Given that a large number of the leprosy cases in the United States involve Latinos coming up from Mexico, Dr. Marc Siegel, an internal medicine specialist with NYU Langone Health, said "it seems only a matter of time before leprosy could take hold among the homeless population" in Los Angeles County.
There are close to 600,000 homeless people in L.A. County and 75% of those people lack "even temporary shelter or adequate hygiene and medical equipment," Dr. Siegel wrote in The Hill. "All of those factors make a perfect cauldron for a contagious disease that is transmitted by nasal droplets and respiratory secretions with close repeated contact."
"Diseases are reemerging in some parts of America, including Los Angeles County, that we haven’t commonly seen since the Middle Ages," said Dr. Siegel. "One of those is typhus, a disease carried by fleas that feed on rats.... I also believe that homeless areas are at risk for the reemergence of another deadly ancient disease — leprosy, also known as Hansen’s disease."
A recent study from the Keck Medical Center at the University of Southern California--Los Angeles studied 187 patients in the United States with leprosy spanning 1973 to 2018. "Most patients were Latino, originating from Mexico, and they experienced a median delay in diagnosis of more than three years," the study found, as reported by Reuters.
They also reported that leprosy cases "continue to emerge in Los Angeles County."
"Leprosy is still more prevalent in Central America and South America, with more than 20,000 new cases per year," wrote Dr. Siegel. "Given that, there is certainly the possibility of sporadic cases of leprosy continuing to be brought across our southern border undetected."
According to the U.S. National Library of Medicine, "Leprosy, also called Hansen disease, is a disorder known since ancient times. It is caused by bacteria called Mycobacterium leprae and is contagious, which means that it can be passed from person to person. It is usually contracted by breathing airborne droplets from affected individuals' coughs and sneezes, or by coming into contact with their nasal fluids. However, it is not highly transmissible, and approximately 95 percent of individuals who are exposed to Mycobacterium leprae never develop leprosy. The infection can be contracted at any age, and signs and symptoms can take anywhere from several months to 20 years to appear.
"Leprosy affects the skin and the peripheral nerves, which connect the brain and spinal cord to muscles and to sensory cells that detect sensations such as touch, pain, and heat. Most affected individuals have areas of skin damage (cutaneous lesions) and problems with nerve function (peripheral neuropathy)."