Leprosy, an ancient disease thought to be history, may now be endemic in Florida, health officials warn.
The Centers for Disease Control and Prevention (CDC) issued an alert to doctors today, urging them to consider the disease as a possible diagnosis.
Florida is the state with the most leprosy cases in the US, accounting for a fifth of the 159 cases detected in 2020, the latest date available. About a third of the infections were thought to have occurred on US soil.
Leprosy, or Hansen’s disease, is caused by bacteria that spread through droplets that attack the skin, nerves, and mucous membranes of the lungs.
The disease, if left untreated, can cause severe disabilities, including blindness and curvature of the hands and feet.
Leprosy, if left untreated, can cause severe disabilities, including blindness and curvature of the hands and feet. (File Image)
The graph above shows leprosy cases in the US by year for the past decade.
But it’s hard to catch, as many patients have to spend months in close contact with an infected patient to contract the disease.
Issuing his warning, the CDC said in a letter: ‘Travel to this area, even in the absence of other risk factors, should prompt consideration of leprosy in the appropriate clinical context.
“By increasing efforts by local physicians to report incidence and supporting further research to assess routes of transmission, a consistent effort can be made to identify and reduce the spread of the disease.”
But what is leprosy? How can you avoid it? And can the disease be cured?:
What is leprosy?
Leprosy is one of the oldest diseases known to man, with records dating back to the ancient Egyptians more than 4,500 years ago.
It is caused by the bacterium Mycobacterium leprae, which is transmitted from patients through contaminated droplets expelled by coughing or sneezing.
The bacteria slowly multiply inside their new host once inhaled, meaning disease symptoms may not appear for years.
He cleveland clinic says it takes three to five years for patients to start showing symptoms, although in some cases this can take up to two decades.
The bacterium attacks the skin, nerves, and mucous membranes, causing symptoms such as skin lesions, nodules, and thick, dry skin in the early stages.
Without treatment, this can lead to irreversible nerve damage leading to loss of sensation in the hands and feet.
Over time, this can also cause muscle weakness and, due to the inflammation caused by the infection, bone resorption, causing the hands to become stiff.
Throughout much of human history, there has been no effective treatment for the disease.
Before modern medicine, communities used to banish the sick to live in leper colonies confined outside cities or even on islands.
But in the 1940s, the balance began to shift after doctors discovered the drug dapsone, a man-made antibiotic that could slow the growth of bacteria and reduce symptoms.
In the 1980s, a multidrug therapy (MDT) combining the drug with two other antibiotics, rifampicin and clofazimine, was introduced to treat the infection.
About five million people worldwide had the disease in the 1980s, but by the 2020s, this number had dropped 44-fold to about 133,000 cases per year.
The World Health Organization now considers leprosy a neglected disease, warns that new cases continue to occur, and calls for action to be taken to stop it.
How can I avoid leprosy?
The CDC says that Americans who travel to Florida are at risk of contracting leprosy.
The disease has also been reported in smaller numbers in several other states, including California, Louisiana, Hawaii, New York and Texas.
The cases are usually related to travelers from countries where the treatments are not available.
But there are also signs of infections now being acquired locally in the United States.
Health authorities say leprosy is difficult to catch and will not be transmitted in standard settings, unlike many other diseases such as measles, one of the most communicable known, and covid.
Brief physical interactions, such as shaking hands with a patient, sitting next to them on a bus or train, or eating meals together, would not lead to transmission.
Instead, a person would need months of regular close contact with an infected patient to be at risk of contracting the disease.
Pictured above are leper colonies in Spinalonga, Greece (left) and Molokai, Hawaii (right). People with the disease were sent to these areas to prevent its spread.
Above is Father Damien with his choir of leprous girls in the Molokai colony, Hawaii, in 1880.
How contagious is leprosy?
Despite the fact that leprosy has plagued humanity for decades, the disease is extremely difficult to contract.
For measles, one of the most contagious diseases in the world, estimates suggest that one patient can infect up to nine out of ten close contacts.
But for leprosy, someone must be repeatedly exposed to an untreated infected patient for months to contract the disease.
Pictured above is a crooked hand caused by leprosy in Srinagar, India (2017)
He American Academy of Dermatology he adds: ‘Scientists have learned that to contract leprosy, a healthy person must have months of close contact with someone who has leprosy.’
They continue: ‘It is believed that the disease is spread when a person who has leprosy coughs or sneezes. If a person repeatedly inhales the infected droplets, this can spread the disease.
‘(But) it takes a lot of exposure to get leprosy.
‘If someone has leprosy, a single handshake or spending a few hours sitting next to that person will not spread the disease. You would have to shake hands or sit next to that person often to get leprosy.’
Another reason leprosy struggles to spread is that an estimated 95 percent of humans have natural immunity and are already protected against the disease.
Is there a cure for leprosy?
There has been a treatment for leprosy available since the 1980s, causing cases to plummet over the last half century.
But the process is long, and patients need to take the drugs for six months to a year to make sure the bacteria are eradicated.
The disease is treated with three drugs: dapsone and clofazimine, which restrict the growth of the bacteria, and rifampicin, which kills the bacteria.
The drugs are usually given as oral tablets, with the amount and order determined by the severity of the infection.
Doctors say that it is important to complete the treatment to ensure that the disease is completely eliminated.
This can completely remove someone’s infection.
Leprosy treatment is free in many countries, including the United States, where it is offered by the National Hansen’s Disease Program (NHDP).
Previous attempts to develop a vaccine against the disease have failed, including a jab from India that was implemented in the 1970s.
However, data shows that other vaccines, such as BCG, provide protection against leprosy.
The vaccine was developed against tuberculosis (TB) and is not routinely offered in the United States, although it can be given to infants and children, as well as healthcare workers at high risk of TB exposure.