Don’t Blame DeSantis for an Uptick in Leprosy in Florida

Leprosy is back in the news, believe it or not, and once again the disease is being exploited for political gain. Sensational headlines. Misinformation. Demonized victims. It’s been going on for centuries.

In the late 1800s, Louisiana’s top health official falsely blamed the “unprincipled, vicious and leprous hordes of Asia” for spreading the disease. Labor leader Denis Kearney also paraded a Chinese man suffering from leprosy through the streets of San Francisco to scare white workers about the alleged threat from abroad. More recently, conservative pundits warned, without evidence, that immigrants in a caravan headed for the U.S. southern border carried the disease, another reason to build the wall.

Now, an obscure medical study has brought a new wave of sensational and misleading headlines and news reports. They warn that central Florida has been identified as a leprosy “hot spot,” that there has been a “surge” of cases in the Sunshine State, and that the Centers for Disease Control and Prevention issued a travel advisory to avoid the region.

Like so much said about leprosy, none of this is true. The report—a research letter published in the CDC’s Emerging Infectious Diseases journal—notes an uptick in cases in central Florida. Most were in Brevard County, which reported 20 cases in 2020, up from 12 the year before, although the number in the county dropped to 5 in 2021. That’s hardly a surge—and it’s not even a sustained uptick. In fact, leprosy, also known as Hansen’s disease, is extremely rare in the United States. The number of cases nationwide has hovered around 200 for decades.

The CDC never advised travelers to avoid going to Florida. The only “travel advisory” was guidance from the report’s authors that physicians take into consideration whether their patients had come from central Florida, because Hansen’s disease might be endemic to the region. Such information can inform efforts to track and reduce the spread of the disease, about which we know little other than that it does not spread easily.

Still, none of this seems to matter when it comes to leprosy, a disease for which fearmongering has always been the most prevalent symptom. Interest in the recent report is clearly linked to the presidential candidacy of Florida Gov. Ron DeSantis, who promises to make his hands-off approach to COVID a national health care model. MSNBC’s Rachel Maddow opined on her Monday night show Aug. 7 that one problem with that promise is that “now, they’ve got leprosy. Not a metaphor. Actual leprosy!” She added, alongside screenshots of the latest headlines, that “Ron DeSantis will then take that model to the whole country. Gulp.”

Gulp, indeed. The truth is that leprosy—despite its reputation—is not a serious threat to public health. It’s easily cured today and only mildly contagious (we don’t entirely know how it’s contracted, though it usually involves sustained contact with an infected individual or exposure to an infected armadillo). In fact, 95 percent of humans are immune to the disease. While DeSantis can be blamed for many things, leprosy is not one of them. The bacteria grow so slowly that the incubation period can be several years. Any patient diagnosed today was likely infected well before Florida’s governor came on the scene.

The bacteria that cause leprosy can attack a victim’s nerves and cause numbness, skin growths, and muscle weakness. If left untreated, it can lead to permanent disabilities, including blindness. Fortunately, Hansen’s disease can be treated today with readily available antibiotics, which make victims no longer contagious within days.

What leprosy patients suffer from most now is stigma, which has proven far more damaging and untreatable than the disease itself. Throughout history, those with leprosy have been isolated and scorned because people wrongly believed it was highly contagious and, in some cases, a punishment from God. For much of the 20^th century, the U.S. government sent leprosy patients to a remote hospital in Carville, Louisiana, where they were confined against their will, often for decades. These Americans lost their freedom, families, homes, and identities, and even the right to vote. There was no medical reason for the quarantine; the government was simply responding to the public’s unfounded fear and ignorance.

Those days are over, thank goodness, but people diagnosed with Hansen’s disease still worry about how society will respond. Many, like my husband’s grandfather, who died at Carville, contemplate suicide. Others who suspect they have leprosy avoid seeking medical care, which only exacerbates their problems.

This also means that cases will go unreported, limiting the collection of valuable information—the whole point of the CDC report that kicked off the fear-laden news cycle. Although few cases of leprosy can be found in Florida, 200,000 new ones are diagnosed each year around the world. These people need help, not headlines that perpetuate the stigma and pain and misguided fears that should have been eradicated decades ago.