“Whereas leprosy in the United States previously affected persons who had immigrated from leprosy-endemic areas, [about] 34% of new case patients during 2015–20 appeared to have locally acquired the disease,” the CDC said.
The CDC said the data represented “mounting epidemiological evidence supporting leprosy as an endemic process in the south-eastern United States”.
Nationally, the number of reported leprosy cases in the US fell from 2019 to 2020, according to the federal Human Resources and Services Administration. The increase in central Florida, however, represents a new cause for concern.
“Travel to this area, even in the absence of other risk factors, should prompt consideration of leprosy in the appropriate clinical context,” the CDC said.
Leprosy, which is spread by moisture droplets passed through the air, can lead to serious disabilities, including nerve damage, if left untreated. However, the disease is curable with medication, and damage can be prevented if leprosy is diagnosed in time.
The CDC cited the case of a 54-year-old man who lives in central Florida. The man had not traveled domestically or internationally, had not had “prolonged contact with immigrants from leprosy-endemic countries”, and had denied exposure to armadillos, which are known to carry the disease.
The man, who has since been treated for leprosy, worked in landscaping, the CDC said, “and spends long periods of time outdoors”.
“The absence of traditional risk factors in many recent cases of leprosy in Florida, coupled with the high proportion of residents, like our patient, who spend a great deal of time outdoors, supports the investigation into environmental reservoirs as a potential source of transmission,” the CDC said.