Leishmaniasis

Sedge Wren, Cerro de Hula, Honduras

I usually write about birds or butterflies here in these pages, and occasionally about bats, but not very often about me. However, the previous entry, Frederick's story, has a little tail, and it concerns me. If it wasn't for him, I would never have gone to the Alonso Suazo Medical Center in Tegucigalpa, where last week one of the doctors noticed a skin lesion on my right hand, and asked me "what is that, and how long have you had that?"

When I answered her that I didn't know what it was, and that I've had it for almost two years, she said: "It looks like possible leishmaniasis. You should have that checked out. Why don't you go to the laboratory here on the third floor."

This I did, but it was Friday afternoon, and they had already closed. I was asked to come back Monday. 

That Monday, a skin biopsy was carried out. The next day, I went back there and was informed that I had tested positive for leishmaniasis.

Leishmaniasis is a tropical disease spread by the bite of the female sandfly. There is visceral leishmaniasis and cutaneous leishmaniasis. The former is more dangerous; I have the latter. If left untreated, this disease is often fatal, for it is a parasite that attacks the immune system. Another disease comes along and the body fails to engage its immune system, and you die. World-wide, about 60,000 people, mostly infants, die from visceral leishmaniasis each year. Treatment of cutaneous leishmaniasis, however, is often successful and the cure is complete. 

The skin lesion on my hand is where the sandfly bit me. Hopefully, it will disappear over the next three weeks.

Treatment here in Honduras consists of a series of 40 injections over a period of 20 days. Since I live about 45 minute drive from that medical center in Tegucigalpa, I researched the possibility to have these shots delivered by my local medical center, but it turns out that they are not adequately staffed to make that happen. So the next two and a half weeks (I started yesterday, on my birthday), I will be driving to Tegucigalpa and back every day for these shots. It is important that I follow the regimen without missing a day. The shots are not painful. On the 17th of February, I will have the good fortune to receive not two but three shots: the last one in the anti-rabies treatment, plus the two for leishmaniasis. Meanwhile, I will continue working here, monitoring bird and bat mortality at a wind farm in Honduras.

This is the second tropical disease that I've had now. I had dengue fever back in 2009 in Veracruz. That was no picnic, but ultimately harmless. (For me, that is. Not for infants and the elderly.) Both diseases were contracted through insect bites. The lesson here is that a mosquito bite in the tropics is not always just that, and that I need to be more pro-active regarding insect repellence, and more careful to have lesions or other oddities looked into.

Next time, I plan to write again about birds. We have what appears to be a large population of Sedge Wrens up in Cerro de Hula, where we live. Since a few weeks, these birds have been singing everywhere, and I've recorded several of them. Xeno-canto has a huge collection of Sedge Wren recordings, but none from Central America.

Finally, I want to advise my readers that I am temporarily without internet, and have to grab whatever little bit of wireless I can get at fast food restaurants in Tegucigalpa these days. If you write me, please be patient. I will reply, but it may take me a while.

Frederick the fruit bat

Last week, we found a bat entangled in a barbed wire fence . It was hanging less than a meter from the ground, with one of its wings wrapped around the barbed wire. It was still alive.

We untangled it and took it home, where we gave it water and a rehydration solution. We fed it with a pipet, from which it readily drank.

We fed it every two to three hours, and between feedings we hung it on a little stick propped inside a closet, in the guest bedroom. 

We soon grew attached to it, and named him - it was a male - Frederick. He had some wing damage from being stuck on the fence, but otherwise seemed in rather good condition. Once rehydrated, he became quite active.

Frederick is a Great Fruit-eating Bat, Artibeus literatus. This species occurs throughout Mexico and Central America, and northern South America. Naturally, fruit bats are a lot easier to care for than insectivorous bats. We made him a banana and watermelon smoothie, which he lapped up readily! 

As Fred got more active, he also tried to fly. At one point we heard noises coming from the room, looked at each other, and said "he must be trying to fly". We went in, and there he was, spread-eagled on the floor, making short flappy jumps. When I reached to pick him up, he bit me.

At first, I didn't think much of it. I cleaned the bite wound on my thumb, and we continued to feed Frederick. A couple of feedings later, he seemed ready to be released. After nightfall, we hung him on a piece of string under a little tree in our yard, and gave him a piece of banana. Twenty minutes later, Fred was still there but the banana was gone. Later that evening, we gave him another piece. The next morning, Frederick was gone.

I researched the bat bite a little on the internet, and learned that any kind of bite from a bat is cause for concern; and that after thoroughly cleaning the bite site, I should also seek medical assistance. This I did: the local hospital did not have the anti-rabies vaccine, but they suggested I go to the town's medical center. That was already closed, so I went the next morning, after our field work.

Our medical center here did not have any anti-rabies vaccine, it turned out. They suggested I contact my medical insurance. They referred me to a medical center in Tegucigalpa, the Honduran capital, which is a 45 min drive from here. 

Once we got there and I was checked into the medical center, there was nothing else to do but wait my turn in the crowded hallway. I re-read Alice in Wonderland beginning to end, and had just started on Through the Looking-Glass, when I was called in for an exam.

After hearing my story, and after finding out the bat was no longer in our possession, medical staff there advised me that very likely I was not infected with rabies, but that I should follow an anti-rabies cure, just to be safe. I received a tetanus injection and the first of a series of anti-rabies injections.

So now I'm traveling to Tegucigalpa every day for my shot of anti-rabies vaccine. My regimen prescribes six shots over a period of six days, then one more shot ten days later. I need to be back there for medical exams two more times after that, once in February and once in April.

I'm the darling of the nurses there. There's usually seven or eight nurses attending me, and they take pictures of me receiving the shots almost every time. I'm not quite sure why. When they asked me why I was there, I explained that I was bitten by a bat, and I reassured them that they were quite safe: the bite had not turned me into a vampire. 

A few days before we found Frederick, we found another fruit bat, also entangled in barbed wire. This bat (we called her Mathilda) had been hanging out in the sun for almost a day, and was severely dehydrated. Her condition was much worse than Frederick's, and despite our care, she died a day later.

Barbed wire fences, apparently, are a threat to fruit bats around the world, as this Australian poster from bats.org.au shows.