Abstract
Autochthonous leprosy has been reported in New York City, where there are no wild armadillos. Recent autochthonous cases also have been reported in Georgia and Florida and blamed on armadillos, including cases with no known armadillo exposure. International migration needs to be considered as a cause of autochthonous leprosy.
Highlights
In 1982, we reported that leprosy in New York City occurred exclusively among foreign-born persons [1]
Autochthonous cases of leprosy reported from the eastern United States should not be assumed to be from armadillos
Leprosy most commonly is characterized by an infiltrative dermopathy, which dermatologists and many physicians know is an indication for skin biopsy
Summary
In 1982, we reported that leprosy in New York City occurred exclusively among foreign-born persons [1]. The transmission of leprosy is poorly understood, international migration of persons with leprosy is a more likely scenario for autochthonous transmission than contact with armadillos, especially if a case-patient has no history of armadillo exposure. Ramos et al linked an increase in autochthonous leprosy in Spain to a 5-fold increase in migration from countries where leprosy is prevalent [9].
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