Be careful when you travel abroad - you could bring something unwanted home with you. In 2002 Alfred Heliah and his wife Helene accompanied research scientists on a trip to Peru. They volunteered to assist in the study of red and green macaws. During their visit they were constantly attacked by biting insects. Though they wore protection right down to their wrists they were bitten black and blue.
On their return home the wounds slowly healed. While shaving one morning Alfred noticed what he thought were pimples on the side of his chin. They didn't hurt, but over time they grew larger. They eventually burst, becoming shallow ulcers oozing a yellow discharge. Treating them with antibiotic ointment had no affect. A new lump appeared and he thought it was time to see a doctor.
After being told by Alfred that he had recently returned from the tropics in Peru, doctors at the local hospital believed that he had leishmanisis that could devour the flesh on his face. It causes major damage to the spleen leading to death. The disease is transmitted by the humble sandfly. Leishmania parasites live in the sandfly's gut and it is vomited into open wounds.
Though the general public has hardly heard of the disease it is endemic to eighty-eight countries. During Desert Storm in Iraq twenty US soldiers came down with the parasitic infection. After returning home, eight more came down with the disease.
Getting back to Alfred. A tropical disease specialist Dr Angami examined him and asked how many were on the team in Peru, Alfred told him about thirty. The Doctor frighteningly replied that some more in the group would have the disease by now.
Biopsies showed that Alfred did indeed have Leishmaniasis. He was given Pentostam, a nitrogenic metal and a medication never approved by the FDA - the only treatment available. Patients must sign away any damages entitlement from the medication's side effects. After only three days with Pentostam being infused into his blood Alfred began to improve. Though he felt worse, doctors could see he was recovering. Alfred did recover. However, there was always the possibility of infectious bumps reappearing at any time in the future. A side effect of Pentostam is tremor in the hands. Alfred had to live with this for the rest of his life. When Alfred was offered a research trip to Africa, he turned it down. He had suffered enough.