Leprosy Cases Surge in Florida, Sparking Fears That the Disease Is Becoming Endemic

Leprosy cases have been rising once again in the US, most especially in Florida. This has left disease specialists concerned.

Leprosy

Leprosy is an infectious condition that can lead to disfiguring and severe skin sores, as well as nerve damage in the legs, arms, and all over the body. The condition has persisted since ancient times.

The disease mainly affects the skin and peripheral nerves, which are the nerves outside the spinal cord and brain. It may also affect the eyes and the thin lining of tissue within the nose.

Leprosy's main symptom is disfiguring bumps, lumps, or skin sores that do not leave even after a couple of weeks or months. Such sores are paler and flatter compared to the skin that surrounds them. Other symptoms include skin growths, swelling or lumps on the ears or face, and skin that is dry, thick, or stiff. Nerve damage can also result in loss of sensation in affected areas, vision issues, and muscle weakness.

As the disease progresses, more symptoms could surface. These include sores on foot soles that do not heal, loss of eyelashes or eyebrows, burning, redness, pain, blindness, hand and foot paralysis, shorter fingers and toes, or deformities in the feet, hands, and nose.

It typically takes roughly three to five years for symptoms to surface post-exposure to the infectious bacteria. In fact, for some individuals, they may only develop symptoms after 20 years. This period between exposure or contact with the bacteria and symptom manifestation is known as the incubation period. This long period of time makes it hard for specialists to know when and where a person got the infection.

Rising Leprosy Cases in Florida

The World Health Organization notes that each year, roughly 200,000 leprosy cases occur across 120 countries all over the world. Often, these cases are linked to contact with armadillos.

Now, the US has been seeing an upward trend as the infection count across the country has more than doubled in the last decade. This is observed among people who were and were not exposed to armadillos.

According to a 2023 report from the Centers for Disease Control and Prevention, the US saw 159 new leprosy cases in 2020, with one-fifth being from Florida. Among the cases in Florida, 81% were from the central area.

The report also notes that southeastern state cases have almost doubled in the last decade.

Francisca Mutapi, a professor of global health infection and immunity and the co-director of the University of Edinburgh's Global Health Academy, explains that Florida saw 10 leprosy cases each year from 2014 to 2002. This went up to 29 new cases in the year 2015. In 2023, there were 15 new cases.

Professor Mutapi explains that between 2019 and 2020, global detection rates plummeted. However, since then, rates have been rising. Part of the decline was attributed to the COVID-19 pandemic's impact on healthcare services.

While the number of cases since 2019 has been going up, the reported cases still do not exceed the ones that have been reported in 2019, with 202,166 new cases. This is in comparison to a 2022 WHO report that notes 174,087 cases.

With the growing number of cases seen in Florida, experts have been fearing that the condition is becoming endemic in the state. This would mean that it has a consistent and established presence in a particular geographic area or population, being observed regularly at a level that is relatively stable.

Professor Mutapi also notes that they do now know what drives the increased cases in Florida. There are studies that are underway in order to learn more about the transmission of the infections. It is possible that people may have gotten infected from other individuals with untreated leprosy or from a nine-banded armadillo, which is a natural host of the leprosy-causing bacteria.