Wait, what? Leprosy in Florida?

[Terabith]

Apparently it's maybe now endemic???  https://www.nbcnews.com/health/health-news/leprosy-may-be-endemic-florida-cdc-rcna97567

[Katy]

It’s endemic to armadillos, and it appeared about the same time they did as an invasive species. Don’t touch them, and if you do wash your hands well and seek immediate medical attention for skin changes. 

[Starr]

I thought I read that they don’t think it’s actually being spread by armadillos. I’ll have to look for the article. 

[Grace Hopper]

Armadillos have been around for a long time. Longer than this recent rise in cases in Florida. They are carriers, but Hansen’s disease is spread by respiratory droplets - human coughs and sneezes. Can spread skin to skin but supposedly that takes prolonged close contact. 
 

I mean you don’t want to play with armadillos but it doesn’t seem logical to me they’re solely responsible for the spread. I mean, maybe someone stepped barefoot in some fresh armadillo droppings, but that’s far from a regular occurrence and from what I’ve read none of those treated so far reported any armadillo encounters. 

 

Edited August 2, 2023 by Grace Hopper

[Arcadia]

13 minutes ago, Starr said:

I thought I read that they don’t think it’s actually being spread by armadillos. I’ll have to look for the article. 

https://wwwnc.cdc.gov/eid/article/29/8/22-0367_article
“Transmission of leprosy has not been fully elucidated. Prolonged person-to-person contact through respiratory droplets is the most widely recognized route of transmission (1). A high percentage of unrelated leprosy cases in the southern United States were found to carry the same unique strain of M. leprae as nine-banded armadillos in the region, suggesting a strong likelihood of zoonotic transmission (4). A recent systematic review analyzing studies conducted during 1945–2019 supports an increasing role of anthroponotic and zoonotic transmission of leprosy (5). However, Rendini et al. demonstrated that many cases reported in eastern United States, including Georgia and central Florida, lacked zoonotic exposure or recent residence outside of the United States (6).

Given those reports, there is some support for the theory that international migration of persons with leprosy is a potential source of autochthonous transmission. Reports from Spain linked an increase in migration from other countries to an increase in autochthonous leprosy (7). The number of international migrants in North America increased from 27.6 million persons in 1990 to 58.7 million in 2020 (8), so a link to migration may account for the increase in incidence of leprosy in historically nonendemic areas. Further, reports from the Centers for Disease Control and Prevention show that, although the incidence of leprosy has been increasing, the rates of new diagnoses in persons born outside of the United States has been declining since 2002 (AppendixFigure) (9). This information suggests that leprosy has become an endemic disease process in Florida, warranting further research into other methods of autochthonous transmission.”

[PaxEtLux]

The article also said that there were 159 new cases of leprosy in the whole US in 2020, and 20% of those where in Florida.  So, while I sure would not want to contract leprosy, apparently "endemic" doesn't necessarily mean "common", and I'm not going to put this on the large list of things I worry about.

[ktgrok]

I live in Florida, and we do weird stuff, but snuggling armadillos isn't one of them. I mean, I could see that one person who was killing one and then handled it got leprosy, then infected other people, but I highly doubt most cases are direct armadillo to human transmission. Even in the land of Florida Man.  

Besides, the little buggers are good at hiding, lol. I have only seen a live one a few times. I DO seem them as road kill fairly often, so maybe someone cleaning up roadkill?

[Lady Florida.]

I read this a few days ago on a local news channel's page. I suspect national news picked it up from them especially since it was an NBC affiliate station that ran the story. Most of the cases are in Central Florida and most are in - surprised but not surprised - my county. 

Edited August 2, 2023 by Lady Florida.

[Grace Hopper]

12 minutes ago, Lady Florida. said:

I read this a few days ago on a local news channel's page. I suspect national news picked it up from them especially since it was an NBC affiliate station that ran the story. Most of the cases are in Central Florida and most are in - surprised but not surprised - my county. 

Are those afflicted field workers? Disney visitors? Just curious. 

[Lady Florida.]

24 minutes ago, Grace Hopper said:

Are those afflicted field workers? Disney visitors? Just curious. 

