Leprosy may be endemic in central Florida, scientists report

Why it matters: The disease can be treated if doctors recognize it.

Leprosy, also known as Hansen’s disease, is caused by slow-growing bacteria called Mycobacterium leprae. About 95 percent of people are genetically resistant to the bacteria.

There were 159 new cases in 2020, the most recent year for which national data is available. New cases are most commonly reported in Florida, California, Louisiana, Hawaii, New York and Texas. Central Florida accounts for 81 per cent of the cases reported in that state.

The bacteria are believed to be transmitted by droplets from the nose and mouth of an infected patient, but only after close, sustained contact. Armadillos famously carry the bacteria, and humans can become infected by contact with the animals.

Caught early enough, leprosy can be cured with standard antibiotics taken over a year. Treatment can make patients non-infectious within a week.

But left untreated, the bacteria can damage nerves and lead to permanent disabilities, including paralysis and blindness. The physical changes associated with the disease can also lead to ongoing stigmatization and isolation of infected people.

“The fact that this patient had never traveled outside of the state of Florida was something that we just wanted to bring to the attention of the clinicians and physicians that are in the area,” said Dr. Rajiv Nathoo, dermatologist and senior author in the field. examination.

Here’s what it looks like: Striking symptoms can take decades to develop.

M. leprae can damage the skin, peripheral nerves, upper respiratory tract and eyes.

The disease starts with either discolored, numb spots on the skin or with small nodules underneath. Early symptoms can easily be confused with other skin diseases such as psoriasis or eczema. Symptoms can develop as many as 20 years after exposure, making diagnosing the disease even more challenging.

Untreated, the bacteria slowly destroys nerves and muscles, leading to striking deformities of the hands and feet, sometimes referred to as claw hands and hammertoes.

The disease was first described thousands of years ago. Although it may seem like a thing of the past, around 200,000 new infections continues to emerge worldwide each year, with a majority in Southeast Asia and India, according to the World Health Organization.

Eliminating the disease in some countries like India has proven much more challenging than public health officials expected.

What Scientists Don’t Know: How Some Matters Are Acquired.

Scientists have identified another type of bacteria that leads to leprosy. Both pathogens are close cousins ​​of the bacteria that cause tuberculosis.

None of these bacterial species can be easily cultured in the laboratory, leaving many questions unanswered about the transmission and progression of the disease.

New cases of leprosy were often diagnosed in people who had traveled to other parts of the world. But since 2015, more than a third of the cases in the United States have been acquired locally.

Many new patients report no travel or contact with armadillos that would explain their infection, according to the researchers.