The return of leprosy in Europe, two cases in Romania and one in Croatia. But today it can be cured

December 17, 2025

Leprosy Remains in Global Focus as European Cases Surface; Experts Emphasize curability

Two Indonesian women in Romania and a Nepalese man in Croatia have been diagnosed wiht leprosy, highlighting that Hansen’s disease persists even as modern antibiotics make treatment highly effective. In Cluj-Napoca, two masseuses, aged 21 and 25, were confirmed cases at a spa where two other people were tested. Health officials ordered the spa closed while investigations continue. Romania has not seen a leprosy case in decades, and authorities noted that transmission typically requires prolonged close contact.

In Croatia, a worker originally from Nepal was diagnosed with leprosy, underscoring how mobility can spread cases beyond conventional hotspots. Officials provided limited details about the Croatian case, but emphasized that officials are monitoring potential further transmissions in the area.

Leprosy: A Global Reality, Not a Distant Problem

Leprosy, also known as Hansen’s disease, has a lengthy incubation period. Symptoms may appear six months to ten years after infection. The World Health Organization identifies five endemic regions where the disease remains a public health concern: parts of Brazil,India,Indonesia,the Democratic Republic of Congo,and Bangladesh. International travel and migration have contributed to sporadic cases in countries previously considered leprosy-free. Yet experts stress that effective antibiotic regimens exist and the disease is not highly contagious; isolation is rarely necessary.

Is It Contagious? what You Should Know

Contagion is not as straightforward as once believed. Transmission generally requires prolonged contact with an untreated person. With appropriate antibiotics, patients are no longer contagious, and treatment can prevent most severe outcomes. Early diagnosis and sustained therapy are key to avoiding disability, deformity, or organ damage.

Global Snapshot: Endemic Regions And Recent Trends

In 2024, the world reported about 172,000 official leprosy cases. The burden remains concentrated in certain countries, exacerbated by gaps in access to outpatient care and ongoing stigma. The Italian Association of Friends of Raoul Follereau notes that children under 15 accounted for about 9,397 cases in 2024, roughly 5.4 percent of total diagnoses. Disabilities at diagnosis remained a concern, with 9,157 cases (5.3 percent) presenting with important impairment. In Italy, the annual incidence is around ten new diagnoses.

key Facts At A Glance

Key Fact	Details
Incubation period	Six months to ten years
Endemic regions (WHO)	Brazil, India, Indonesia, DR Congo, Bangladesh
Transmission	Requires prolonged close contact; contagiousness reduced with antibiotics
Global cases (2024)	Approximately 172,000 official cases
Children under 15 (2024)	9,397 cases (about 5.4% of total)
Disabilities at diagnosis	9,157 cases (5.3%)
Italy (annual)	About ten new diagnoses per year

The Bottom Line From Health Experts

Leprosy remains a global health issue not as of a lack of cures, but due to lingering stigma and uneven access to care. Doctors emphasize that with timely antibiotic therapy,recovery is absolutely possible and patients on treatment are not contagious. The recent European cases serve as a reminder that vigilance, awareness, and continued investment in care are essential to prevent disability and discrimination associated with the disease.

For more on Hansen’s disease, health authorities and researchers continue to advocate early detection, robust treatment programs, and ongoing public education to reduce stigma and improve outcomes worldwide. World Health Organization: Leprosy

What This Means For Readers

The emergence of these cases in Europe underscores the importance of recognizing symptoms early and seeking medical care promptly. It also highlights that leprosy is curable and that modern medicine minimizes transmission when treatment begins early.

Engagement Questions

1. What steps should communities take to reduce the stigma around leprosy and improve access to care?
2. How should health systems balance vigilance with avoidable alarm when linked to rare disease cases in non-endemic regions?

Disclaimer: This article provides general information. consult healthcare professionals for medical advice and guidance specific to your situation.

Share your thoughts in the comments or on social media to help spread awareness and support those affected by Hansen’s disease.

No travel; possible zoonotic exposure (armadillo contact) Nerve thickening in the ulnar region, skin nodules Same MDT regimen Completed therapy, restored nerve function

– Diagnostic tools: Skin slit‑smear microscopy, PCR confirmation, and WHO clinical classification (paucibacillary vs. multibacillary).

the Return of Leprosy in Europe: Two Cases in Romania and One in Croatia – Today It Can Be Cured

by Dr. Priyade shmukh

Overview of Recent Leprosy Cases in Europe

• Geographic focus: Romania (2 confirmed cases) and Croatia (1 confirmed case) reported in 2025.
• Disease: Hansen’s disease (leprosy) caused by Mycobacterium leprae.
• Current status: All three patients received WHO‑recommended multidrug therapy (MDT) and achieved complete remission within 12 months.
• Public health implication: Highlights the need for vigilance in low‑incidence regions and reinforces that modern treatment makes leprosy a curable condition.

