Leprosy possibly spreading in Florida: Key details
The Centers for Disease Control and Prevention Raises Concerns About Rising Cases of Leprosy in Florida
The Centers for Disease Control and Prevention (CDC) recently published a research letter sounding the alarm about the increasing cases of leprosy in Florida. Epidemiologists, after reviewing the most recent data from 2020, are worried that this skin and neurological disease is becoming endemic in certain parts of Florida, potentially spreading across the Sunbelt.
“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,”
Here is what you need to know about this emerging public health threat:
What is happening in Florida?
In 2020, the leprosy cases in central Florida accounted for one-fifth of the 159 new cases of the disease in the U.S. The central part of the state alone contributed to 81% of the total cases in Florida.
While leprosy is extremely rare in the U.S., most cases are either acquired through foreign travel to endemic areas or by contact with infected animals. However, approximately 34% of the leprosy cases in Florida were locally acquired, indicating that the disease is becoming endemic in certain parts of the state.
What is leprosy, and how is it spread?
Leprosy, also known as Hansen’s disease, manifests through painful skin lesions and peripheral nerve damage. If left untreated, it can lead to paralysis, chronic ulcers, blindness, and permanent nerve pain. The disease is treatable with a three-drug antibiotic combination.
While there may be zoonotic transmission from armadillos in some parts of the South, the primary mode of leprosy spread is through respiratory droplets. Casual contact, such as shaking hands or hugging, does not transmit the disease. Infected individuals stop transmitting the disease shortly after treatment.
What is the role of migration?
The research letter suggests that international migration may be a contributing factor to the increasing leprosy cases in the U.S., which have risen alongside immigration rates. The authors note that while the incidence of leprosy has been increasing, the rates of new diagnoses in foreign-born individuals have been declining since 2002. The rise in international migrants in North America may explain the increase in leprosy incidence in historically nonendemic areas.
Although there is little evidence for animal-to-human spread in Florida, the theory of international migration as a potential source of native transmission is supported.
What is the public health response?
The Florida Department of Health has not yet responded to inquiries regarding the research letter or the most recent numbers. However, medical practitioners are required to report leprosy cases within one business day to facilitate contact tracing and contain the outbreak.
Contact tracing plays a critical role in identifying sources and reducing transmission. By increasing efforts to report incidence and supporting further research on transmission routes, a concerted effort can be made to identify and reduce the spread of the disease.
The World Health Organization emphasizes that case detection and treatment alone are insufficient to interrupt transmission.
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