A rare flesh eating parasite that is not normally fatal caused a death in Scotland last year, raising fears that the health service is not treating patients until it is too late.
A man in his late 60s died of leishmaniasis, a parasite spread by sandflies that can cause serious disfigurement. It is the first recorded death from the parasite in Scotland since at least 2001, when current records began.
Leishmaniasis can cause open wounds and pus-filled sores all over the body. It is mainly found in the Middle East and there were just 199 cases detected in Europe in 2020.
There is also a strain called canine leishmaniasis, found in dogs, which is endemic in southern Europe but extremely rare in the UK.
The UK Health Security Agency (UKHSA) updated its leishmania risk assessment in January after it was found in dogs imported from Afghanistan while under quarantine in 2021.
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Thousands of Afghan refugees arrived in the UK last year following the withdrawal of US forces and the resurgence of the Taliban.
Public Health Scotland would not confirm if the man was a refugee or had travelled abroad, but UKHSA said there have been “no known locally acquired cases of human leishmaniasis in the UK” since at least 2005.
The agency said: “Leishmaniasis is currently re-emerging in Europe and the wider Mediterranean region. In the 1990s, endemic areas in Europe saw a rise in visceral leishmaniasis cases in adults, linked to co-infections with HIV. Conflict areas in the Middle East have seen an important recrudescence of cutaneous leishmaniasis, and it is thought that migration and forced displacement from these areas may be contributing to the emergence.”
Scotland also had the first recently recorded death from scabies. A woman in her late 70s was killed by the mites that cause septic sores. Scabies is usually only fatal if left untreated. UKHSA said that about one in 50 care homes experience an outbreak of scabies each year, but this is thought to be an underestimate as sufferers are often reluctant to report the condition amid public misconceptions that it is linked to bad hygiene.
Scabies was also implicated in the death of Debbie Leitch, 24, who also had Down’s syndrome. Her mother Elaine Clarke, 49, was jailed in March for gross negligence manslaughter after Leitch starved to death in a “squalid” bedroom in her Blackpool home in 2019. Her face was covered in scabies sores that left her unrecognisable.
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Q Fever, an illness most commonly spread by farm animals, was another rare illness that made a fatal resurgence in 2021, killing a man in his early 70s.
It is extremely rare, with just nine reported diagnoses in the UK in 2019, according to the most recent published data. It can be treated with antibiotics but most people recover naturally.
Q Fever is particularly prevalent in Spain where it was linked to four deaths in 2019, the European Centre for Disease Prevention and Control said.
Across Scotland, there were 63,587 deaths in 2021, according to Public Health Scotland and National Records of Scotland, nearly 6,000 higher than the five-year average before the Covid pandemic. Other rare causes of death included an elderly woman killed by sunburn, a man killed by a dog for the first time in a decade, a pensioner who died of haemorrhoids, and three babies who accidentally suffocated in bed.
Doctors have noted a rise in deaths from normally treatable illnesses that became critical due to a lack of medical attention during the pandemic. More people avoided hospitals and GPs through misinterpretation of government messaging that the NHS was overwhelmed or because they were afraid of catching coronavirus.
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A Scottish government spokesman said: “Our thoughts and condolences are with all those who have lost a loved one. The Scottish government will continue to work closely with Public Health Scotland and National Records of Scotland to analyse a broad range of data and better understand causes of death and any implications for public health.”