Amidst an alarming surge in leprosy cases in Florida, the U.S. Centers for Disease Control and Prevention (CDC) have issued a warning stating that the disease may be becoming endemic in the region. Travelers heading to central Florida in the southeastern United States should be aware of the potential risk of transmission, as advised by the CDC. According to a report published by the CDC on Monday, there has been an increase in leprosy cases in Florida that lack traditional risk factors, along with a decrease in diagnoses in foreign-born individuals. This indicates that leprosy may have become endemic in the southeastern United States. The CDC recommends considering travel to Florida when conducting leprosy contact tracing in any state. Florida reported 159 new cases of leprosy in 2020, making it one of the top reporting states in the country.
Leprosy, also known as Hansen’s disease, is an ancient infectious disease caused by the bacteria Mycobacterium leprae, which affects the skin and nerves. The bacteria grow very slowly and may take up to 20 years to manifest after initial infection. They attack the nerves, leading to swelling under the skin and loss of sensation in the affected areas. If left untreated, leprosy can result in paralysis of the hands and feet. Leprosy is not highly contagious, and the exact mode of transmission is not well understood. The CDC suggests that transmission may occur when an infected person coughs or sneezes, and a healthy person inhales the droplets containing the bacteria. However, prolonged and close contact with an untreated leprosy patient over several months is needed to contract the disease.
If detected early, leprosy can be cured with antibiotics. While rare, cases of leprosy have been reported in Canada, including in Ontario. The number of imported cases per year is very small, with only one reported case in 2021. The CDC states that historically, leprosy has been rare in the U.S. The peak occurrence was in 1983, followed by a significant decline in the number of cases until 2000. However, since then, there has been a gradual increase in leprosy cases, with more than twice the number of reported cases in the southeastern states over the past decade. The notable difference is that a significant portion of new cases from 2015 to 2020 seemed to have contracted the disease locally, raising concerns about transmission within the U.S.
The CDC’s report highlighted a case of a 54-year-old man living in central Florida who became sick with leprosy without any risk factors for known transmission routes. This suggests that there may be environmental reservoirs as a potential source of transmission. The CDC emphasizes that although the incidence of leprosy has been increasing, the rates of new diagnoses in individuals born outside the U.S. have been declining since 2002. This indicates that leprosy has become an endemic disease process in Florida. The CDC advises considering leprosy in the appropriate clinical context when traveling to the affected area in Florida.