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Leprosy, also known as Hansen's disease, is a chronic infectious illness caused by the pathogen Mycobacterium leprae. The condition is historically associated with social stigma and discrimination due to a collective misunderstanding of its transmission mode and disfiguring effects. In 2000 the World Health Organization (WHO) declared that the disease was eliminated as a public health problem in the United States (US), indicating that active cases were statistically low. But the WHO theory was recently debunked by a research report published by the Centers for Disease Control and Prevention on 08 August 2023, which claimed that "leprosy has become an endemic disease process in Florida."
According to an investigation team led by Dr. Aashni Bhukhan, the US has experienced a gradual increase in the prevalence of leprosy among its citizens. Oft associated with global regions with limited access to healthcare and medical resources, the emergence of sporadic cases of leprosy has US public health officials on high alert. Bhukhan claims, "The number of reported cases has more than doubled in the southeastern states over the last decade," as Florida recorded 159 new incidents in 2020, respectively. "Central Florida, in particular, accounted for 81% of cases reported in Florida and almost one-fifth of nationally reported cases," Bhukhan stated.
The incubation period for leprosy can be quite long, ranging from months to several years. As a result, some symptoms may only appear after a considerable amount of time has passed since the initial infection. WHO experts contend, "The disease is primarily transmitted through respiratory droplets from the nose and mouth. Prolonged, close contact over months with someone with untreated leprosy is needed to catch the disease." The organization claims that leprosy is not easily spread through casual encounters with an infected person, and transmission is thwarted as soon as treatment is initiated.
Dr. Bhukhan believes the "transmission of leprosy has not been fully elucidated." Yet the prevailing theories accounting for the cases in Central Florida include zoonotic (germs that spread between animals and humans), droplet, and migratory considerations.
"There is some support for the theory that international migration of persons with leprosy is a potential source of autochthonous transmission," says Bhukhan. From 1990 to 2020, the number of multinational immigrants in the US more than doubled from 27.6 to 58.7 million. However, regions outside of North America have witnessed a steady decline in leprosy cases, giving pause to the notion that immigration is the main pathway for transmission.
Contract tracing conducted by the National Hansen's Disease Program revealed that the most recent cases "experienced no associated risk factors, including travel, zoonotic exposure, occupational association, or personal contacts." Dr. Bhukhan asserts that the absence of historical hazards and a rise of leprosy in Floridian outdoor enthusiasts points to suspected "environmental reservoirs as a potential source of transmission."
The leprosy outbreak in Florida is...
0%A. Alarming, but it could be worse.
0%B. Not terribly surprising.
0%C. Something I don't think about.
The research team suggests airing on the side of caution if traveling to central Florida but not necessarily canceling your Disney World or Busch Gardens vacation. Instead, Bhukhan aims to enhance leprosy reporting among regional healthcare providers to identify transmission routes and mitigate pathogen contamination.
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