As the world still struggles to recover from the aftermath of COVID-19, Floridians and visitors to the sunshine state may have a new endemic health concern to be wary of.
Pro-tip: If you’re sick, stay home; even at Disney World
Throughout its history, Florida has been no stranger to foreign diseases. The state has faced a variety of health challenges stemming from imported illnesses over the years. In recent times, the COVID-19 pandemic has proven particularly difficult to combat, with Florida ranking as the third highest state in terms of COVID-19 mortality as of March 2023, with nearly 87,000 deaths. Despite the unprecedented nature of the viral outbreak, Florida has faced similar challenges in the past due to atypical diseases that have arrived via foreign modes of transportation. These outbreaks have tested the state’s public health systems and required swift and effective responses to protect the health and safety of its residents.
Florida’s Long History of Disease
During the late 1870s, Florida, like much of the southern United States, grappled with the devastating impact of Yellow Fever, a potent arbovirus that took a significant toll on the population. In the decades that followed, the state was also hit by the 1918 Spanish Influenza epidemic, which claimed the lives of an estimated 4,000 people. Despite these challenges, Florida has emerged as a leader in the fight against infectious diseases such as the Zika Virus and West Nile, which have posed significant public health threats in recent years. Given its tropical climate and status as a popular tourist destination, the state remains particularly vulnerable to the spread of exotic disease processes, underscoring the need for continued vigilance and proactive measures to protect public health. Although Florida has a significant history of bacterial and viral diseases, the current Public Health crisis in the state is astonishingly of a magnitude comparable to literal biblical plagues.
Florida is Now an Endemic State for Leprosy
Recently the Centers for Disease Control have released a report indicating that Central Florida is now facing an endemic disease process for leprosy. This is due to a significant surge in the number of leprosy cases being reported in the State of Florida, which has been duly recognized by the National Hansen’s Disease Program. According to data, Florida has been the top reporting state for leprosy since 2020, with a staggering 159 cases reported. In fact, Florida alone accounts for 81% of all leprosy cases in the United States, with around ≈34% of cases being locally acquired. While the number of cases in individuals born outside of the United States is declining, the number of cases acquired locally continues to rise.
What Is Leprosy
Hansen’s disease, more commonly known as leprosy, has been a scourge on humanity for centuries. Even the Bible mentions it, indicating that it has been around for a very long time. It is caused by the bacterium Mycobacterium leprae. The disease has a slow-growing incubation period that can lead to severe nerve and skin issues, paralysis, and even blindness if left untreated. However, early detection can lead to a relatively easy cure.
While leprosy is often associated with under-developed countries, the United States has seen very few cases or deaths due to advanced hygiene practices, medical innovations, and proper reporting measures. It is important to understand that leprosy is not easily transmitted and requires prolonged contact with an untreated infected individual for many months for infection to occur.
Despite the stigmatization surrounding leprosy, it is important to note that it cannot be contracted through a single touch, sharing meals, or standing near someone who has contracted the disease. It is crucial to dispel myths surrounding leprosy and those sick with the disease in order to prevent further discrimination and fear towards those affected by this disease.
Signs and Symptoms
When we hear the word leprosy, we conjure images of rotting flesh in our minds. Although leprosy does have a serious impact on human skin, other infected areas can include the eyes and mucous membranes around openings in the body. Symptoms of leprosy typically include discolored patches of skin, loss of eyebrows and eyelashes, nodules on the skin, and painless ulcers on the soles of the feet.
A Few Notes About Leprosy
- Pets are not at risk for becoming sick with the disease
- Infected individuals become rapidly non-infectious once treatment begins
- Early warnings signs include pale and rashy skin
- Those at high-risk remain non-blood relatives that live in close proximity to someone who is infected with the disease
- Leprosy is part of a group of illness called Neglected Tropical Diseases (NTDs)
- Transmission can takes months to occur
- Treatments include a multi-drug therapy (MTD) that can last up to twelve months
- Associate cutaneous co-morbidities related to leprosy are warts, scabies, and a varitey of other skin issues
How Did Leprosy Arrive in Central Florida
It is quite surprising to know that leprosy has been present in the United States for some time now. Even though cases have appeared sporadically, the recent news is quite concerning. The reason for this concern is that cases in Central Florida indicate that the disease is now endemic, which means that it has been locally acquired and is now part of the health landscape in the area. It is highly probable that infection no longer depends on sick immigrated individuals who find a home in Florida. Instead, locally acquired cases are now on the rise as leprosy typically requires prolonged contact to spread between humans.
Apart from human-to-human contact, there are also other factors to consider when it comes to leprosy becoming an endemic problem in Central Florida. The bacterium that causes leprosy can benefit from zoonotic transmission, which means that it can use animals to spread through urine, feces, bites, or saliva, much like other diseases such as the black plague. However, studies suggest that the current infection rates in Florida and Georgia are not a result of zoonotic exposure. Instead those sick with leprosy don’t have to travel or depend on animals anymore to contract the communicable disease. It’s in their own back yard.
What Does This Mean for Those Traveling to Disney World
It’s worth repeating that leprosy is primarily transmitted through prolonged and close contact with an infected individual. However, visitors to Central Florida need not be overly concerned about exposure to the disease. This region is home to some of the world’s most popular tourist destinations, such as Walt Disney World and Universal Orlando, which welcome millions of visitors each year. Despite this, the incidence rate of leprosy in the area is not high enough to cause excessive concern about exposure. In fact, any potential exposure to the disease within the theme parks would likely not be significant or prolonged enough to result in transmission. Rest assured that even in the unlikely event of exposure, there is still little cause for worry.
It is crucial to acknowledge that leprosy is a notifiable disease, indicating that instances are likely to be recognized and addressed promptly in the United States. Although there might be a surge in locally acquired occurrences in Central Florida, individuals traveling to the state need not feel excessively anxious about their well-being. It is reassuring to know that the state’s healthcare system and Public Health offices are well-equipped to handle any reported cases, and visitors can rest easy knowing that they are in safe hands.
As always, if you feel unsafe or fear that you may have been exposed to any disease, please check with your local physician. For more information about leprosy in Florida please visit the Florida Department of Public Health.