Leprosy, a bacterial infection caused by Mycobacterium leprae and M. lepromatosis, is becoming increasingly common in the southeastern United States. A 54-year-old Florida resident has been diagnosed with leprosy, contributing to an increase in the number of cases identified in the region. This follows a recent report by the US Centers for Disease Control and Prevention (CDC) of the first cases of indigenous malaria infections in the US in two decades, with four cases reported in Florida.
Leprosy has been on the rise in the southern U.S. since 2000, and the number of reported cases in the southeastern states has more than doubled in the past decade. Central Florida now accounts for nearly one-fifth of all leprosy cases in the United States. This alarming trend, along with the decreasing proportion of cases diagnosed in people born outside the country, suggests that leprosy has become endemic to the southeastern United States.
Leprosy, also known as Hansen’s disease, is a curable but neglected tropical disease that is still prevalent in more than 120 countries. Approximately 150 cases of leprosy are reported in the United States each year. Although most cases involve individuals who have traveled from countries where leprosy is prevalent or endemic, there has been an increase in cases without typical risk factors.
According to dermatologists who alerted health officials to the diagnosis of the Florida man, these trends indicate that leprosy is becoming a serious problem in the southeastern United States. Researchers highlight other risk factors, such as contact with armadillos, which are known carriers of the bacteria, and prolonged contact with untreated leprosy patients.
However, the 54-year-old man had not traveled recently, nor had he been in contact with known leprosy patients or armadillos. He works as a landscaper and spends a significant amount of time outdoors, raising concerns about possible reservoirs of the disease in the environment. The man was admitted with a painful rash and skin lesions that started on his legs and arms but then spread to his trunk and face. A biopsy confirmed the diagnosis and health officials were immediately notified.
The case of this Florida man, as well as other cases of local leprosy reported between 2015 and 2020, underscore the need for increased efforts to detect and reduce the spread of the disease in central Florida. Researchers are eager to explore possible reservoirs of the bacteria in the environment, as leprosy transmission appears to be more complex than previously thought.
In a recent systematic review analyzing leprosy transmission data from 1945 to 2019, researchers emphasized the need for further research and increased reporting efforts to combat the spread of leprosy. Understanding transmission routes and identifying potential reservoirs will enable concerted efforts to control and prevent further spread of this once neglected disease.
