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Leprosy is often associated with the concept of ‘uncleanliness’ in Biblical times, making it surprising that the CDC released a report this week suggesting the disease might be spreading unnoticed in Florida. However, there's no need to panic; we’ll explore what the report really means and debunk some common misconceptions about leprosy.
So, what exactly is leprosy?
Leprosy, now more commonly referred to as Hansen’s disease, is a bacterial infection caused by the bacterium Mycobacterium leprae. Since it’s bacterial, it can be treated with antibiotics—so it's neither a fatal condition nor a reason to isolate someone from society.
The bacteria responsible for Hansen's disease are slow-growing, often taking decades before visible symptoms appear. They primarily affect the eyes, nose, skin, and nerves. Nerve damage can lead to a loss of sensation, particularly in the fingers and toes. This has led to the misconception that leprosy causes fingers and other body parts to “fall off.” In reality, minor injuries can accumulate, and the body may absorb the damaged tissues, resulting in the gradual disappearance or shortening of fingers (the CDC has photos here).
How contagious is leprosy?
It turns out, not very contagious. Approximately 95% of people are naturally immune to the disease. For the remaining 5%, it typically takes years—sometimes decades—of close contact with an infected person before transmission occurs. According to the CDC says, the disease is believed to spread through respiratory droplets (such as from the coughs and sneezes of an untreated infected person) over an extended period of time, often many months.
In addition to humans, armadillos are known to carry leprosy. While it is theoretically possible to contract Hansen's disease from an armadillo, it’s highly unlikely. The CDC reassures us that 'Most people who come into contact with armadillos are unlikely to get Hansen’s disease.'
Why is leprosy often viewed as a highly contagious and frightening disease? Likely because of its Biblical associations with skin afflictions that caused a person to be considered 'unclean.' However, the term that was translated as 'leprosy' in the Bible could not have referred to Hansen's disease; the symptoms do not match up, as dermatologist David Kaplan explains in a paper comparing Biblical descriptions with known symptoms of leprosy. Additionally, the scriptures describe leprosy as appearing on clothing or the walls of houses, which likely refers to something more akin to mold or mildew.
The Nepal Leprosy Trust emphasizes how Biblical and historical depictions, and the way we speak about them, perpetuate the stigma against those suffering from Hansen's disease. This issue was prevalent in medieval Europe and continues to affect even modern-day America, where people in Hawaii diagnosed with the disease were sent to a leper colony on Molokai as recently as the 1960s, well after a cure had been discovered.
Explore the authentic history of those living with leprosy.
The Colony: The Harrowing True Story of the Exiles of Molokai by John Tayman
Leprosy in Medieval England by Carole Rawcliffe
Carville’s Cure: Leprosy, Stigma, and the Fight for Justice by Pam Fessler (which examines another U.S. institution for people with Hansen's disease, located in Louisiana)
What is happening with leprosy in Florida?
The CDC's report aims to inform healthcare providers that people in Florida are contracting Hansen's disease, though the exact source of infection is unclear. The report centers around a case involving a 54-year-old landscaper who had no known close contact with individuals diagnosed with the disease, nor with those who had traveled to areas where it is more common. He had never visited those areas himself and had no interactions with armadillos. The mystery remains: how did he contract it?
This is where public health experts grow concerned: If the source of an infection is unclear, it's likely the disease has been silently spreading for some time. In technical terms, it’s endemic. To put it another way: Leprosy might now be present in Florida. The CDC advises that, alongside questioning patients about visits to countries like India, Brazil, and Indonesia—regions known for leprosy—doctors may also need to ask if patients have recently traveled to central Florida.
What are the consequences of contracting leprosy?
Thankfully, Hansen’s disease can be treated. While it’s not as straightforward as taking a quick z-pack like for a typical infection, antibiotic treatment is available. Generally, it involves a combination of two or three antibiotics, taken over the course of a year or more. After the first few doses, the person is no longer contagious.
Antibiotic therapy can stop the disease from worsening, but it cannot reverse any damage already done. This is why it’s important to get checked if you notice symptoms of Hansen’s disease, such as patches of skin that appear lighter, darker, or thickened, possibly accompanied by numbness. The CDC offers a more detailed list of signs and symptoms on their website.
However, leprosy remains extremely rare (even in Florida) and difficult to contract. On average, fewer than 200 cases of Hansen’s disease are reported in the U.S. each year. In Florida, healthcare providers are required to report any cases to ensure proper tracking and that anyone in contact with the patient is notified and offered potential treatment.
