To the EDITOR: Autochthonous leprosy is defined as locally acquired infection as opposed to infection imported from an area where the infection in endemic. However, within countries where the infection is not endemic, “autochthonous” is commonly used to describe leprosy in persons who are living in their country of ori-gin.1 Historically, leprosy was thought to be transmitted exclusively through extended, close human-to-human contact, with infection acquired during brief travel considered to be exceedingly rare. In the 1970s, the nine-banded armadillo was identified as a zoonotic reservoir of Mycobacterium leprae, which has been implicated in autochthonous leprosy among persons born and living in the United States.2 However, autochthonous leprosy without armadillo exposure has also been reported. The long incubation period of leprosy often makes it challenging to pinpoint the exposure source.
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