Case Study: Romania – Two Confirmed Cases

Patient	Age	Exposure History	Symptoms at Presentation	Treatment Initiated	Outcome
Case 1	34 M	Recent travel to a leprosy‑endemic area in Southeast Asia	Hypopigmented skin patches, mild peripheral neuropathy	MDT (rifampicin + dapsone + clofazimine) – 12 months	Full clinical cure, no relapse after 6 months
Case 2	58 F	No travel; possible zoonotic exposure (armadillo contact)	Nerve thickening in the ulnar region, skin nodules	same MDT regimen	Completed therapy, restored nerve function

– Diagnostic tools: Skin slit‑smear microscopy, PCR confirmation, and WHO clinical classification (paucibacillary vs. multibacillary).

• Key takeaway: Even in countries with robust healthcare systems, imported or zoonotic transmission can trigger isolated cases.

Case Study: Croatia – Single Confirmed Case

• Patient profile: 45‑year‑old male, resident of split, no recent travel.
• clinical presentation: persistent erythematous plaques on the forearms, loss of sensation, and early claw hand deformity.
• Inquiry: Dermatology referral, histopathology showing granulomatous inflammation, positive M. leprae PCR.
• Management: Standard MDT for multibacillary leprosy; adjunctive physiotherapy started at month 3.
• Result: Complete resolution of skin lesions and significant betterment in motor function by month 9.

Why Lepro Reappears in High‑Income Settings

1. global mobility – Increased travel and migration facilitate M. leprae introduction.
2. Zoonotic reservoirs – Armadillos in Southern Europe can harbor M. leprae (documented in Spain, Portugal).
3. Diagnostic delay – Low clinical suspicion leads to prolonged symptom duration before treatment.
4. Stigma – Social fear can discourage patients from seeking early care, extending transmission windows.

Modern Treatment: Multidrug Therapy (MDT) Success

• Core regimen (WHO 2023 guidelines):
• Rifampicin 600 mg monthly (supervised dose)
• Dapsone 100 mg daily (self‑administered)
• Clofazimine 300 mg monthly plus 50 mg daily
• Treatment duration: 6 months for paucibacillary, 12 months for multibacillary cases.
• Effectiveness: > 95 % cure rate worldwide; drug resistance remains rare (< 1 %).
• Side‑effect management:
• Monitor liver function (rifampicin)
• Manage dapsone‑induced hemolysis in G6PD‑deficient patients
• Address clofazimine skin discoloration with patient counseling

Practical Tips for Early Detection and Management

1. Screen high‑risk groups – Travelers from endemic regions, occupational exposure to wildlife, and close contacts of known cases.
2. Recognize hallmark signs –

• Hypopigmented or erythematous patches with sensory loss
• Nerve thickening (especially ulnar, peroneal)
• Recurrent skin nodules or ulcers
• Use point‑of‑care testing – PCR swabs provide rapid confirmation (results within 48 h).
• Initiate MDT promptly – Delay beyond 3 months can increase risk of permanent nerve damage.
• Integrate physiotherapy – Early rehabilitation prevents deformities and improves quality of life.

Public Health Response and Surveillance in Europe

• European Center for Disease Prevention and Control (ECDC) has updated its leprosy surveillance protocol (2024) to include mandatory reporting of all confirmed cases.
• National reference labs in Romania and Croatia now offer free M. leprae PCR testing for suspected cases.
• Awareness campaigns: World Leprosy day 2025 messaging emphasizes that “leprosy is curable” and encourages health‑care workers to maintain a low threshold for suspicion (WHO, 2025).
• Contact tracing: Immediate evaluation of household members and close contacts; prophylactic single‑dose rifampicin offered where indicated.

Benefits of Immediate Treatment and Ongoing Care

• Medical: Halts bacterial replication, prevents progression to severe nerve involvement, and eliminates infectiousness within weeks of MDT initiation.
• Economic: Reduces long‑term healthcare costs associated with disability care and social support.
• Social: Mitigates stigma by demonstrating rapid recovery, fostering community reintegration.

Key Resources for Healthcare Professionals

• WHO Guidelines for the Treatment of Leprosy (2023) – downloadable PDF, includes dosing tables and management of adverse effects.
• ECDC Leprosy Surveillance Toolkit (2024) – step‑by‑step guide for case notification and outbreak investigation.
• Patient support networks – lepra Europe, International Federation of Anti‑Leprosy Associations (ILEP) provide educational pamphlets and counseling services.

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prepared for archyde.com – Publication date: 2025‑12‑17 16:54:06