A Disease as Deadly as Ebola and More Lethal Than the Plague — but Potentially Eradicable

Their villages are not listed on any maps. They do not appear in the photo. And, at first, not even the name of the curse that haunts them inspires terror. Nevertheless, Carrión’s disease , a malady omitted even from the list of the world’s forgotten diseases, has the dubious honour of being one of the most aggressive bacterial infections on the planet. With a mortality rate during the acute phase of between 44% and 88%, it is as deadly as Ebola and more lethal than the plague.

Carrión’s disease , a malady omitted even from the list of the world’s forgotten diseases, has the dubious honour of being one of the most aggressive bacterial infections on the planetThe impact of Carrión’s disease is greatest among vulnerable populations: the infection is particularly dangerous in pregnant women and children and those most at risk are people who live in rural areas where resources are limited. Originally, the disease was endemic only in the Andean valleys of Peru, Ecuador and Colombia. However, now that pathogens appear to have developed a taste for travel—a tendency amply demonstrated by Ebola and Chikungunya —it has begun to spread to neighbouring regions and to threaten the whole area that is home to the titira sand fly, the insect vector that transmits the infection.

The situation is further complicated by three additional problems that represent a challenge to scientists looking for ways to combat the disease:

• The lack of data on the number of people affected by this neglected disease found mainly in remote rural areas because rigorous epidemiological data are an essential prerequisite for designing public health strategies.
• The large number of people in endemic areas who are carriers of Bartonella bacilliformis—the bacteria that causes Carrion’s disease—but do not develop symptoms. This phenomenon contributes to the continued spread of the disease wherever the insect vector is present because the asymptomatic carriers are not detected by the health system and act as reservoirs of infection.
• The fact that the bacteria thrive in remote areas of countries with weak healthcare systems, where the capacity to diagnose the disease is severely limited by the lack of resources.

So much for the bad news. Now, let’s take a look at the good.

These deaths are entirely avoidable. Unlike Ebola and chikungunya, Carrion’s disease can be treated. Fortunately, antibiotics are still effective against this infection.

Unlike Ebola and Chikungunya, Carrion’s disease can be treatedFor the moment, although factors such as climate change are contributing to its spread, the disease is still restricted to a limited geographical area. This, coupled with the fact that there is no known animal reservoir, is what leads us to a hopeful conclusion: if we can develop an effective diagnostic tool, if we can greatly improve the capacity of local health systems to conduct surveillance and detect asymptomatic carriers, and if we can deliver mass treatment to endemic populations, Carrion’s disease is—can you guess what? Yes, it is a potentially eradicable disease. Now, who should take the first step?

[This text has been written by Cláudia Gomes, researcher in ISGlobal and Pau Rubio, Responsible for Online Communications in ISGlobal]

For More Information

The Forgotten Disease of The Andes