Very Normal! Leprosy Cases Surging in Florida, Government Says

Between invasive anacondas and "Florida man," Florida may well be termed the Weirdest State instead of the Sunshine State.

And now adding to the state's general weirdness is the ancient plague of leprosy — yes, leprosy — a rare disease that's usually confined to the pages of the Bible. And yet it's reared its ugly head in Florida with a surge of cases, according to a new report from the Centers for Disease Control and Prevention (CDC), and apparently it may now be endemic to the state, like the way malaria is associated with certain regions.

"Several cases in central Florida demonstrate no clear evidence of zoonotic exposure or traditionally known risk factors," the CDC wrote, adding that data suggests that "leprosy has become an endemic disease process in Florida."

Big yikes.

Though the scope is limited — there were a decidedly medium-numbered 159 cases reported in the United States in 2020 — the CDC warns that leprosy, also called Hansen's disease, is on the uptick overall.

But the CDC says incidences have more than doubled in southeastern America over the past decade, with Central Florida becoming a particular flashpoint: the region lays claim to 81 percent of cases throughout the state and nearly one fifth of all reported leprosy cases across the country.

What's interesting about the Florida leprosy cases is that people are catching this rare bacterial infection not through "traditional risk factors," according to the CDC's analysis, such as exposure to leprosy-carrying armadillos or travelers who come from countries where the disease is widespread.

Leprosy is caused by the Mycobacterium leprae bacteria and can cause foot ulcers, dull patches of skin, swelling and growths on the body — along with nose bleeds and eye and nerve issues. The condition is slow to progress and can take years for a person to develop signs of an infection.

Untreated leprosy can lead to extensive nerve damage and harm to feet and hands, as well foot ulcers that never heal and even blindness, according to the CDC. But unlike ancient times when people with leprosy were thought to be highly contagious and had to be shunned from the greater community, leprosy is actually hard to catch. It requires close exposure to an infected person over numerous months, and even then, more than 95 percent of people are not susceptible to the disease due to a "natural immunity" — all factors, it's worth noting, that make Florida's outbreak more striking.

Thankfully the disease can be cured if caught early and treated, which is what happened to a 54-year-old Florida man whose condition is detailed in this recent CDC report. No need to shuttle off to the Valley of the Lepers like in the 1959 "Ben Hur" movie.

The CDC included the Florida man's case in the report because it's emblematic of leprosy's now-endemic status in the state. The man had complained to his doctor about a painful rash and lesions, but hadn't traveled, hadn't been contact with armadillos or immigrants from countries with widespread leprosy, nor had he hung out with someone recently who had the disease.

So why is Central Florida getting hit with endemic leprosy cases that appear not to arise from common risk factors? The CDC report lays down a few tantalizing bread crumbs: the Florida man worked outside as a landscaper, and "coupled with the high proportion of residents, like our patient, who spend a great deal of time outdoors," these cases of leprosy may be arising from "environmental reservoirs as a potential source of transmission."

This jives with past scientific research that leprosy can be found in soil, water and vegetation.

But could also climate change be behind this rash of leprosy cases in Florida, like how anthrax and thawing permafrost in Siberia are possibly linked?

Earlier this year, an Insider article pointed out the rise of infectious diseases around the world due to rising temperatures and highlighted a provocative 1995 study in Malawi that showed higher rainfall and hence overall proximity to bodies of water like rivers were connected with increased cases of leprosy.

Big picture, though? We don't really know. Despite the largely successful efforts to eradicate this disease in developed countries, the transmission of leprosy is still poorly understood. The CDC report recommends further investigation into the possible environmental factors leading to the rise of cases in Florida.

"It's a very complex disease and much about leprosy remains a gripping puzzle, even today," drug development scientist and global program head at the pharmaceutical company Novartis Gangadhar Sunkara told the BBC earlier this year.

It seems scientists should devote more scrutiny to this ancient plague which has bedeviled man for more than a millennium, especially as it's apparently found a persistent toehold in a developed country that hasn't seen this many cases in years.

More on diseases: A Brief List of Bizarre Diseases Currently Spreading in the United States