The article doesn't say where in Central Florida or where in my county specifically the cases are. However my county is anywhere from 45 minutes to 2 hours away from Disney depending on where one lives. Some Disney workers live here but not many and most are just college kids working at Disney for the summer. There also isn't a lot of agricultural land here anymore so there's not a lot of field workers. Sounds to me like it's just the general population.

ETA: we don't get a lot of Disney visitors here unless they're going to the Space Center or staying overnight near the port if they're going out on a cruise ship, either the Disney ship or one of the other cruise ships. We get beach vacationers, but most are local to somewhere in Central Florida.

https://www.wesh.com/article/leprosy-florida/44693829

Edited August 2, 2023 by Lady Florida.

[Lady Florida.]

I found this CDC report -

https://wwwnc.cdc.gov/eid/article/29/8/22-0367_article

From the report:

A 54-year-old man sought treatment at a dermatology clinic for a painful and progressive erythematous rash (Figure). 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. Biopsies of multiple sites demonstrated a diffuse dermal infiltrate composed of disorganized aggregates of foamy histiocytes and lymphocytes. Fite stains revealed acid-fast bacilli within histiocytes and cutaneous nerve twigs, a pathognomonic finding of leprosy. He was referred to an infectious disease specialist who, under the direction of the National Hansen’s Disease Program, prescribed triple therapy with dapsone, rifampin, and clofazimine.

 

The absence of traditional risk factors in many recent cases of leprosy in Florida, coupled with the high proportion of residents, like our patient, who spend a great deal of time outdoors, supports the investigation into environmental reservoirs as a potential source of transmission.

[kbutton]

In a Covid FB group I'm in, someone posted about a significant increase in cases in Mumbai as well, and there is speculation that immune compromise from Covid might explain it.

I'm not on X/Twitter, and I can't access the original tweet. 

[Faith-manor]

I just want to say that I had a LOT of things on my 2023 bingo card, many things. I was trying to really think outside the box. I even had something similar to "marine biologists remove marine life and cool them in refrigerated tanks", and dang it all, yep, they are pulling coral out and putting in aquariums to preserve it. So ya know, I thought I was doing a pretty good job and anticipating the insanity that would befall us this year. But no where did I have " leprosy endemic to a state". Nope. I feel like a failure. I should have seen this coming. I will have to try harder for 2024.

[Matryoshka]

38 minutes ago, kbutton said:

In a Covid FB group I'm in, someone posted about a significant increase in cases in Mumbai as well, and there is speculation that immune compromise from Covid might explain it.

I'm not on X/Twitter, and I can't access the original tweet. 

This (Covid damaging immune system).  Leprosy is normally very hard to catch.   Was just reading a book set partially in a leper colony, and it pointed out that, historically, pre-antibiotics and modern medicine, many people who worked their whole lives tending to lepers never caught the disease, in spite of long term, close contact.  It seems to take advantage of compromised immune systems.  And now there are ... a lot more of those now.

[WildflowerMom]

The guy that got it that @Lady Florida. referenced was active in landscaping.  Could it be that Covid causes the immune system to act funky and when exposed to an armadillos’ scat or whatever, the body can’t fight it off?   I’m just throwing something out there.   The possible Covid link is very interesting.   
btw, we had a baby armadillo in our backyard that I rescued and moved away from the fence.  I held him with grocery bags on my hands so I wouldn’t touch him.   I’m only including that because I think they are probably around our yards, gardens, etc more than we might realize.  

[73349]

3 hours ago, Grace Hopper said:

Are those afflicted field workers? Disney visitors? Just curious. 

What I read indicated that most people exposed to it don't catch it and that it can be many months between exposure and the appearance of symptoms, so it's hard to pinpoint a source of spread.

Also, apparently armadillos caught it from humans in the first place; there was no leprosy known in the Americas--even though there were armadillos all over Central and South America and a bit of southern North America--until Europeans arrived. But of course armadillos are now spreading north, so... yeah.

Edited August 2, 2023 by 73349

[Grace Hopper]

38 minutes ago, WildflowerMom said:

The guy that got it that @Lady Florida. referenced was active in landscaping.  Could it be that Covid causes the immune system to act funky and when exposed to an armadillos’ scat or whatever, the body can’t fight it off?   I’m just throwing something out there.   The possible Covid link is very interesting.   
btw, we had a baby armadillo in our backyard that I rescued and moved away from the fence.  I held him with grocery bags on my hands so I wouldn’t touch him.   I’m only including that because I think they are probably around our yards, gardens, etc more than we might realize.  

