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According to a report, Central Florida has been identified as a hotspot for leprosy

According to a report, Central Florida has been identified as a hotspot for leprosyAccording to a report, Central Florida has been identified as a hotspot for leprosy

According to a report, Central Florida has been identified as a hotspot for leprosy

Publish – 2 aug , 2023

A 54-year-old landscaper sought help at an Orlando dermatology clinic, presenting with a painful and splotchy rash. Dr. Rajiv Nathoo, a dermatologist and complex clinic director for Advanced Dermatology and Cosmetic Surgery Clinics in Orlando, suspected leprosy as the cause, a diagnosis that was later confirmed by biopsy results. What puzzled the medical team was the absence of typical risk factors associated with this rarely encountered infection.

Noticing a cluster of other leprosy cases in the region, Dr. Nathoo began to suspect that Central Florida might be an unexpected hotspot for leprosy. To raise awareness and caution other healthcare providers, his team published a research letter in the journal Emerging Infectious Diseases, revealing that Central Florida has one of the highest rates of leprosy in the United States.

While the World Health Organization reports around 200,000 new leprosy cases globally each year, the United States reported only 159 cases in 2020. Surprisingly, Central Florida accounted for a staggering 81% of cases in Florida and nearly 1 out of 5 leprosy cases nationwide. This alarming revelation prompts a call for vigilance among healthcare professionals in the area to be on the lookout for similar cases.

According to a report, Central Florida has been identified as a hotspot for leprosy
 getty images

also known as Hansen’s disease, is caused by the bacterium Mycobacterium leprae, which targets nerves beneath the skin. While the exact mode of transmission is not entirely understood, it is believed to spread through droplets when an infected person coughs or sneezes. The disease presents distinct symptoms, including numb or insensate lesions and rashes due to nerve involvement.

In the Southeastern United States, nine-banded armadillos are potential carriers of the bacteria, and genetic studies have linked human infections to strains found in these animals. However, it remains unclear how humans come into contact with the bacteria carried by armadillos, as many patients do not recall any interactions with these creatures.

Notably, this is not casually transmitted through handshakes or sitting next to an infected person. Rather, it necessitates prolonged and close contact with an untreated leprosy patient over several months. Approximately 95% of people are naturally resistant to the infection due to their genetically programmed immune systems.

Given these factors, this is a rare disease in the United States.

However, some puzzling cases arise where doctors cannot determine the source of exposure. States like Florida exhibit higher incidences of leprosy, even without a clear explanation. Dr. Linda Adams, chief of the laboratory research branch at the National Hansen’s Disease Program, points out that some cases remain unexplained, as individuals reported no foreign travel or contact with armadillos.

One such case involves a 54-year-old man in Florida who had never left the state. Despite spending considerable time outdoors, the source of his infection remains a mystery.

 

According to a report, Central Florida has been identified as a hotspot for leprosy
 getty images

According to a report, Central Florida has been identified as a hotspot for leprosy

A research letter reveals that approximately 34% of new cases between 2015 and 2020 in Florida did not have the traditional risk factors associated with the disease. These cases seem to have been locally transmitted, indicating that leprosy may be becoming endemic in the region. However, experts emphasize that “endemic” doesn’t imply rising infection rates but rather a regular presence of the disease.

Dr. Nicole Iovine from the University of Florida Health Shands Hospital clarifies that leprosy remains relatively rare, and there is no need for public health panic. The number of cases is still low. Nevertheless, Dr. Rajiv Nathoo, a dermatologist, has observed a cluster of 15 biopsy-proven leprosy cases in eastern Orlando and Volusia County over the past five years. Of these, 14 had not traveled outside the United States, and none were connected to each other.

The misconception among doctors is that leprosy only occurs in foreign-born individuals or those exposed to armadillos. Dr. Charles Dunn, a study author, highlights the importance of dispelling these assumptions since their patients did not exhibit these typical risk factors. While armadillos are often linked to this, the exact transmission route remains uncertain, as most people do not have prolonged contact with these animals.

 

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