Infection
Could Leprosy Become Endemic to Florida? What to Know
Aug
- Leprosy cases have been increasing in Florida, according to a CDC report.
- The bacterial infection is also known as Hansen disease.
- Leprosy affects the peripheral nerves, skin, respiratory tract, and eyes.
Cases of leprosy have been increasing in central Florida and the disease may have become endemic in the region, according to a new report from the Centers of Disease Control and Prevention (CDC).
Health officials are warning travelers to consider their risk of contracting leprosy, otherwise known as Hansen disease, when visiting Florida.
Leprosy, a chronic bacterial infectious disease that impacts the skin and peripheral nervous system, affects the peripheral nerves, skin, upper respiratory tract, and the eyes.
Left untreated, the disease can cause nerve damage, paralysis, deformities in the hands and feet, and blindness.
Leprosy reached its peak in the United States in the early 1980s before tapering out by the year 2000.
Over the last decade, the number of locally acquired cases has doubled in southeastern states, with Florida accounting for about a fifth of the cases reported nationwide.
Daniel M. Parker, PhD, an associate professor of population health and disease prevention in the program in public health at the University of California, Irvine, said it’s not entirely clear what’s driving the increase in cases in Florida.
Though the number of cases remains low in the country, the recent trend is concerning to public health experts.
“Globally, cases have been decreasing in recent decades, so this pattern is worrisome and may indicate some underlying public health or socioeconomic problems,” Parker told Healthline.
What’s behind the recent transmission of leprosy?
According to the CDC, transmission of leprosy is not fully understood.
It’s believed to predominantly spread through prolonged close contact with infected individuals, exposure to infected armadillos, and travel to leprosy-endemic countries.
In Florida, contact with armadillos, some of which are naturally infected with leprosy, can lead to disease.
“Leprosy has likely been endemic in Florida for several years if not longer as it is home to armadillos, which carry the bacteria,” said Amesh Adalja, MD, FIDSA, a senior scholar at the Johns Hopkins University Center for Health Security and an infectious disease expert.
But some people in Florida claim they’ve contracted the disease without zoonotic exposure, a term used to describe exposure to animals with the disease or travel to an area where leprosy is endemic.
“Contact tracing efforts have often left public health authorities stumped because many cases aren’t associated with contact with armadillos and some cases in the U.S.A. are occurring in areas where there are no armadillos,” said Parker.
Some health officials suspect international migration has contributed to non-zoonotic transmission in the U.S. Per the CDC report, the number of international migrants to North America jumped from 27.6 million people in 1990 to 58.7 million in 2020.
In addition, several of the patients who’ve contracted leprosy in Florida spent a lot of time outdoors, prompting local health officials to explore environmental reservoirs as another potential route of leprosy transmission.
“It is possible that there are other environmental reservoirs of the disease and studies are ongoing,” Parker said.
How to prevent leprosy
The overall risk of contracting leprosy is low.
The majority of people diagnosed with the disease acquired it through close, sustained contact — for months — with another individual who is infected.
“Many folks who live with, or work closely with, folks who have leprosy are able to remain disease-free,” Parker said.
According to Adalja, 95% of the human population is resistant to leprosy.
If you live with someone who has leprosy, it’s crucial to practice good hygiene and consult a healthcare provider as soon as possible.
Simply washing your hands before and after eating and keeping your hair, skin, and nails clean can significantly lower your risk.
Adalja’s best piece of advice, as of now, is to avoid contact with armadillos.
Here’s how we track and treat leprosy
Anyone diagnosed with leprosy in Florida is required to report it to their local department of health within one business day, according to the Florida Department of Health.
Contact tracing, which involves identifying people who may be infected, monitoring them for symptoms, and encouraging them to isolate or seek treatment when necessary, helps public health officials reduce the spread of diseases like leprosy.
A combination of antibacterial medications, which are highly effective, are used to treat leprosy.
Depending on the severity of the disease, the treatment may last up to six months or even a year, said Parker.
Prompt treatment can prevent disabilities from forming.
“Catching an infection early, beginning treatment early, and completing the treatment regimen can drastically reduce chances of severe outcomes,” Parker said.
The bottom line:
Cases of leprosy have been increasing in central Florida, so much so that the disease, known for causing nervous system issues and skin lesions, may now be endemic in the region. A new report from the Centers of Disease control and Prevention (CDC) is exploring new potential routes of transmission as some cases appear to be locally-acquired in Florida without traditional risk factors, such as prolonged exposure to an infected individual or armadillo.
