The treatment of a rare case of leprosy in the southwest of Ireland last year led to complex public health challenges.
That’s according to an article published in Eurosurveillance, Europe's journal on infectious disease surveillance, epidemiology, prevention and control.
It was one of five cases of leprosy in the Republic of Ireland in the last decade, and first in the southwest in that time.
The authors of the article have said there should be a more harmonised approach to the public health response to sporadic cases of leprosy in Europe.
This case involved an individual in their 30s, who was born and grew up in a Caribbean country where leprosy remains endemic.
They moved to Ireland from southern Brazil after living there for ten years; also an area with a high incidence of leprosy.
The person, who was living in what was described as a congregate setting, presented to clinical services in late 2023 with pain and numbness in the right arm and hand, as well as several lesions on the face, thorax, arms and legs.
They underwent a number of investigations over seven months before being diagnosed last summer, before receiving multi-drug therapy which resulted in recovery.
One of the conclusions in the article is that healthcare professionals in regions where there is a low prevalence of leprosy are often unfamiliar with signs and symptoms, which leads to delayed diagnosis, as in this case.
This delay can increase the risk of irreversible nerve damage.
The authors also undertook detailed contact tracing, noting there is no universally agreed close contact definition for leprosy, nor guidelines for close contact management in Ireland.
The study identified three close contacts, for whom arrangements were made for yearly follow-up skin and neurological examinations for a minimum of 5 years.
The article says European countries should remain vigilant to the possibility of leprosy cases arising, and there should be greater standardisation of contact tracing and follow-up pathways across public health guidelines.
