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UF leprosy symposium addresses increase in Florida cases

Dr. Kartik Cherabuddi demonstrates how he conducts an examination to determine whether a patient has leprosy.
Adam Goodson
/
WUFT
Dr. Kartik Cherabuddi demonstrates how he conducts an examination to determine whether a patient has leprosy during the Hansen’s Disease (Leprosy) Symposium at the University of Florida in Gainesville Oct. 27, 2023.

The recent spike in the disease, now typically spread by armadillos, has caused some concern among experts and led to educational events like one held recently at the University of Florida.

In Florida, armadillos are known as mostly harmless creatures that often end up as unfortunate roadkill. If encountered, people should avoid contact with them as they can spread a disease that has been on the rise in the U.S. in recent years: Hansen’s disease, also known as leprosy.

“Humans first transferred it [leprosy] to armadillos, and now they are transferring it back to us,” said Dr. Norman Beatty, assistant professor of medicine at University of Florida.

Nationally, 263 cases of leprosy were reported in 2022. Florida was among the top five states accounting for most cases. Around 95% of people have natural immunity to Mycobacterium leprae, the bacteria that causes the infection, and are not at risk of infection. But the increase in cases has caused some concern among experts.

This has led to educational events like the one held at the University of Florida on Friday. The Hansen’s Disease (Leprosy) Symposium's goal was to educate people about the disease.

“I am impressed by the Emerging Pathogen Institute’s efforts for public awareness, and they brought in some talented speakers,” said Pat Barlett, 74, a retired local Gainesville resident who has written books on reptiles and amphibians.

She said she became interested in leprosy after reading a book in the eighth grade about a soldier who was forced to live in a leper community after contracting the disease. She attended the event after learning about it on Facebook.

“There has been an increase in the trend [of reported cases] over the past few years,” said Danielle Stanek, with the Florida Department of Health. “But the increased number of cases could also be caused by an increase in recognition [of the disease].”

The reason for the trend is unknown. Symposium speakers informed the public of the dangers of the disease in the wake of the increasing numbers.

The chart from the Florida Department of Health shows the number of leprosy cases in Florida over 20 years.
The chart from the Florida Department of Health shows the number of leprosy cases in Florida over 20 years.

According to Jessica Fairley, who directs the Emory Hansen’s Disease Program, a satellite clinic of the National Hansen’s Disease Program, human-to-human transmission is rare in the United States.

The nine-banded armadillo, frequently found in the Southeast, is the main carrier of the disease in Florida. It is possible to contract the disease from roadkill, contaminated soil, exposure to their waste, handling them and consumption.

“If you happen to run over an armadillo, don’t use your bare hands to clean it up,” said Juan Campos Krauer, an assistant professor in the UF College of Veterinary Medicine.

At-risk occupations include landscapers, farmers and professionals who work with soil. While the speakers mentioned it is unclear how it happens, people can become infected through soil that is contaminated with the bacteria.

According to Dr. Kartik Cherabuddi, a professor of medicine at UF, when diagnosing the disease, “skin examinations are key.” Symptoms include patches on the skin (any shape), lesions, loss of sensation in affected areas, muscle weakness, sweat and mucus gland damage, and long-term nerve damage.

If the disease is treated early enough, according to Kairley, it is possible to reverse nerve damage in the infected area.

The bacteria that cause Hansen’s prefers to grow at a temperature lower than average body temperature. The areas that it prefers include skin, ears, nose and nasal cavities.

Symposium speakers listen as an audience member asks a question after the presentation during the Hansen’s Disease (Leprosy) Symposium at the University of Florida in Gainesville Oct. 27, 2023.
Adam Goodson
/
WUFT
Hansen's Disease (Leprosy) Symposium speakers listen as an audience member asks a question after Friday's presentation.

The disease is one of the oldest human diseases.

According to Beatty, the disease was recognized in ancient texts between 1200 and 600 BCE. The disease was found on skeletal remains in India dating back to 2000 BCE. The bacteria that causes the disease was first discovered in 1873 by G.H. Amauer Hansen, for whom the disease was named.

Despite leprosy’s long history, there are still many questions among experts about transmission and the long-term effects. It cannot be grown in a lab, which creates trouble for research.

“Leprosy has been a very distinct part of even art,” Beatty said. “It is the first well-described, stigmatized human disease.”

In times past, people with Hansen’s were required to walk around shaking noise-making devices. The noise would alert people to their presence to avoid them out of fear of catching the disease. It was common for people with Hansen’s disease to be isolated from communities.

“One of the more sorrowful parts of the disease is people moving lepers to isolated villages,” said Beatty.

Communities would send people with Hansen’s to isolated villages out of fear of catching the disease. The United States was not excluded.

According to Kairley, in 1894, the Louisiana Leper House was established in Carville. People who were sent there did not receive treatment. It was only a means to separate them from uninfected people.

Today, the house has become home of the National Hansen’s Disease Program. This is the center for research, treatment and information about the disease.

Since the 1940s, there has been available antibiotic treatment. Treatment requires taking a cocktail of antibiotics monthly for six to 24 months. After treatment, some patients may have symptoms flare up and require additional treatment.

If you believe that you or a loved one has been infected with Hansen’s, seek an expert medical council and consult with your doctor.