Instituto de Patologia Tropical e Saúde Pública, Universidade Federal de Goiás, Goiânia, Goiás, Brazil.
Instituto Lauro de Souza Lima Bauru, São Paulo, Brazil.
PLoS One. 2019 Jan 10;14(1):e0209491. doi: 10.1371/journal.pone.0209491. eCollection 2019.
There is evidence that in southern US, leprosy is a zoonosis infecting wild Dasypus novemcinctus armadillos but the extent of this finding is unknown. This ecological study investigated leprosy in rural communities and in wild armadillos from the Brazilian Amazon. The study area was the Mamiá Lake of Coari municipality, Amazonas State, Northern region, a hyper endemic leprosy area where residents live on subsistence farming, fishing and armadillo hunting and its meat intake are frequent. The leprosy survey was conducted in sixteen communities by a visiting team of specialists. Local partakers provided wild armadillos to investigate M. leprae infection. Volunteers had complete dermato-neurological examination by a dermatologist with expertise in leprosy diagnosis, suspect skin lesions were biopsied for histopathology (Hematoxylin-eosin/HE, Fite-Faraco/FF staining); slit skin smears were collected. Armadillos' tissue fragments (skins, spleens, livers, lymph nodes, adrenal glands, others) were prepared for histopathology (HE/FF) and for M. leprae repetitive element-RLEP-qPCR. Among 176 volunteers, six new indeterminate leprosy cases were identified (incidence = 3.4%). Suspect skin sections and slit skin smears were negative for bacilli. Twelve wild D. novemcinctus were investigated (48 specimens/96 slides) and histopathological features of M. leprae infection were not found, except for one skin presenting unspecific inflammatory infiltrate suggestive of indeterminate leprosy. Possible traumatic neuroma, granuloma with epithelioid and Langhans cells, foreign-body granuloma were also identified. Granulomatous/non-granulomatous dermatitides were periodic-acid-Schiff/PAS negative for fungus. M. leprae-RLEP-qPCR was negative in all armadillos' tissues; no bacillus was found in histopathology. Our survey in rural communities confirmed the high endemicity for leprosy while one armadillo was compatible with paucibacillary M. leprae infection. At least in the highly endemic rural area of Coari, in the Brazilian Amazon region where infectious sources from untreated multibacillary leprosy are abundant, M. leprae infected armadillos may not represent a major source of infection nor a significant public health concern.
有证据表明，在美国南部，麻风病是一种感染野生九带犰狳的动物传染病，但这一发现的程度尚不清楚。这项生态研究调查了巴西亚马逊地区农村社区和野生犰狳中的麻风病。研究区域是亚马逊州科阿里市的马米亚湖，这是一个麻风病高度流行的地区，居民以自给农业、渔业和捕猎犰狳为生，经常食用犰狳肉。麻风病调查由一个专家访问小组在 16 个社区进行。当地居民提供野生犰狳供调查麻风分枝杆菌感染情况。志愿者由一名具有麻风病诊断专业知识的皮肤科医生进行完整的皮肤神经学检查，对可疑皮肤病变进行活检进行组织病理学检查（苏木精-伊红/HE、费特-法科/FF 染色）；收集皮肤刮片。收集犰狳的组织片段（皮肤、脾脏、肝脏、淋巴结、肾上腺、其他）进行组织病理学检查（HE/FF）和麻风分枝杆菌重复元件-RLEP-qPCR。在 176 名志愿者中，发现了 6 例新的不确定型麻风病病例（发病率=3.4%）。可疑皮肤切片和皮肤刮片均未发现杆菌。调查了 12 只野生九带犰狳（48 个样本/96 个载玻片），未发现麻风分枝杆菌感染的组织病理学特征，除了 1 只皮肤呈现非特异性炎症浸润，提示为不确定型麻风病。还发现了可能的创伤性神经瘤、含上皮样细胞和朗汉斯细胞的肉芽肿、异物肉芽肿。革兰氏染色/PAS 对真菌呈阴性，无肉芽肿/非肉芽肿性皮炎。所有犰狳组织的麻风分枝杆菌 RLEP-qPCR 均为阴性，组织病理学检查未发现杆菌。我们在农村社区的调查证实了麻风病的高度流行，而有一只犰狳可能感染了少菌型麻风分枝杆菌。至少在科阿里这个巴西亚马逊地区高度流行的农村地区，由于未经治疗的多菌型麻风病的感染源丰富，感染麻风分枝杆菌的犰狳可能不是主要的感染源，也不会对公共卫生构成重大威胁。
