Leprosy may be endemic in Florida. Because the disease is not highly contagious, your patients do not need to avoid the state.
Key Takeaways
Leprosy may be endemic in Florida.
The infection, which is not easily transmissible between humans, can cause nerve and skin damage.
People with symptoms of leprosy should be quickly referred to treatment for best results.
People do not need to avoid Florida because of this news.
Leprosy may be endemic in Florida, according to a new report. The report, published in the Center for Disease Control and Prevention’s (CDC) journal, Emerging Infectious Diseases, points to growing numbers of leprosy cases in Florida and a lack of knowledge of foreign sources of transmission as reasons to infer a leprosy endemic in the sunshine state. Data presented in the report shows that Florida—specifically Central Florida—has contributed to a high number of US leprosy infections over the last few years and held the highest number of US leprosy infections in 2020.
Leprosy has existed since biblical times and causes infections that can persist for one to two years (with treatment), often causing scarring and nerve damage that can be long-lasting. Leprosy is not, as once believed, easily transmissible between humans, and infected people do not need to isolate themselves from others. Despite the rise in cases, doctors discourage fear-mongering or unnecessary alarm.
“Interest and awareness are appropriate, but concern is certainly not warranted for this," says Charles Bailey, MD, the medical director for infection prevention at Providence Mission Hospital and Providence St. Joseph Hospital in Orange County, California. Dr. Bailey adds that the new report may help raise awareness for treatment and provide “an opportunity to clear the air about what leprosy is and is not.”
What is leprosy, and how does it spread?
Also known as Hansen’s disease, leprosy is caused by a Mycobacterium leprae (M. leprae) infection. When contracted, this infection can induce nerve damage and swelling of the skin. People may also experience a scaly, discolored rash that can be numb, according to the CDC.[]
The ways in which M. Leprae spreads are still under investigation. Researchers say leprosy is most commonly transmitted through “prolonged person-to-person contact with respiratory droplets.” Because prolonged contact is necessary, this does not mean that a person diagnosed with leprosy poses an immediate threat to the general public, says Dr. Bailey. People with leprosy generally do not need to quarantine or isolate themselves from others, and people without the disease do not need to avoid those with it, he adds.[]
People may also be able to catch leprosy from wild animals, such as armadillos, although this connection has not been firmly established. Research has found that some armadillos in the United States carry the same strain of leprosy detected in humans. Whether that means armadillos give humans the infection, humans give armadillos the infection, both, or neither, is unclear.[]
People most commonly contract the infection when living in or traveling to areas where the disease is endemic—which now may include Florida.[]
Contract tracing of leprosy in any state, which can be conducted to pin down the source of the infection, should now consider whether people with the disease traveled to Florida, according to the report.[]
How to intervene if someone has leprosy
Leprosy may be first identified by its signature rash but can be more affirmatively diagnosed through a skin or nerve biopsy.[]
People diagnosed with leprosy can be prescribed a series of antibiotics to help cure the disease. A combination of two or three medications, dapsone with rifampicin, and/or clofazimine, is a typical line of treatment, according to the CDC. Treatment can be necessary to ward off long-term damage such as crippling hands or feet or paralysis. Further, to help patients heal properly, it is important to encourage them to take their full course of antibiotics and not stop if they start to feel better.[]
“It's not a seven to 10-day course of something,” Dr. Bailey explains. “It's a prolonged course, and the response can be relatively slow to the treatment, but it is effective.”
He adds that, unfortunately, not all of the damage from leprosy can be reversed through treatment. Some people may have permanent nerve damage or scarring.
Can people travel to Florida?
The findings do not necessitate travel restrictions to Florida, says Dr. Bailey. (And neither the CDC nor other health agencies have recommended any sort of travel ban to Florida.) However, the report does recommend that travel to Florida be considered in data collection for contact tracing purposes.
“I'd hate to think of anybody in that area changing their lifestyle to avoid this when the risk is so minimal,” says Dr. Bailey. For anyone who does contract leprosy, he adds that while the treatment is not quick or easy, it exists and can be effective.
People undergoing treatment don’t require isolation and should not be stigmatized, he adds.
“For the most part, other than their close friends and family, or other acquaintances, the general public would be unaware that they even have the disease,” Dr. Bailey says.
What this means for you
Leprosy may be endemic in Florida. Patients with disease symptoms should be referred to treatment immediately for best results. People do not need to avoid Florida based on the news.