An ancient illness dating back roughly 4,000 years is drawing renewed concern in Florida, where health officials are working to understand why cases are appearing again.
As of July 18, the Florida Department of Health had recorded 17 cases this year of Hansen’s disease — more commonly known as leprosy — across the state’s northern and central regions.
Hansen’s disease is a long-term bacterial infection that most often targets the skin, peripheral nerves and upper respiratory tract. Without proper treatment, it can cause lasting nerve damage and other serious complications.
Although many people in the United States may assume leprosy vanished centuries ago, the heavily stigmatized disease still affects up to 225 Americans annually and about 250,000 people worldwide each year.
Florida has increasingly emerged as a notable Hansen’s disease hotspot, with recent reports of cases in 14 counties that together are home to more than nine million residents.
Investigators have not confirmed the exact source of the infections, but researchers suspect the spread may be linked to the nine-banded armadillo, an animal known to carry the bacteria responsible for the disease.
Norman Beatty, an assistant professor of medicine at the University of Florida College of Medicine, told the Daily Mail: “There is evidence that direct contact with an armadillo, whether it is alive or dead, can be a source of infection.
“In some communities, eating armadillo is also considered a Southern delicacy.”
Beatty, who treats leprosy patients in Florida, said his clinic had identified at least two patients who had eaten armadillo and may have been exposed while preparing or handling the animal.
A 54-year-old man in central Florida was diagnosed with lepromatous leprosy in 2022 after seeking treatment for a rash
‘We would want to avoid touching or eating the animal,’ he said.
Beatty also noted that his clinic has identified additional cases that have yet to be reported to the state health department or included in its official tally.
‘These numbers are going to continue to grow for the rest of this year,’ he said. ‘It’s probable that we will surpass last year’s number of cases in Florida.’
The state recorded 36 confirmed cases in 2025, nearly double the 20 reported in 2024.
The rise marks a dramatic departure from previous decades, with Florida averaging six cases annually between 1992 and 2014 before recording 29 infections in 2015.
Since then, the state has averaged over 21 examples each year, with approximately 214 reported over the past decade.
The current cases identified this year were spread across Charlotte, Miami-Dade and Volusia, with each reporting two infections.
Scientists are confident it is the nine-banded armadillo is behind the infections
Brevard, Duval, Highlands, Lake, Lee, Manatee, Okeechobee, Orange, Seminole, St Johns and Sumter each recorded one.
Beatty said the rise was ‘probably multifactorial,’ driven partly by doctors becoming better at recognizing the disease and Florida’s growing and aging population.
His clinic is seeing leprosy most commonly among patients in their 60s and 70s, an age pattern that differs from other parts of the world, where younger people and even children are more frequently diagnosed.
Scientists have warned Hansen’s disease may now be endemic in parts of Florida, meaning the bacterium is circulating locally rather than appearing only in people infected overseas.
Several Florida patients had no history of travel to countries where leprosy is widespread, no known prolonged contact with an infected person and no direct exposure to armadillos, the animal most commonly associated with transmission in the southern US.
Some locals who contracted leprosy believe the infection came through soil contaminated with the bacteria.
‘We also have another group of people who have never touched an armadillo, or even seen an armadillo, but they’ve interacted in the soil,’ Beatty said.
Some had worked in industries involving frequent soil exposure while for others, their only known outdoor exposure was golfing.
Leprosy expert Norman Beatty said infections are likely caused by interacting with the armadillos, and even eating them. Pictured is the 54-year-old man who was infected four years ago
Beatty urged people to wear gloves when handling soil in areas armadillos live, particularly around burrows and gardens where they have been digging.
Despite the increase, health officials stress that leprosy remains rare, difficult to catch and curable with antibiotics.
Approximately 95 percent of people are naturally resistant to the bacteria that cause it.
Beatty said research involving his clinic’s patients found little evidence that Floridians were passing the disease directly to one another.
‘Our household contact data does not show much, if any, transmission between humans,’ he said.
‘Humans are infectious to others in some situations, but it’s probably less common than anyone ever thought.’
Instead, Beatty said his team’s research points toward environmental and animal exposure as the more likely sources of infection in Florida.
Because the bacteria multiply extremely slowly, symptoms can take years, and sometimes as long as two decades, to emerge after a person becomes infected.
Early warning signs include discolored, pale or reddish patches of skin that may have little or no sensation. Patients may also develop nodules, thick or dry skin, painless ulcers on the soles of their feet and swelling around the face or earlobes.
Other symptoms include the loss of eyebrows or eyelashes, numbness, weakened or paralyzed muscles and enlarged nerves around the elbows, knees or neck.
The disease can also attack the eyes and nasal passages, causing vision problems, congestion or recurring nosebleeds.
Beatty noted rarity if human transmissions and 95 percent of people are immune to leprosy
Without treatment, the infection can inflict permanent nerve damage, leaving patients unable to feel pain in affected areas. This can allow burns, cuts and other injuries to go unnoticed and become severely infected.
Contrary to a long-standing myth, leprosy does not make fingers and toes simply fall off.
Instead, repeated injuries, chronic ulcers and secondary infections can destroy tissue and cause digits to shorten or be lost. Advanced cases can also result in paralysis, blindness and facial disfigurement.
Beatty said early diagnosis is crucial because antibiotics can cure the infection but cannot always reverse damage that has already occurred.
‘The longer you’re living with leprosy untreated, yes, there are chronic sequelae,’ he added. ‘You can have a chronic neuropathy, you can also have skin lesions that remain for life.’
Treatment varies according to the form of leprosy, but patients typically receive a combination of antibiotics for an extended period.
‘We typically use at least three different types of antibiotics, and they have different mechanisms of action,’ Beatty said.
‘This is a slow-growing bacterium, and we have to treat for a little bit longer periods than we would with other infectious diseases, so a person will be on antibiotics for one to two years.’
Leprosy is one of the oldest diseases known to humanity, with the earliest skeletal evidence discovered in India dating back roughly 4,000 years.
Florida officials want people to wear gloves when touching soil that could be contaminated
The disease is believed to have spread across continents through ancient migration, conquering armies and international trade routes.
However, its precise origin remains disputed, with studies pointing to possible beginnings in Africa or Asia.
Ancient religious texts describe people with certain skin diseases being isolated and forced to announce themselves as ‘unclean,’ although historians caution that not every biblical reference to leprosy necessarily described the illness now known as Hansen’s disease.
Beatty said his team is working to dismantle the ancient stigma surrounding the disease and ensure patients understand effective treatment is available.
‘This is a disease that is curable, and early recognition can prevent any of the chronic sequelae that we do see in later stages,’ he said. ‘We have treatments that can cure you of leprosy.’
