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History -

Leprosy has been a troubling presence in civilizations for millennia, with its presence documented as far back as the second millennium BCE.

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Timeline -

A recurring theme in biblical parables, leprosy remained widespread from ancient times through the mid-20th century. 

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Lack of treatment -

With few treatment options available, the bacteria could invade the body, leading to severe physical deformities like disfigured hands and feet.

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Knowledge gap -

Limited medical understanding often led the public to misidentify a wide range of debilitating skin conditions, including skin cancers and severe fungal infections, as leprosy, causing unnecessary fear and stigma.

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Isolation treatment -

The historical practice of isolating leprosy patients often led to the establishment of dedicated cemeteries. In 2021, the discovery of approximately 400 skeletons in one such cemetery underscored the profound impact of this disease throughout history.

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Still present -

This significant archaeological find served as a poignant reminder that while leprosy has been largely eradicated in many parts of the world, it tragically continues to affect vulnerable populations in others.

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Ongoing challenge -

According to World Health Organization (WHO) data, Brazil, India, and Indonesia have each reported over 10,000 new cases of leprosy since 2019, while more than a dozen other countries have seen between 1,000 and 10,000 new cases during the same period.

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Risk factors -

Historically, countries with leprosy have faced heightened risks due to factors like zoonotic exposure—the transmission of diseases from animals to humans—and societal disparities.

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Leprosy in the US -

Contrary to popular belief, leprosy is not a relic of the past or confined to impoverished tropical regions. This ancient disease is re-emerging in unexpected places, including parts of North America.

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Leprosy in the US -

In fact, leprosy cases are steadily increasing in the southeastern United States, highlighting the ongoing need for vigilance and effective treatment.

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Hardest hit state -

Notably, Florida had a significant number of cases, with Central Florida alone accounting for a staggering 81% of the state's total and nearly one-fifth of all reported cases nationwide.

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Nationwide -

In 2020, the National Hansen's Disease Program reported 159 new leprosy cases across the United States. 

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Surge in cases -

Until 2010, Florida saw 67 reported leprosy cases, with Miami-Dade County leading the count with 20 infections. However, the following decade witnessed a dramatic surge, with the state recording over twice as many cases—176 in total. This shift saw Brevard County emerge as the new epicenter of the disease in Florida.

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Domestic transmission -

A startling finding in Brevard County was that at least 25% of leprosy cases were acquired locally, suggesting domestic transmission. 

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Domestic transmission -

While India, Brazil, and Indonesia remain global hotspots, reporting over 135,000 cases combined in 2022, these local infections in Brevard County raised concerns.

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Experts confirm -

As Barry Inman, a former epidemiologist at the Brevard Health Department, explained, people were contracting the disease despite having no travel history to endemic regions or known contact with infected individuals.

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Potential cause -

US dermatologists have observed a link between leprosy cases and contact with armadillos. Some patients reported handling these animals or spending time in areas armadillos are known to inhabit.

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Armadillo population -

Florida is home to an estimated population of over one million armadillos, according to the University of Florida's Department of Large Animal Clinical Sciences.

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Infection stats -

While the exact percentage of infected armadillos remains unknown, a 2015 study examining over 600 armadillos across Alabama, Florida, Georgia, and Mississippi revealed that approximately 16% showed signs of leprosy infection.

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Infecting humans -

As armadillos forage for food, they may shed soil bacteria into the environment. These bacteria can then be transmitted to amoebas, which may in turn infect humans.

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Other suspects -

Leprosy experts are investigating potential insect vectors, with blood-sucking ticks emerging as a possible culprit based on laboratory research. 

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Investigation -

As some infected individuals had limited or no contact with armadillos, "there is likely another source of transmission in the environment," noted Norman Beatty, assistant professor of medicine at the University of Florida.

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What causes leprosy? -

Leprosy, also known as Hansen's disease, is caused by bacterial infection. While historically attributed to Mycobacterium leprae, scientists identified a second causative agent, Mycobacterium lepromatosis, in 2008.

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Consequences -

The chronic infectious disease primarily affects the skin and nerves. Left untreated, the bacteria responsible for this condition can multiply, causing significant damage that can extend beyond the skin.

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Consequences -

When the disease affects nerves and other parts of the body, it can lead to blindness, and severe disabilities such as claw-hand deformity, where fingers and thumbs become permanently curled.

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Severe cases -

In cases of severe, untreated leprosy, patients may experience tissue damage that can lead to the loss of limbs or other body parts.

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Not that easy -

Leprosy is contagious and it can spread from person to person. However, it's crucial to understand that catching leprosy requires prolonged and close contact with an infected individual. For example, a few hours of proximity would be highly unlikely to transmit the disease.

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Hard to catch -

In addition to leprosy not being easily transmitted, the US Centers for Disease Control and Prevention (CDC) states that about 95% of people are immune to the bacteria responsible for the disease.

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Is there a cure? -

Leprosy is curable with antibiotics, but early treatment is key. While antibiotics eradicate the bacteria, they cannot reverse existing nerve damage. Seeking medical attention promptly upon noticing any potential symptoms and reporting possible exposure risks is crucial to minimize long-term complications.

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Symptoms -

Early symptoms, which can include a rash, skin discoloration, numbness, and eye sensitivity, may often be mistaken for other conditions. However, leprosy has a long incubation period, meaning symptoms can take years, even decades, to appear after initial infection.

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Prevention -

If you notice any skin changes, consult a dermatologist. If other symptoms occur, also see a physician. Avoid contact with armadillos and steer clear of areas and activities where they may be present, such as gardening in known armadillo habitats.

Sources: (US Centers for Disease Control and Prevention) (WUSF) (American Academy of Dermatology) (The Conversation) (Emerging Pathogens Institute
University of Florida) 

See also: Diseases you can catch from animals that could be deadly

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