A New York City doctor and professor of medicine, writing on the political website The Hill, has warned that a once-dreaded medieval disease — leprosy — might soon start affecting America’s homeless population.

Also known as Hansen’s disease, leprosy was a common affliction in Europe in the Middle Ages. A chronic bacterial infection causing lesions that damage the skin, nerves, eyes, and limbs, it was once believed (incorrectly) to be highly contagious. Sufferers were isolated and ostracized — so much so that “leper” became a metaphorical term for somebody shunned for moral or social reasons.

In a just-published article called “Is a Dark Ages disease the new American plague threat?,” Dr. Marc K. Siegel, professor of medicine at New York University School of Medicine, notes that “The poor are disproportionately affected by this disease” due to “close quarters, poor sanitation, and lack of prompt diagnosis or treatment.”

An early 20th-century chemist, Alice Ball, invented the first injectable treatment for Hansen’s disease, used for more than 20 years, until antibiotic therapy replaced it. It has not been a pressing health concern in the U.S. since, unlike these serious public health issues.

More than 200,000 new cases of leprosy are reported each year, according to the Centers for Disease Control and Prevention. Two-thirds of those are in India, while more than 20,000 of the rest are found in Central and South America.

Thus far, only between 100 and 200 new cases are discovered in the U.S. annually — but, writes Siegel, “[I]t seems only a matter of time before leprosy could take hold among the homeless population in an area such as Los Angeles County, with close to 60,000 homeless people and 75 percent of those lacking even temporary shelter or adequate hygiene and medical treatment.”

The National Organization for Rare Disorders stresses that “Leprosy is a treatable and curable disease…[and] patients on treatment are not infectious and do not spread the disease.” Unfortunately, that isn’t true of all diseases. These are the infections that even doctors are afraid of.

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