5 things you should know about leprosy
Leprosy is not common, but confirmed cases have jumped this year in Florida. There are usually 0-12 new cases of leprosy reported in the state every year. However, nine cases have been reported already. That's more cases than had been expected just after the mid-year point, and in all these cases, the people who were infected had had contact with armadillos—the likely source of the infection.
Here's what you need to know about the uptick in leprosy cases, according to Dr. Consuelo Beck-Sagué, a pediatric infectious disease specialist at the FIU Robert Stempel College of Public Health and Social Work:
1. What causes leprosy?
Leprosy is caused by a microorganism called Mycobacterium leprae. This is a bacteria (not a virus) in the same genus as the bacteria (Mycobacterium tuberculosis) that causes tuberculosis.
Only 5 percent of humans can get infected with the microorganism that causes leprosy. It's a genetic susceptibility. That means that 95 percent of humans cannot get leprosy, of course.
In families with a case of leprosy, those who have married into the family are generally at no risk, while blood relatives are at higher risk. But it's hard to transmit leprosy even to people who are susceptible, and it probably requires contact with respiratory secretions.
Armadillos are among the few mammals that can get and spread leprosy. Research has shown that of the cases of leprosy that turn up in Americans in the South, who haven't traveled to countries where there's a lot of leprosy, are most probably linked to contact with armadillos.
2. What are the symptoms of leprosy?
There are several types of leprosy and its severity depends on immune response, as well as on how much involvement there is of the nerves. Mycobacterium leprae is the only bacteria with a strong tendency to attack nerves.
Early symptoms include a dry patch or patches of skin, sometimes lighter than the rest of the skin, which have no sensation. In these patches, the patient cannot feel heat, touch or pain; it's as if the patches had been anesthetized. Those are very typical of leprosy.
Bumps on the skin are sometimes seen. Thickening of the nerve on the neck that makes it feel almost ropy and loss of the outer part of the eyebrows are also seen, usually later in the course.
3. What steps should Floridians take to avoid catching leprosy?
The most important thing to remember is to not touch or have contact with armadillos or other wild animals. This is important, mainly to avoid catching this disease.
Children and youth should be taught that touching or having any contact with any wild animals or their secretions isn't safe. People with outdoor occupations and hobbies need to be conscious of the risks (including leprosy, rabies and others) that accompany having contact with wild animals.
Within 24 hours of starting treatment, people can no longer spread the disease. But before treatment, prolonged contact with nasal or other body secretions of a person with leprosy is believed to be among the principal ways that leprosy is spread to other people in the 5 percent of humanity that can catch leprosy.
4. Is there treatment available to those who have contracted leprosy?
Leprosy is entirely curable. Effective treatment for leprosy can be obtained for free in the United States. When caught early, the person generally doesn't have permanent damage from the condition. The treatment takes 12-24 months and it requires 2-3 medications.
But this is a situation where an ounce of prevention is worth a pound of cure. This treatment is highly effective, however, it's by no means easy to be on these medications, and there are reactions that can accompany treatment that are unpleasant.
5. What should people do if they think they've been exposed to leprosy?
If you think you've been exposed, you should certainly go to your doctor. Since the period between initial infection and showing symptoms can take up to a year, you have to mention exposure to leprosy if you start having lesions that can be seen in leprosy, even if the exposure was a year or more before.
The Florida Department of Health is a wonderful resource if you think you may have been exposed. There's no medicine or immunization to take for "post-exposure" protection from leprosy like there is with rabies in the United States. But careful evaluation to diagnose and treat leprosy early is useful and important.