Leprosy on the Rise: Florida Now an Endemic Zone, Says CDC

Did you know that leprosy, one of the world’s oldest diseases, was once so feared that those afflicted were banished to isolated colonies? While leprosy is now treatable and curable, this ancient malady is making an unexpected comeback in the Sunshine State. Florida has become a hotspot for leprosy cases in the United States, with Central Florida accounting for a significant portion of the nation’s reported infections.1

While leprosy remains rare in the U.S., Florida has seen a steady rise in cases over the past decade, many of which lack the traditional risk factors associated with the disease.

This puzzling trend has health experts searching for answers. What’s causing the resurgence of leprosy in Florida? Here’s what we know.

A Disease as Old as Time

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Leprosy has a long and complex history, with the earliest possible account dating back to 600 BC in India.(ref) Throughout much of world history, people with leprosy faced severe stigma and were often isolated in leper colonies.

In the Middle Ages, those with the disease had to wear special clothing and ring bells to warn others of their presence.

While leprosy is now curable with antibiotics, the social stigma persists in many parts of the world. This can lead to delayed diagnosis and treatment, as people may avoid seeking care due to fear of discrimination.

The Numbers Don’t Lie

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According to recent CDC data, Florida is becoming a hotspot for leprosy cases in the United States. In 2020 alone, Central Florida accounted for nearly one-fifth of the 159 cases reported nationwide

The state has seen a steady increase in cases over the past decade, with 81% of Florida’s cases occurring in the central region.

While leprosy is still relatively rare in the U.S., with an average of 150-250 new cases diagnosed each year, the concentration of cases in Florida is concerning. Globally, over 200,000 new cases are reported annually, with most occurring in India, Brazil, and Indonesia.(ref)

Risk Factors & Transmission

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Leprosy is caused by the slow-growing bacteria Mycobacterium leprae and Mycobacterium lepromatosis. The disease is transmitted through close and prolonged contact with untreated cases, particularly those with the multibacillary form of the disease.

In the U.S., most cases occur in immigrants from countries where leprosy is more common. However, the nine-banded armadillo, which can carry the bacteria, has also been implicated in transmission, particularly in the southern states.

Other risk factors include age (highest risk between 5-15 years and over 30), genetic susceptibility, and immunosuppression. Poor hygiene and malnutrition may also play a role in endemic regions.

A Mysterious Trend

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What’s puzzling health experts is that many of the new cases in Florida lack the traditional risk factors associated with leprosy. A significant portion has no history of international travel, contact with armadillos, or exposure to known cases, suggesting the possibility of undetected local transmission.

Researchers are working to understand these unusual cases and identify potential sources of infection. Theories range from environmental reservoirs to possible animal-to-human transmission beyond armadillos

As more cases emerge, the pressure is on to find answers and halt the spread.

Symptoms & Diagnosis

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Leprosy primarily affects the skin, peripheral nerves, upper respiratory tract, and eyes. Symptoms can take 5-20 years to appear after infection and may include:

  • Skin lesions that are lighter or reddish in color
  • Numbness or loss of sensation in affected areas
  • Muscle weakness or paralysis (especially in hands and feet)
  • Eye problems that can lead to blindness

Diagnosis involves a clinical exam, skin biopsy, and other tests. However, the rarity of the disease in the U.S. can lead to delayed recognition and misdiagnosis.

Treatment & Prognosis

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The good news is that leprosy is curable with multidrug therapy (MDT), which includes antibiotics like dapsone, rifampicin, and clofazimine. Treatment usually lasts 6-12 months for paucibacillary leprosy and 12-24 months for multibacillary leprosy.

Early diagnosis and treatment are critical to prevent permanent nerve damage and disability. When treated promptly, the prognosis is excellent, and most people can lead normal lives.

However, the stigma surrounding leprosy can be a barrier to care, even in the U.S. Patients may face isolation and discrimination, making it harder to access treatment and support.

A Call to Stay Informed

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As Florida grapples with this new endemic threat, it’s important for residents to stay informed and vigilant. If you notice any unusual skin changes or numbness, don’t hesitate to see a doctor.

With increased awareness and early intervention, we can fight back against leprosy and protect our communities.

Source:

  1. Emerging Pathogens Institute
Martha A. Lavallie
Martha A. Lavallie
Author & Editor | + posts

Martha is a journalist with close to a decade of experience in uncovering and reporting on the most compelling stories of our time. Passionate about staying ahead of the curve, she specializes in shedding light on trending topics and captivating global narratives. Her insightful articles have garnered acclaim, making her a trusted voice in today's dynamic media landscape.