Dr. Rajiv Nathoo performed five or six biopsies on a 54-year-old landscaper who visited an Orlando dermatology clinic with a chronic, splotchy rash. The man had a rash that spread from his limbs to his face, but prior medical professionals had no idea what was causing it. The biopsy results verified Nathoo’s suspicion, which he described as a diagnosis you read in your textbooks: leprosy.
Nathoo, a dermatologist and complex clinic director for Advanced Dermatology and Cosmetic Surgery Clinics in Orlando, became worried that Central Florida might be a leprosy hotspot after observing a cluster of other cases nearby. His team is now advising other healthcare professionals to watch out for situations that are similar to this one nearby.
According to a study letter authored by Nathoo and his colleagues and published by the journal, Central Florida has one of the highest incidences of leprosy in the nation. According to the World Health Organization, 200,000 new cases are recorded a year worldwide, although only 159 cases were reported nationally in 2020. According to the latest letter, 81% of leprosy cases in Florida and nearly 1 in 5 cases nationwide occurred in Central Florida.
Leprosy, also referred to as Hansen’s disease, is brought on by the bacterium Mycobacterium leprae, which damages the skin’s nerves. While scientists are uncertain as to how it spreads, the majority of them think that when an infected person coughs and sneezes, droplets are released that are then inhaled by others. Lesions and rashes that are numb or lack sensation due to nerve involvement are among its characteristic symptoms.
Although it’s not always apparent how humans come into contact with armadillo-borne germs, DNA analyses have connected human infections to the leprosy strains carried by the animals. Nine-banded armadillos are also known to carry the bacteria in the Southeastern United States.
Limited Transmission of Leprosy
Shaking hands or sitting near an infected individual does not cause the disease to spread. According to the US Centers for Disease Control and Prevention, spreading leprosy needs months of close proximity to a person who is diagnosed with the disease. Leprosy is consequently a rare disease in the US.
Leprosy has historically mostly affected travelers to nations with high rates of the disease or those who come into contact with infected armadillos. But occasionally, doctors are unable to determine how a patient was affected. Nevertheless, Nathoo has located the medical records of 15 leprosy cases with biopsy evidence that have gathered in eastern Orlando and Volusia County during the last five years. None of them are connected to each other in any manner, and 14 of them have never left the country.
Additionally, if a patient’s diagnosis was delayed—which happens frequently in the US since medical professionals aren’t accustomed to seeing the disease, a cure might not be able to reverse things like nerve or skin damage. The sluggish growth of the bacteria is one of the difficulties of leprosy. According to the CDC, it may take up to 20 years for signs like pale, numbing blotches, rashes, ulcers, and lesions to appear depending on the type of infection.
Given the delay, it could be challenging to identify the genesis and spread of a leprosy infection. The patient in this latest study’s case report experienced leprosy symptoms for five years prior to visiting Nathoo and getting screened for Hansen’s disease. Before that, he had been informed by a number of medical professionals that they were unclear of his illness.
Healthcare personnel must report leprosy to the state health department within 24 hours, afterwards the National Hansen’s Disease Program will deliver the particular medications to the office and begin a contact-tracing procedure. According to Adams, leprosy just isn’t on the dermatologist’s radar because its signs and symptoms are frequently missed.