Earlier this month, a report in Emerging Infectious Diseases prompted a flurry of internet headlines plus some outlandish theories. COVID vaccines causing leprosy? Seriously?
Nonetheless, the data themselves were notable. Although the overall count of newly diagnosed Hansen’s disease in the U.S. — roughly 150 to 200 cases per year — hasn’t changed in several decades, the percentage found in southeastern states has risen over time. In 2020, an astounding one in five infections in the U.S. were diagnosed in central Florida, and 34% were locally acquired.
Is Florida an emerging hotspot on the leprosy map? I believe the answer is yes. For one thing, Florida has plenty of nine-banded armadillos, a known animal reservoir of Mycobacterium leprae in certain parts of the Americas. But before focusing on this possible source of transmission, let’s step back.
Although leprosy remains a neglected infectious disease that sometimes causes tragic, lifelong disability, its global incidence has dramatically fallen since the mid-1980s. Much of this drop reflects newer multi-drug treatments. Nonetheless, transmission still occurs unabated in highly endemic countries. Ignorance and fear surrounding leprosy also persist in many parts of the world, countering efforts both to identify and treat what some might argue is one of the world’s least contagious infections.