@phdthesis{100506,
  keywords = {autochthonous leprosy transmission, Florida, armadillos, Pacific Islanders},
  author = {Darcy MF},
  title = {Leprosy, Armadillos, and U.S. Affiliated Pacific Islanders},
  abstract = {<p>News stories in the United States have highlighted the incidence of autochthonous leprosy transmission in Florida attributed to armadillos. Globally, leprosy is spread by human-to-human transmission, and public health initiatives focus on mitigating exposure and preventative treatment in endemic areas. The U.S. and the Americas are unique in that the native nine-banded armadillos are the only zoonotic reservoir of the M. leprae bacteria known to transmit the bacteria to humans. The longevity of the sub-clinical incubation period of M. leprae creates a significant burden in identifying transmission patterns within populations. Despite the availability of treatment, challenges remain for eliminating the disease. Genomic testing has provided a definitive link between armadillos and some U.S. cases. Worldwide, Pacific Islanders have the highest proportion of leprosy new case detection. The U.S. has a unique relationship with six nations, the former Pacific Trust Territories or U.S. Affiliated Pacific Islands. These partnerships significantly impact public and leprosy elimination with this group, both on the USAPI and in the U.S., regarding access to healthcare and engagement with World Health Organization Zero Leprosy initiatives. Zoonotic armadillo transmission does not explain why regional U.S. cases are disproportionately identified in Pacific Islanders. Leprosy is relatively simple to treat clinically in the early stages of disease progression The U.S. and USAPI show high multibacillary (advanced) leprosy diagnosis rates in new case detection. Significant gaps in U.S. public data and a lack of engagement in global partnerships prohibit comprehensive public health planning for this unique disease and disproportionately impacted populations.</p>
},
  year = {2024},
  journal = {Faculty of the  Graduate College},
  pages = {1-167},
  publisher = {Oklahoma State University},
  url = {https://media.proquest.com/media/hms/PFT/2/vbCBZ?_s=FrtP2OdoVCYayiPslDTfVRPCXKk%3D},
  language = {ENG},
}