Diseases are reemerging in some parts of America, including Los Angeles County, that we haven’t commonly seen since the Middle Ages. One of those is typhus, a disease carried by fleas that feed on rats, which in turn feed on the garbage and sewage that is prominent in people-packed “typhus zones.” Although typhus can be treated with antibiotics, the challenge is to identify and treat the disease in resistant, hard-to-access populations, such as the homeless or the extremely poor in developing countries.
I also believe that homeless areas are at risk for the reemergence of another deadly ancient disease — leprosy, also known as Hansen’s disease. Leprosy involves a mycobacteria (tuberculosis is another mycobacteria) that is very difficult to transmit and very easy to treat with a cocktail of three antibiotics.
Yet according to the Centers for Disease Control (CDC), there are more than 200,000 new cases of leprosy reported in the world every year, with two-thirds of them in India, home to one-third of the world’s poor. The poor are disproportionately affected by this disease because close quarters, poor sanitation, and lack of prompt diagnosis or treatment easily can convert a disease that should be rare to one that is more common.