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Leprosy cases on the rise in Fla., CDC says

A recent report by the agency found that Central Florida accounts for nearly 20% of all cases in the country

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Lepromatous leprosy in a 54-year-old man in central Florida. Violaceous nonblanching macules coalescing into patches along dorsum of feet bilaterally. Erythematous papules coalescing into plaques along extensor aspects of upper and lower extremities bilaterally.

Centers for Disease Control and Prevention

By Hunter Boyce
The Atlanta Journal-Constitution

ATLANTA — Cases of leprosy in Central Florida are on the rise, concerning scientists whose work was recently published by the Atlanta-based Centers for Disease Control and Prevention (CDC). According to an Aug. 2023 report in the Emerging Infectious Diseases Journal (EID), leprosy may have reached endemic status in the U.S. Southeast.

Leprosy, also known as Hansen’s disease, is an infection caused by slow-growing bacteria that can affect nerves, skin, eyes and the lining of the nose. While once “feared as a highly contagious and devastating disease,” the CDC classifies leprosy as a slow spreading and easily treatable ailment. Left untreated, however, leprosy can cause nerve damage capable of crippling hands and feet, and causing paralysis and even blindness.

Cases of leprosy have been considered “historically uncommon” within the U.S., with cases dwindling year after year until around 2000. However, the recent EID report noted that leprosy cases experienced a gradual increase within the U.S. in the last two decades. The number of reported leprosy cases within southeastern states has more than doubled over the last decade alone. A total of 159 new cases were reported within the U.S. in 2020, and Central Florida accounted for nearly 20% of all cases.

One factor of interest to the report’s researchers is the origin of modern leprosy cases in Florida.

“Whereas leprosy in the United States previously affected persons who had immigrated from leprosy-endemic areas, ≈34% of new case-patients during 2015–2020 appeared to have locally acquired the disease,” according to the EID report. “Several cases in central Florida demonstrate no clear evidence of zoonotic exposure or traditionally known risk factors.”

“Further, reports from the Centers for Disease Control and Prevention show that, although the incidence of leprosy has been increasing, the rates of new diagnoses in persons born outside of the United States has been declining since 2002,” the EID report continued. “This information suggests that leprosy has become an endemic disease process in Florida, warranting further research into other methods of autochthonous transmission.”

The report, “Case Report of Leprosy in Central Florida,” is a Kansas City University-affiliated research letter completed by researchers Aashni Bhukhan, Charles Dunn and Rajiv Nathoo. In the letter’s abstract, the researchers stated that Florida’s rise in leprosy cases could spread throughout the Southeast.

“Florida, USA, has witnessed an increased incidence of leprosy cases lacking traditional risk factors,” according to the EID report. “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.”

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