Dr. Oriol Mitjà: seeking to understand old and new infectious diseases

Howard Fischer
Uppsala, Sweden

 

“Research needs to give answers to real problems.”
– Dr. Oriol Mitjà

 

A seated man in a dress shirt looking up and to the left
Oriol Mitjà. Photo by Oriol.mitja, 2016, on Wikimedia. CC BY-SA 4.0.

Dr. Oriol Mitjà (b. 1980) earned his M.D. degree from the University of Barcelona. He then completed an internal medicine residency, followed by a fellowship in infectious disease. He earned a Diploma in Tropical Medicine and Hygiene from the London School of Hygiene and Tropical Medicine.1

In 2010 he was invited to fill a temporary physician’s position at a health center in Papua New Guinea. He stayed there for ten years and became an expert on the tropical disease yaws. Yaws is a bacterial disease caused by a treponema, the same sort of organism that causes syphilis, but is not transmitted sexually. The organism enters through a scratch in the skin and produces an ulcerating nodule. The treponema may then invade bone or cartilage, producing painful swelling and extreme fatigue in the sufferer, most often a child. The final stage, occurring in about ten percent of patients, is a mutilating destruction of bone. Yaws was nearly eradicated in the ’50s and ’60s when campaigns of penicillin injections were employed. With the decrease in the number of yaws cases, surveillance slackened and the disease came back to infect hundreds of million patients workdwide.2

When Dr. Mitjà arrived in Papua New Guinea, he had never seen a case of yaws. It soon became clear to him that the painful intramuscular injection of penicillin was the reason that patients avoided coming for treatment. He and his team studied the value of a single oral dose of the antibiotic azithromycin as a treatment for yaws. This approach produced a 96% cure rate after six months. The results were published in Lancet.3 An accompanying editorial called it “the most important paper on yaws in the past fifty years.” The World Health Organization changed its recommendations and advised that azithromycin, not penicillin, was the preferred treatment for yaws.

Dr. Mitjà earned a Ph.D. from the University of Barcelona in 2012. His next major project in Papua New Guinea was an island-wide mass treatment program of yaws in 2013. The oral treatment reduced the number of cases by 90%.4

He has published an impressive 110 papers on yaws, describing treatment, transmissibility, cost-effectiveness of treatment, outcome prediction, and gene sequencing of the treponema.5 He also produced articles on the bacterium Hemophilus ducreyi, which can also produce skin ulcers, as well as reports on dengue, malaria, filariasis, and listeriosis. His goal, and now the goal of the World Health Organization (should the funds become available), is to completely eradicate yaws. There has been some question of the feasibility of this attempt by the International Task Force for Disease Eradication, which believes that the presence of an animal reservoir—chimpanzees, gorillas, and other primates—of T. pallidum makes eradication impossible. However, there is no evidence of humans becoming infected by other primates.6

Since 2019 Dr. Mitjà has been in Barcelona at the Hospital Universitari German Trias i Pujol, researching the SARS-CoV-2 virus, the cause of COVID-19 diseases. He has produced thirty articles7 about the epidemiology of the disease, the immune response to it, antigen detection, viral load and infectivity, clinical manifestations, the spread of COVID in nursing homes, and antiviral treatment.

As Dr. Martin Luther King, Jr. said, “We are prone to judge success by the index of our salaries…rather than by the quality of our service and relationship to mankind.” Bravo, Dr. Mitjà.

 

References

  1. Oriol Mitjà. Wikipedia.
  2. NA. “Yaws,” 2021. emedicine.medscape.com
  3. Oriol Mitjà, Russell Hayes, et al. “Single-dose azithromycin versus benzathine penicillin for treatment of yaws in children in Papua New Guinea: an open label, non-inferiority, randomised trial,” Lancet, 379 (9813), 2012.
  4. Oriol Mitjà, Wendy Houinei, et al.,”Mass treatment with single-dose azithromycin for yaws,” NEJM, 372 (8), 2015.
  5. researchgate.net. Oriol MITJA|Professor (associate)|Fundación Lucha Contra el sida, Barcelona|STI and Skin NTDs p.2, 2022.
  6. Martin Enserink. “On a remote Pacific island this doctor has revived a 60-year quest to eradicate a disfiguring disease,” Science, 14 July 2018.
  7. researchgate.net

 


 

HOWARD FISCHER, M.D., was a professor of pediatrics at Wayne State University School of Medicine, Detroit, Michigan.

 

Spring 2022  |  Sections  |  Infectious Diseases