Evidence of zoonotic leprosy in Pará, Brazilian Amazon, and risks associated with human contact or consumption of armadillos

PLoS Negl Trop Dis. 2018 Jun 28;12(6):e0006532. doi: 10.1371/journal.pntd.0006532. eCollection 2018 Jun.

Abstract

Mycobacterium leprae (M. leprae) is a human pathogen and the causative agent for leprosy, a chronic disease characterized by lesions of the skin and peripheral nerve damage. Zoonotic transmission of M. leprae to humans by nine-banded armadillos (Dasypus novemcinctus) has been shown to occur in the southern United States, mainly in Texas, Louisiana, and Florida. Nine-banded armadillos are also common in South America, and residents living in some areas in Brazil hunt and kill armadillos as a dietary source of protein. This study examines the extent of M. leprae infection in wild armadillos and whether these New World mammals may be a natural reservoir for leprosy transmission in Brazil, similar to the situation in the southern states of the U.S. The presence of the M. leprae-specific repetitive sequence RLEP was detected by PCR amplification in purified DNA extracted from armadillo spleen and liver tissue samples. A positive RLEP signal was confirmed in 62% of the armadillos (10/16), indicating high rates of infection with M. leprae. Immunohistochemistry of sections of infected armadillo spleens revealed mycobacterial DNA and cell wall constituents in situ detected by SYBR Gold and auramine/rhodamine staining techniques, respectively. The M. leprae-specific antigen, phenolic glycolipid I (PGL-I) was detected in spleen sections using a rabbit polyclonal antibody specific for PGL-I. Anti-PGL-I titers were assessed by ELISA in sera from 146 inhabitants of Belterra, a hyperendemic city located in western Pará state in Brazil. A positive anti-PGL-I titer is a known biomarker for M. leprae infection in both humans and armadillos. Individuals who consumed armadillo meat most frequently (more than once per month) showed a significantly higher anti-PGL-I titer than those who did not eat or ate less frequently than once per month. Armadillos infected with M. leprae represent a potential environmental reservoir. Consequently, people who hunt, kill, or process or eat armadillo meat are at a higher risk for infection with M. leprae from these animals.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Animals
  • Antigens, Bacterial / genetics
  • Antigens, Bacterial / immunology*
  • Antigens, Bacterial / isolation & purification
  • Armadillos / microbiology*
  • Brazil / epidemiology
  • Disease Reservoirs / microbiology*
  • Enzyme-Linked Immunosorbent Assay
  • Female
  • Glycolipids / genetics
  • Glycolipids / immunology*
  • Glycolipids / isolation & purification
  • Humans
  • Leprosy / epidemiology
  • Leprosy / microbiology
  • Leprosy / transmission*
  • Male
  • Meat / microbiology*
  • Middle Aged
  • Mycobacterium leprae / genetics
  • Mycobacterium leprae / immunology
  • Mycobacterium leprae / isolation & purification*
  • Polymerase Chain Reaction
  • Rabbits
  • Risk
  • Spleen / microbiology
  • Young Adult
  • Zoonoses

Substances

  • Antigens, Bacterial
  • Glycolipids
  • phenolic glycolipid I, Mycobacterium leprae

Grants and funding

This work was supported by grants from Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq grant 486183/2013-0 to MBS; 448741/2014-8 grant to JGB; 481652/2012-4 grant to CGS; and a Visiting Science without Borders award 402239/2012-1 to JSS), a post-doctoral grant from the Coordenacão de Aperfieçoamento de Pessoal de Nivel Superior (CAPES BEX 6907/14-8 to MBdS, and 157512-0 to JGB), CAPES PROAMAZÔNIA 3288/2013, a Fulbright Scholar to Brazil 2015-2016 award to JSS, and a grant from The Heiser Program of the New York Community Trust for Research in Leprosy, grant number P15-000827 and P16-000976 (CGS, STC, MJ, JTB, AG and JSS). Environmental approval of armadillo tissue sampling was obtained by SISBIO/44831-1. The authors thank Heiser, the Colorado State University Libraries Open Access Research and Scholarship (OARS) Fund, PROPESP/UFPA and FADESP for funding the publication cost of this article. The funders had no role in the study design, data collection and analysis, decision to publish, or the preparation of the manuscript.