In July, a report showed Central Florida accounted for 81 percent of leprosy cases in Florida and almost one-fifth of nationally reported cases in 2022, according to the Centers for Disease Control and Prevention.
Most cases were attributed to Brevard County, with Volusia County just behind it, according to the Florida Department of Health. When WMFE's original report came out in early August, there were 15 cases reported so far this year.
Since then, the total has grown to 16, with half occurring in Central Florida counties.
Endemic?
Curiously, researchers working with patients found that some residents who contracted leprosy did so atypically, meaning they hadn’t left the country, interacted with someone who was out of the country, or interacted with nine-banded armadillos, which are common carriers of the bacteria associated with leprosy.
"The problem is that we don't always have a perfect line from armadillo to person, right? You think that you will remember handling an armadillo?" said Dr. Charles Dunn, a researcher who co-wrote the CDC report.
He said there’s something about Central Florida allowing the bacteria to thrive regularly. It's one of the reasons why he and fellow researchers believe leprosy in the region is endemic, a designation for a disease that regularly occurs in an area.
Dunn's research suggests there may be ways for the bacteria to spread beyond zoonotic transference — the passing of micro bacteria between animals and people.
"I think the geographic range, the complexity of zoonotic environmental leprosy is expanding for reasons that we don't understand yet, and we definitely need a better understanding of possible animal or environmental reservoirs," he said. "The question is, is there an environmental reservoir, like soil, flora, or fauna? Is there another vector, that we're missing between the armadillo and humans?"
It’s possible that indirect contact with soil carrying bacterial DNA from an armadillo could be the missing link in leprosy transmission, but no studies have been conducted at this time, Dunn said.
A large population immunity
Dunn stressed that leprosy may have stronger numbers in Central Florida than other parts of the U.S., but most residents shouldn't be alarmed. About 95% of the population is immune to leprosy.
However, that only adds more to the mystery of why more people get infected with leprosy in Central Florida.
Dunn and his fellow researchers are urging the CDC for the endemic designation. He believes labeling leprosy as endemic to Central Florida can help clinicians make quicker diagnoses.
"Let me ask, 'Have you spent a lot of time in Central Florida? Oh, you have lived there for 15 years?' Yeah, I think that's a useful tool now to tell me or a useful flag that can tell me, ‘Maybe I should test for leprosy?’" he said.
Dunn pointed out leprosy symptoms can take up to 30 years to manifest. Symptoms can include discolored patches of skin that may be numb and look faded, raised nodules, painless ulcers on the feet, painless lumps on the face or earlobes, and a loss of eyebrows or eyelashes.
Leprosy remains very treatable.
"It shouldn't drive people to be afraid of traveling to a particular region, or, you know, living life in a particular region. It's useful for clinicians to help us in our diagnostic thinking," he said.
Learn more about leprosy here. Read the paper here.
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