Leprosy may now be endemic in Florida, report suggests

Cases of leprosy have increased in Florida and the southeastern United States over the past decade, according to a new reHarbor.

Leprosy, officially called Hansen’s disease, is a rare type of bacterial infection that attacks the nerves and may cause swelling under the skin. The new research paper, published in the Centers for Disease Control and Prevention’s Journal of Emerging Infectious Diseasesfound that reported cases have doubled in the Southeast over the past 10 years.

Central Florida, in particular, has seen a disproportionate share of cases, indicating that it may be an endemic site for the disease, meaning that leprosy has a consistent presence in the region’s population rather than appearing as one-off outbreaks.

“According to the National Hansen’s Disease Program, 159 new cases were reported in the United States in 2020; Florida was among the top reporting states,” the report states. “Central Florida, in particular, accounted for 81% of reported cases in Florida and nearly one-fifth of nationally reported cases.”

Although leprosy can be spread from person to person, it is not known exactly how. The disease is not spread through casual physical contact such as shaking hands or sitting next to someone on the bus, according to the CDC. Rather, the researchers’ current thinking is that the bacteria are transmitted via droplets from an infected person’s cough or sneeze during an extended period of close contact.

Contact with armadillos, some of which are naturally infected with leprosy-causing bacteria, can be another way people can get sick.

The recent report described a particular case of leprosy in Florida: a 54-year-old landscaper who had no known contact with infected animals or humans and had not traveled to any countries where the disease is more common.

There have been 15 cases of leprosy in Florida this year, the majority of which were in Brevard County, according to NBC affiliate WESH.

Dr. Nicole Iovine, senior hospital epidemiologist and an infectious disease physician at the University of Florida, told WESH that leprosy can sometimes present as a rash with pigmented, scaly skin lesions. A person may also have disfiguring nodules on the face and hands.

The main difference between the rash and leprosy is the loss of sensation in the affected area, she said.

“If you have something like a few inches on your arm and you can’t feel it, that’s going to be different than a typical rash, which is going to be itchy,” Iovine told WESH.

The authors of the new report suggested that doctors and other health professionals should consider leprosy as a potential diagnosis for patients who have spent time in Central Florida.

“Travel to this area, even in the absence of other risk factors, should prompt consideration of leprosy,” the report said.

Leprosy is treatable—patients typically take a combination of two or three antibiotics for one to two years. Untreated, nerve damage from the infection can lead to paralysis and paralysis of a person’s hands and feet. Damage that occurred before the start of treatment cannot be restored.