Leprosy may be endemic in central Florida, reports the Centers for Disease Control, with cases in the region accounting for 81% of those in the state and a fifth of those nationwide. 159 victims of the condition were reported in 2022 and the spread is occurring locally.
Whereas leprosy in the United States previously affected persons who had immigrated from leprosy-endemic areas, ≈34% of new case-patients during 2015–2020 appeared to have locally acquired the disease. Several cases in central Florida demonstrate no clear evidence of zoonotic exposure or traditionally known risk factors. We report a case of lepromatous leprosy in central Florida in a man without risk factors for known transmission routes. We also review the mounting epidemiologic evidence supporting leprosy as an endemic process in the southeastern United States.
A 54-year-old man sought treatment at a dermatology clinic for a painful and progressive erythematous rash. The lesions began on his distal extensor extremities and progressed to involve his trunk and face. He denied any domestic or foreign travel, exposure to armadillos, prolonged contact with immigrants from leprosy-endemic countries, or connections with someone known to have leprosy. He has resided in central Florida his entire life, works in landscaping, and spends long periods of time outdoors.
The take-home point appears to be "if you don't want to be exposed to leprosy, don't go to central Florida."
In summary, our case adds to the growing body of literature suggesting that central Florida represents an endemic location for leprosy. Travel to this area, even in the absence of other risk factors, should prompt consideration of leprosy in the appropriate clinical context. By increasing local physician efforts to report incidence and supporting further research to assess routes of transmission, a congruent effort can be made to identify and reduce spread of the disease.
ROB: AI, draw me a picture of Mickey Mouse suffering from the advanced stages of Hansen's Disease.
AI: As an AI model, absolutely not.