Thanks. They are somewhat nocturnal but they are noisy. Camping once in the south I awoke, sure I was going to see a bear. It was an armadillo, making a huge racket snuffling through leaves. 
 

They're actually fascinating creatures, giving birth to litters of genetically identical quadruplets which makes them valuable as research subjects. 

[Farrar]

One of the articles I read said that doctors didn't fully understand how leprosy was transmitted. Which... WHAT? Like, I guess they know it's "close" contact, but there is apparently some scientific debate about it, which I found astounding for a disease that we have this long a history with.

[Terabith]

10 minutes ago, Farrar said:

One of the articles I read said that doctors didn't fully understand how leprosy was transmitted. Which... WHAT? Like, I guess they know it's "close" contact, but there is apparently some scientific debate about it, which I found astounding for a disease that we have this long a history with.

I read something about that years ago in the early 00’s.  It’s baffling. 

[Farrar]

26 minutes ago, Terabith said:

I read something about that years ago in the early 00’s.  It’s baffling. 

It makes me think about how they didn't really understand how Covid was transmitted in part because they didn't believe that it was easy for droplets to stay in the air and be breathed in and then doctors refused to listen to physicists explain why it was totally possible. But it turned out we'd all been doing cold and flu prevention wrong for decades. 

Basically, I think doctors are full of it about disease transmission a little bit.

[Grace Hopper]

44 minutes ago, Farrar said:

One of the articles I read said that doctors didn't fully understand how leprosy was transmitted. Which... WHAT? Like, I guess they know it's "close" contact, but there is apparently some scientific debate about it, which I found astounding for a disease that we have this long a history with.

There was a hospital in Carville LA for a long time, but with the disease considered pretty much eradicated, I imagine it wasn’t sexy enough to garner much US research funding. 
 

As a kid though I remember talk of Carville, especially at Easter when Ben Hur would come on TV. 
 

https://en.m.wikipedia.org/wiki/Leprosy_in_Louisiana#:~:text=The first leprosarium in the,consulting%2C research%2C and training.

 

Edited August 2, 2023 by Grace Hopper

[kbutton]

54 minutes ago, Farrar said:

Basically, I think doctors are full of it about disease transmission a little bit.

Infectious disease doctors are a thing for a reason, lol!

[J-rap]

22 minutes ago, kbutton said:

Infectious disease doctors are a thing for a reason, lol!

My understanding is that infectious disease doctors are more about focusing on people who already have a disease/infection, not figuring out how they got it in the first place.  

[kbutton]

37 minutes ago, J-rap said:

My understanding is that infectious disease doctors are more about focusing on people who already have a disease/infection, not figuring out how they got it in the first place.  

They do a lot of prevention in hospital settings too--deciding on best practices to control infection. 

[J-rap]

1 hour ago, kbutton said:

They do a lot of prevention in hospital settings too--deciding on best practices to control infection. 

Oh right, that's true!  

[Katy]

11 hours ago, ktgrok said:

I live in Florida, and we do weird stuff, but snuggling armadillos isn't one of them. I mean, I could see that one person who was killing one and then handled it got leprosy, then infected other people, but I highly doubt most cases are direct armadillo to human transmission. Even in the land of Florida Man.  

Besides, the little buggers are good at hiding, lol. I have only seen a live one a few times. I DO seem them as road kill fairly often, so maybe someone cleaning up roadkill?

I grew up in a much more rural area than you and I've seen hundreds.

[kbutton]

12 hours ago, Katy said:

I grew up in a much more rural area than you and I've seen hundreds.

We vacationed in Alabama this spring and decided armadillo roadkill must be used in place of mile markers on the smaller highways. 😉 Dead ones were ubiquitous!

[Katy]

My dad could see them in his peripheral vision more than a quarter mile away. I rarely noticed until he pointed them out. I assume his amazing nature vision was from multiple tours in Vietnam. 

[73349]

Also typhus is in Texas; LA county; and Hawaii. https://lite.cnn.com/2023/08/03/health/fleaborne-typhus-la-county-cdc-wellness/index.html

Stupid germs.