Patricia Casas: The first Spaniard to be attacked by bacteria that devour human flesh: “It's like a shark bite” | Sciences

biology Patricia Casas He was The first Spanish person Who suffered from one of the most forgotten diseases on the planet: Buruli ulcerIt is caused by bacteria that devour human flesh and can disfigure the face and limbs. Casas spent five months in the jungles of Peru, for a conservation project…

biology Patricia Casas He was The first Spanish person Who suffered from one of the most forgotten diseases on the planet: Buruli ulcerIt is caused by bacteria that devour human flesh and can disfigure the face and limbs. Casas spent five months in the jungles of Peru for a conservation project Trunk monkeyUpon his return a decade ago, something resembling a cigarette burn appeared on his left arm. Day after day, that ulcer continued to grow without stopping, until it became a terrifying ulcer 12 cm long, with inflammation reaching from his elbow to his armpit. Her doctors, defeated by an unknown enemy, had to admit her to Lyon Hospital for a month and a half. “We didn't know what the name was for so long that I named her Deborah,” he recalls. Deborah ate his arm and stayed there for four years.

Buruli ulcer is one of Twenty neglected tropical diseases, a cluster of devastating diseases in the world's poorest regions, where roads end. the 2000 annual notifications These bacteria are concentrated in Central Africa, but cases have also been detected in other countries, such as Peru, Mexico and, above all, Australia. The big mystery is how the predatory microbe reaches humans and where it hides in nature. A team of Australian scientists now points to the alleged culprit: Mosquitoes.

Casas, who was born in Leon 42 years ago, lived in hell. bacteria, Mycobacterium ulceransIt is difficult to grow in the laboratory from a wound, so identifying it and getting a correct diagnosis is very complex. The biologist went to an outpatient clinic in Lyon on March 10, 2014, three months after his return from Peru. The health workers thought he had a minor burn so they gave him ointment. As the ulcer continued to grow, they suspected an allergic reaction. As the treatment failed, Casas ended up going to the emergency room at Leon Hospital, frightened. Doctors fumbled for months while the germ ate his arm. Until the diagnosis came: Buruli ulcer. The biologist had never heard of this disease.

Bacteria changed his life. Casas spent nearly two years taking antibiotics. The shock treatment damaged his liver and caused deafness. When his defenses were down, Deborah reappeared and continued to devour his arm. After four years and numerous surgeries, he was finally discharged from the hospital permanently. Along the way, Casas had to abandon his passion and biology and devote himself to hospitality. He now runs an inn with a music bar In Pedron de Torrio, a city in Lyon with a population of 80 people. A huge scar reminds him of his ordeal. “It bit me like a shark had bitten me off,” he explains.

The mechanism of transmission of Buruli ulcer has remained a mystery since the disease was described. In 1948. Casas is convinced that, in her case, it all started with a mosquito bite on her left arm, one day while she was in a hut in the Peruvian Amazon. New study published In the specialized magazine Nature MicrobiologySupports your intuition.

The Australian city of Melbourne has witnessed a wave of infections since 2017 More than 200 cases every year. Microbiology team Tim Steiner Rich state means were used to solve the mystery of Buruli ulcer, a mystery that remains alive because nothing like it has ever happened in poor areas of Africa. The researchers analyzed more than 65,000 mosquitoes on the Mornington Peninsula, a tourist area with beaches and vineyards located about an hour's drive from Melbourne. There is more than one case per 2,000 people.

Steiner's analyzes reveal that people with ulcers and mosquitoes that carry the bacteria overlap in the same areas. There is also a third actor: Ring-tailed phalanx, a marsupial mammal that weighs only one kilo, eats its own waste to make the most of the nutrients found in eucalyptus leaves. The microbe that causes Buruli ulcer is also found in these wastes. Mosquitoes appear to carry the bacteria from marsupials to humans. The University of Melbourne, where Stenier works, announced the announcement It's a statement: “80-year-old mystery solved: Mosquitoes spread the carnivorous Buruli ulcer.”

