known.)
• Travel history doesn’t just include long trips or exotic locales. Any travel to a different region can result in different risks. Some people don’t say “yes” to the travel question for what they consider to be routine travel, such as yearly trips to Florida from Canada. From an animal standpoint, we run into this when people don’t consider visits to the family cottage as “travel,” even though there may be very different disease risks at the cottage compared to the city.
• While direct armadillo contact wasn’t reported here, limiting contact with wildlife is a good idea, and any time there’s any contact, hand hygiene shouldn’t be forgotten.