According to a recent research letter shared by the Centers for Disease Control and Prevention (CDC), the number of leprosy cases in Florida, particularly in Central Florida, is on the rise. The authors of the letter warn that leprosy has become endemic in the southeastern United States, with an increased incidence of cases lacking traditional risk factors. In fact, the number of reported leprosy cases in southeastern states has more than doubled in the last decade.

This alarming trend highlights the need to consider travel to Florida when conducting leprosy contact tracing in any state. Previously, leprosy cases in the United States were mainly seen in individuals who had immigrated from leprosy-endemic areas. However, a significant percentage of new cases now appear to have locally acquired the disease. Of particular concern are the cases in central Florida, where many patients show no clear evidence of zoonotic exposure or traditionally known risk factors.

A case study presented in the research letter sheds light on this concerning situation. A 54-year-old man, a lifelong resident of central Florida and a landscaper by profession, was diagnosed with lepromatous leprosy in 2022. Seeking treatment for a painful and progressive rash, the man denied any recent travel, exposure to armadillos, contact with immigrants from leprosy-endemic countries, or connections with known leprosy patients.

While some cases in the South have been linked to zoonotic transmission from nine-banded armadillos, it is worth noting that many cases in eastern United States, including Georgia and central Florida, lack zoonotic exposure. The authors of the research letter suggest a potential link to international migration as a source of autochthonous transmission, although rates of new diagnoses in people born outside the U.S. have been declining since 2002.

In light of these findings, the authors call for further research into other methods of autochthonous transmission and the investigation of environmental reservoirs as potential sources of leprosy transmission in Florida. They emphasize that travel to the area, even without other risk factors, should prompt consideration of leprosy in the appropriate clinical context.

Leprosy, also known as Hansen's disease, is a chronic infectious disease that primarily affects the skin and peripheral nervous system. Historically uncommon in the United States, the incidence of leprosy has been gradually increasing in recent years. However, it is important to note that the disease is curable with antibiotics and is primarily spread through prolonged person-to-person contact or respiratory droplets.

The rising cases of leprosy in Florida, particularly in Central Florida, highlight the need for increased awareness and vigilance among healthcare professionals and the general public. Efforts should be made to identify potential sources of transmission and implement appropriate preventive measures to curb the further spread of this debilitating disease.