On the heels of warnings that malaria cases have been identified in Florida for the first time in decades, the Centers for Disease Control and Prevention issued another advisory for the state this week.
According to the CDC’s Emerging Infectious Diseases journal, a spike in leprosy cases have been confirmed in the Sunshine State and across the region.
While there are rare occurrences of leprosy — also known as Hansen’s disease — across the U.S., the latest warning cites “rising evidence that leprosy has become endemic in the southeastern United States.”
The number of confirmed cases plummeted throughout the 1980s and 1990s, but diagnoses have ticked back up during the first two decades of the 21st century.
Furthermore, the CDC advises that the rise in Florida cases come without “traditional risk factors.”
Central Florida appears to be the epicenter of the outbreak, with about 81% of the cases reported statewide originating in that area. About one-third of all patients who acquired the disease between 2015 and 2020 were believed to have been infected locally.
As a result, the CDC journal advised: “Travel to Florida should be considered when conducting leprosy contact tracing in any state.”
“Rising evidence is pointing to the possibility that leprosy has become endemic in the southeastern U.S. with Florida being named among the top reported states.” https://t.co/srV7DEGCrM
— David Wallace-Wells (@dwallacewells) July 29, 2023
Dr. Rajiv Nathoo of Orlando recalled the biopsy he analyzed for one patient who complained about a spreading rash, describing the leprosy diagnosis as something “you read in your textbooks.”
Nevertheless, he said that the overall number of cases has not reached a point at which Americans should be particularly alarmed.
“It’s really rare still,” the doctor said. “These numbers are still relatively super low here. We’re not that concerned with it.”
Proper diagnosis remains a major hurdle in addressing such outbreaks since the disease is rare and its symptoms advance slowly. Cases can only be confirmed via biopsies, but common symptoms include nerve damage and numbness as well as skin issues including discolorations, growths, dry skin, foot ulcers, facial swelling, and eyebrow or eyelash loss.
As Linda Adams of the National Hansen’s Disease Program Laboratory Research Branch explained: “Leprosy is here in the United States. It’s very low incidence and a very low endemic country, but it is here.”
