The U.S. Centers for Disease Control and Prevention (CDC) says cases of the infectious disease of leprosy have become more common in Florida in recent years, and some health officials believe that the ancient disease may now be endemic in the state.
The federal health agency stated in a report that about one-fifth of all leprosy cases in the United States are found in central Florida and that about 81 percent of all cases in the country are located in Florida.
Leprosy, a chronic infectious disease also known as Hansen’s disease, is caused by the Mycobacterium leprae bacteria and has appeared in literature and religious texts—notably the Bible—since ancient times. It affects the skin, peripheral nerves, mucosa of the upper respiratory tract, and the eyes.
Within the United States, leprosy has historically been uncommon, and most cases came from individuals who had recently emigrated to the country. But since 2000, cases have gradually been rising, doubling in the Southeastern United States over the past decade, according to the CDC.
It also noted that about 34 percent of all cases reported from 2015 to 2020 have been locally transmitted.
“Florida, USA, has witnessed an increased incidence of leprosy cases lacking traditional risk factors. Those trends, in addition to decreasing diagnoses in foreign-born persons, contribute to rising evidence that leprosy has become endemic in the southeastern United States. Travel to Florida should be considered when conducting leprosy contact tracing in any state,” the CDC stated in its latest report.
The agency stated that some cases in central Florida had “no clear evidence of zoonotic exposure or traditionally known risk factors,” noting that there was a reported case of lepromatous leprosy in central Florida in a man who didn’t have “risk factors for known transmission routes.”
The CDC is warning doctors to investigate leprosy when examining individuals who have traveled to Florida or elsewhere in the Southeastern United States.
The Florida Department of Health requires medical practitioners to report leprosy in Florida by the next business day, according to the CDC. It noted that contact tracing is also critical so as to identify sources and reduce its transmission.
“In our case, contact tracing was done by the National Hansen’s Disease Program and revealed no associated risk factors, including travel, zoonotic exposure, occupational association, or personal contacts,” it stated. “The absence of traditional risk factors in many recent cases of leprosy in Florida … who spend a great deal of time outdoors, supports the investigation into environmental reservoirs as a potential source of transmission.”
The report comes weeks after the CDC issued an alert about locally transmitted malaria in Florida. Malaria is caused by the Plasmodium parasite and is spread via certain types of mosquitoes.
“It is not known exactly how Hansen’s disease spreads between people. Scientists currently think it may happen when a person with Hansen’s disease coughs or sneezes, and a healthy person breathes in the droplets containing the bacteria,” the agency stated. “Prolonged, close contact with someone with untreated leprosy over many months is needed to catch the disease.”
Signs and Symptoms
While communities used to shun people with leprosy in so-called leper colonies, the bacteria can be treated with antibiotics if caught early, officials said. Most cases are spread from person to person, but there are instances when it spreads from zoonotic contact, namely from armadillos.
Officials say that in the southern United States, armadillos can be infected with the bacteria. It can be spread to people that come into contact with the animals.
Leprosy occurs when the bacteria attacks the nerves. The nerves can then become swollen under the skin.
“This can cause the affected areas to lose the ability to sense touch and pain, which can lead to injuries, like cuts and burns. Usually, the affected skin changes color,” the CDC stated.
Some who develop advanced cases can lose fingers, toes, and limbs or can appear disfigured in other ways.
Health officials report that it’s most common in people aged 5 to 15 and those older than the age of 30. More than 95 percent of people who are infected with the Mycobacterium leprae bacteria never develop the disease, as their immune systems can fight it off.
Symptoms of the infection include painless wounds on the hands and feet, muscle weakness, and skin patches. There’s also a numbness or tingling in the hands, feet, arms, and legs, according to health officials.
The disease can develop slowly, making it difficult to pinpoint the cause and can make it hard to treat early. Antibiotics can generally treat the bacteria, although permanent damage can be done if not treated early.
The World Health Organization says more than 200,000 new cases are reported each year in more than 120 countries, while CDC data show that some 150 people are infected with the bacteria in the United States every year.