Prevalence of Leprosy in Florida Leaves Health Officials Determined to Root Out the Cause

Health officials are working to determine the cause of leprosy in Florida, where a notable number of cases have been recorded in recent years. 

Leprosy, an illness that can be traced back to Biblical times and is believed to be the oldest disease in mankind, is also known as Hansen’s disease. It can lead to nerve damage and disfigurement in humans.

A 2023 research letter from three doctors published in the journal of Emerging Infectious Diseases to the World Health Organization said Central Florida accounted for 81% of cases in the state and nearly one out of five leprosy cases nationwide. “Several cases in central Florida demonstrate no clear evidence of zoonotic exposure or traditionally known risk factors,” the 2023 research letter said.

The uptick of cases in Florida has been on the radar of health officials for years. Florida’s Brevard County reported 13% of the 159 leprosy cases found in the U.S. in 2020, according to an analysis of state and federal data conducted by the Tampa Bay Times.

Leprosy is caused by a bacteria known as Mycobacterium leprae, which attacks nerves under the skin. Scientists are still not completely sure of how it spreads, but it is believed to be transmitted via droplets when an infected person coughs and sneezes. 

Symptoms of the disease include: discolored or lighter patches of skin; nodules on the skin; thick, stiff, or dry skin; painless ulcers on the soles of feet; painless swelling or lumps on the face or earlobes; and a loss of eyebrows or eyelashes, according to the Centers for Disease Control (CDC).

Leprosy also causes nerve symptoms including numbness of affected skin areas; muscle weakness or paralysis, especially in the hands and feet; enlarged nerves, usually around the elbows, knees, and side of the neck; eye problems that may lead to blindness, the CDC says. If left untreated it can cause paralysis and crippling of hands and feet; shortening of toes and fingers due to reabsorption; chronic non-healing ulcers on the bottoms of the feet; and even blindness.

“In the United States, leprosy is rare,” the CDC tells Inside Edition Digital. “Most people with leprosy in the U.S. became infected in a country where it is more common.”

But a recent 2024 study by the University of Florida’s College of Medicine noted that some cases in the Sunshine State have arose after the patients had contact with armadillos.

After a man accidentally ran over an armadillo with his riding lawn mower, “the resulting mess sprayed armadillo blood and bits onto his leg, where he later developed a lesion that turned out to be Hansen’s,” the study reported. “Others may have had exposure to bacteria in the soil through jobs like landscaping,” Dr. Juan Campos Krauer said in the study. 

Dr. Charles Dunn, one of the doctors who penned the 2023 research letter in the journal of Emerging Infectious Diseases, tells Inside Edition Digital that the nine-banded armadillo, especially those in the southeast, has been “shown to carry sero-variants of the bacteria that cause leprosy in humans. How, or even if, they transmit it to humans isn’t clear, but studies have consistently shown them to carry strains of the bacteria that are also found in people with symptomatic leprosy.”

Campos Krauer, veterinarian with wildlife expertise, noted in the University of Florida study that there are benefits to having the relatively harmless animals around, saying that armadillos “eat spiders, they’ll eat cockroaches. Really, I don’t think people need to go to war with armadillos. Just make sure to wear gloves, or wash your hands thoroughly. Change clothes if you were working with lots of dust and dirt, and change your shoes or at least clean them before going inside.”

The illness remains rare in the U.S., but in other parts of the world like India, Brazil, and Indonesia, their hot and humid climates, much like Florida, as well as the effects of climate change, could be a factor.

“I don’t think you can ignore the fact that climate change is impacting infectious diseases epidemiology. We are seeing tick born illnesses, for instance, in areas of the country that were historically inhospitable to ticks. Leprosy has a very specific set of parameters in which it can survive, and I think that climate change expands the areas in which these parameters are met,” Dunn says.

Dr. Norman Beatty, an infectious disease specialist at University of Florida’s College of Medicine, who is also examining the illness, said in a recent report, “As a scientific community, we really have to acknowledge that certain diseases have been put on the back burner, and Hansen’s is one of them. As our state continues to change, as our environment and climate changes, diseases like Hansen’s will continue to evolve. Without doing the research that’s needed, we’re not going to understand who’s at risk.”

Dunn also acknowledged the climate change theory. 

“Why now and Why here? It’s possible that climate change and increasing heat indexes earlier in the year are driving changes in our local flora, fauna, and animal populations that allows them to carry and transmit disease easier. But that is conjecture,” Dunn says. “A pretty shocking geographic predilection for cases in Florida has emerged in the last three years, where an astounding 80+ percent of cases diagnosed in the state were being diagnosed within Central Florida. The geography is much more of an interesting point than the number itself.”

As authorities work to determine the cause or causes of the spread of the illness in the U.S., they urge anyone with symptoms to seek out treatment and to push back against the very real stigma associated with the disease. 

“A large portion of people diagnosed with leprosy never seek medical care and struggle with suicidal ideation because societal views remain stuck on a fear based antiquated view of this disease process. That needs to change,” Dunn says. Ninety-five percent “of the human population is naturally immune to leprosy. If you do contract the disease, a single treatment renders people non-infectious within weeks. The disease is hard to contract and easy to cure.

“Leprosy has existed at low levels for decades in the United States. We’re actually at a better place now than we have almost ever been as a country in terms of disease control,” Dunn continues. “Unfortunately, though, we haven’t changed much for the better in terms of our ability to handle the stigma associated with this disease process … While we are doing great with disease control, the levels have never reached zero. And this report brings up the point that we may not reach that due to the complex and evolving nature of this illness.”

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