'%20x='0'%20y='0'%20height='100%25'%20width='100%25'%20%0A%20%20%20%20%20%20%20%20%20%20xlink%3Ahref='data:image/jpg;base64,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'%3E%3C/image%3E%3C/svg%3E)
Recent reports indicate that leprosy is on the rise in Southeast USA, specifically in Central Florida. The Sunshine State faces the threat of the disease, generally uncommon in the United States, materializing into an endemic. According to the CDC, Central Florida accounted for nearly 1/5th of the total cases reported in the country.
In a recently published research letter, the CDC also stated that the number of leprosy cases in the southeastern states had doubled over the last decade. The disease, which is difficult to diagnose at the beginning due to a long development cycle, is treatable via antibiotics but can cause permanent nerve damage.
A research letter by the CDC, originally published on July 11, 2023, warned the public about the gradual increase of leprosy in the United States. The letter pointed out that during the last decade, the number of cases had doubled in the southeastern states.
"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. Central Florida, in particular, accounted for 81% of cases reported in Florida and almost one fifth of nationally reported cases."
Previously, the disease had only affected those who immigrated to the United States from leprosy-ridden areas, but during the 2015-2020 time period, 34% of those affected in the country are alleged to have locally acquired the disease. On a worrying note, the letter claimed:
"Several cases in central Florida demonstrate no clear evidence of zoonotic exposure or traditionally known risk factors."
Leprosy and its symptoms
According to the CDC, leprosy, also known as Hansen's disease, is "a chronic infectious disease caused by the acid-fast rod Mycobacterium leprae." It primarily affects the skin and peripheral nervous system. The CDC states:
"The disease can affect the nerves, skin, eyes, and lining of the nose (nasal mucosa). The bacteria attack the nerves, which can become swollen under the skin. This can cause the affected areas to lose the ability to sense touch and pain, which can lead to injuries, like cuts and burns. Usually, the affected skin changes color."
The affected skin changes color and either becomes "lighter or darker," "dry or flaky," and may be accompanied by a "loss of feeling" or a reddish hue due to skin inflammation.
If left untreated, the disease can have drastic effects. The resultant nerve damage would lead to paralysis of the hands and feet. The lack of sensation would result in multiple injuries, and, eventually, the reabsorption of affected digits, thereby causing an "apparent loss of toes and fingers."
Some of the other signs include Corneal Ulcers, and blindness, due to the disease affecting the facial nerves. It may also lead to the loss of eyebrows, and damage the nasal septum, which is likely to result in Saddle-nose deformity. Skin patches and numbness of the hands are also common symptoms of leprosy.
Although the exact mode of transmission is unclear, the most widely recognized transmission method of the disease is person-to-person contact through "respiratory droplets." The disease can also spread through armadillos, although animal-to-human transmission is on the lower side.
Early diagnosis and treatment prevent the more drastic effects of the disease, and patients can still lead an active normal life. The CDC informs:
"Once treatment is started, the person is no longer contagious. However, it is very important to finish the entire course of treatment as directed by the doctor."
The CDC, also further states that the disease depends on the person's susceptibility to leprae. According to FDOH, about 95% of the population has a natural protective immunity against the disease.
CDC case study reveals worrying details
The abstract of the July 11, CDC letter reads:
"Florida, USA, has witnessed an increased incidence of leprosy cases lacking traditional risk factors."
It further states:
"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. Travel to Florida should be considered when conducting leprosy contact tracing in any state."
The letter studied the case of a 54-year-old patient from Florida, who developed the disease without being exposed to known transmission routes. According to the case study:
"He denied any domestic or foreign travel, exposure to armadillos, prolonged contact with immigrants from leprosy-endemic countries, or connections with someone known to have leprosy."
Furthermore,
"He has resided in central Florida his entire life, works in landscaping, and spends long periods of time outdoors."
Through contact tracing done by the National Hansen’s Disease Program, it was revealed that this particular case lacked contact with any of the traditional risk factors like "travel, zoonotic exposure, occupational association, or personal contacts." This was the case with most cases in the state, thereby triggering an investigation into "environmental reservoirs" as a potential transmission source.