However, the Australian microbiologist is cautious. And remember that the largest study conducted in Africa, in a region of Benin hit by the disease, was barely examined 4300 mosquitoesWithout finding any relationship to bacteria. “Given that the frequency of positive mosquito cases in Australia was 1%, the absence of evidence in the Benin study does not mean there is evidence of absence,” Stenier tells EL PAÍS. The microbiologist recalls what other researchers in Ivory Coast have pointed out Some aquatic insects As potential transmission vectors Cane rats Serves as a reservoir for animals. For Steiner, there is an urgent need to conduct in-depth research in the most affected African regions.

The mosquito is in the spotlight Aedes notoscriptusIt is an Australian species that was discovered in 2014 in the American city of Los Angeles and has been around since then You have invaded California. Microbiologist Tim Steiner believes it is “theoretically possible” that cases of Buruli ulcer could emerge in the United States, provided there is a suitable animal reservoir and also Bacteria are introduced. Melbourne area It has a Mediterranean climateLike California, Steiner also sees “no reason to rule out” that the insects could in the future transmit Buruli ulcer to other temperate countries, such as Spain.

Mosquitoes They tend to spread parasitesSuch as malaria, viruses such as dengue and yellow fever, but not bacteria. Team of biologists Jordi Figuerolafrom the Doñana Biological Station (CSIC). Guadalquivir Mosquito ObservatoryTo track potential disease vectors. For now, Figuerola isn't worried about mosquitoes Aedes notoscriptus A Buruli ulcer, however Aedes aegyptiIt is another strange mosquito that has invaded Spain for three centuries and caused it Serious epidemics of dengue and yellow fever Until it was eliminated in the middle of the twentieth century.

he Aedes aegypti It has already been revealed On schedule in the Canary Islands On several occasions in recent years, although the Ministry of Health considers the situation under control. Figuerola warns that the continuing increase in the movement of goods – especially plants and used tires – and in the number of travelers will inevitably facilitate the movement of insects and diseases. “In addition, as temperatures rise due to climate change, the distribution of mosquitoes will expand and the number of months they will be active will increase,” he warns.

Patricia Casas wonders what would have happened to her if she had not had robust free public health care and a doctor at her disposal, Jose Manuel Guerra Laso, completely dedicated to his recovery. “They probably had to amputate my arm,” he laments. Casas urges the authorities to allocate more resources to prevent suffering caused by neglected diseases in the poorest countries. “It is in your hands,” he says, “and it must also be in your conscience and in your heart.”

The biologist's case is unique in Spain. Biochemist Israel Cruzhead of the international health department at the Carlos III Health Institute, has only evidence that another former patient was infected: 27 year old woman From Equatorial Guinea, he traveled to Barcelona in 2003, four years after he developed a Buruli ulcer in his left leg, to try to treat it. Doctors at Hospital Del Mar had to amputate his limb due to a very severe ulcer that was exacerbated by HIV.

If diagnosed early, standard Buruli ulcer treatment requires just eight weeks of two antibiotics: rifampicin and clarithromycin. The costs of illness remain It's disastrous For many families. Israel Cruz participates in it International consortium, coordinated by the University of Zaragoza, is trying to reduce the treatment time to just four weeks, by adding amoxicillin and clavulanic acid. During the clinical trial, in remote areas of Benin and Ivory Coast, Cruz saw patients whose entire limbs had been consumed by Buruli ulcers.

Biochemist praises new Australian study. They used all their artillery to uncover how the infection was transmitted in Australia. However, in Africa, there are no financial resources to support research of this level. The ideal situation is to apply the same desire and the same means in the African context.

Patricia Casas took it with humor, but she feared for her life. There came a time when his ulcer “resembled a French omelette” on his arm. “My mother said to me, ‘How’s tortellina?’” he recalled. The biologist laughed, but she was in distress. “Medical studies usually describe it as Painless ulcerBut nothing is painless. “It hurt me a lot,” he explains. With his defenses low, Casas abandoned biology, partly out of fear of contracting the disease when in contact with wildlife. “When I started working as a waitress, I imagined customers having the heads of birds, turtles or monkeys, to make my work easier,” she recalls. Now, a decade after flesh-eating bacteria entered his life, he intends to return to biology: “I need poetry and a pen now.”

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