Leprosy cases in central Florida account for nearly 20% of national cases. What to know

Rising evidence is pointing to the possibility that leprosy has become endemic in the southeastern U.S. with Florida being named among the top reported states.

In a recently published research letter regarding emerging infectious diseases, the Centers for Disease Control and Prevention (CDC) said that Florida is witnessing an increase in leprosy cases lacking traditional risk factors and recommending that travel to Florida be considered when conducting leprosy contact tracing in any state.

Leprosy, which is scientifically known as Hansen's disease, is a chronic infectious disease that primarily affects the skin and peripheral nervous system.

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The number of reported leprosy cases across the country has doubled over the past decade, according to the CDC. Citing data from the National Hansen’s Disease Program, the CDC says there were 159 new cases reported in the U.S. in 2020. Nearly 70% of these new cases were reported in Florida, California, Louisiana, Hawaii, New York and Texas.

Florida stands out in the report for two reasons: Central Florida alone accounted for nearly 20% of the total number of cases reported nationally and several new-case patients in central Florida demonstrated no clear evidence of zoonotic exposure or traditionally known risk factors.

A 54-year-old man in central Florida was diagnosed with lepromatous leprosy in 2022.
A 54-year-old man in central Florida was diagnosed with lepromatous leprosy in 2022.

Hansen’s disease has never been common in the U.S., with most cases previously involving people who immigrated from leprosy-endemic areas. But the new report shows that about 34% of the reported cases between 2015 and 2020 were locally acquired.

The report concludes that a growing body of evidence suggests central Florida may represent an endemic location for leprosy and recommends that physicians consider leprosy in the appropriate clinical context in patients who have traveled to the area, even in the absence of other risk factors.

The CDC hopes that local physicians can help identify and reduce the spread of the disease through their efforts to report cases and their support in further research to assess routes of transmission.

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What is Hansen's disease (leprosy)?

Leprosy is a disease that primarily infects the skin and nerves in the skin, though it can sometimes infect other parts of the body like the lining in the airway passages of the nose, according to the Florida Department of Health. It has been around for thousands of years, with the earliest known records appearing in China and India around 600 B.C.

Despite its biblical description, the disease is not easily spread and about 95% of people have natural protective immunity, according to the FDOH. Leprosy can be easy to treat, especially if it’s addressed early. However, going without treatment can result in permanent nerve damage.

The disease is caused by Mycobacterium leprae, which is a slow-growing type of bacteria. It can often take years for signs and symptoms to develop following exposure because of this bacteria. Once the first sign of infection appears, it can take anywhere between two weeks to months for it to progress.

What are the signs and symptoms of leprosy?

Early signs of leprosy include pale or slightly red areas or rash on the body that is often associated with a loss of sensation in the affected area, according to the FDOH.

Other symptoms include:

  • Loss of feeling in hands and feet

  • Dry, stiff and sometimes painful skin in the affected area

  • Thinning of the eyebrows and eyelashes (if the face is involved)

  • Nasal congestion is sometimes reported

If the disease goes untreated, weakness in the muscles of the hands and feet can also occur.

Can leprosy be treated or cured?

Leprosy is a curable disease. Doctors prescribe antibiotics to patients with leprosy. Patients are typically no longer infectious after a few days of antibiotics, but the treatment lasts between one to two years due to the bacteria's slow growth.

Is leprosy contagious?

Leprosy is contagious and can be transmitted by untreated people infected with the disease, however, most people have natural protective immunity. Exposure to people infected with leprosy should still be avoided, especially among family members as protective immunity is genetic.

How is leprosy transmitted or contracted?

How leprosy is transmitted isn't fully known due to how uncommon it is. Scientists do know it's not spread through casual contact, sexual transmission or from mother to fetus. The prevailing theory is that high levels of the bacteria are developed in a person's nose and are spread to others not immune through prolonged contact.

Leprosy in armadillos

A genetic study conducted at the National Hansen's Disease Program found that armadillos in the southern U.S. develop a high number of M. leprae bacteria. Transmission between animals to humans is low, but the program advises that people still take proper precautions around armadillos.

Leprosy cases in Florida by county

This article originally appeared on Pensacola News Journal: Florida leprosy cases point to possible endemic. Here's what to know