For decades, the evocation of
leprosy referred to pages of history textbooks and stories of distant leprosariums. However, this infectious disease, caused by the bacillus Mycobacterium lepraehas just been confirmed in Romania and Croatia, two countries of the European Union which have not been confronted with it since the 1980s-1990s. The official announcements immediately revived curiosity, sometimes fear, around this pathology little known to the general public.
In Romania, where no case had been recorded since 1981, several workers from Asia tested positive or were considered suspicious in a massage parlor in Cluj-Napoca. In Croatia, a foreign worker from Nepal was diagnosed in Split, the first case since 1993. The authorities repeat that the risk remains very low, but a question remains: how can a disease that was thought to have disappeared still reappear in the heart of Europe?
Leprosy Romania Croatia: the facts
The alert began in Cluj-Napoca, a large city in Transylvania, where four suspected cases were spotted among Asian masseuses employed in the same establishment. Two of them, Indonesian nationals aged 21 and 25, were diagnosed with Hansen’s disease (another name for leprosy) confirmed; two others remain under analysis. According to the Romanian Ministry of Health, one of the patients had just returned from a month spent in Asia with her mother, hospitalized for the same illness.
As a precaution, the spa was closed, all employees examined and disinfection operations launched, while the epidemiological investigation continues. Minister Alexandru Rogobete recalled that contagion requires prolonged and close contact, which strongly limits the risk for occasional customers.
An isolated case in Croatia under control
In Croatia, the National Center for Public Health confirmed an isolated case in the Split region. The patient, a foreign worker from Nepal who had been living in the country for two years with his family, presented himself around ten days ago with symptoms suggestive of leprosy. “The case was quickly identified“, indicated a health official cited by the authorities, specifying that the patient is currently under treatment and that his close contacts have received preventive therapy.
The Croatian authorities emphasize that the situation is under control and that no other positive cases have been detected at this stage. The messages converge with those of Romania and several European experts. “There is no cause for alarm. Even in the case of cases imported into our country (Italy, Editor’s note), we have all the necessary tools to best manage the problem. So, let’s avoid clichés, alarmism and stigmatization, which ultimately harm everyone.“, Italian infectious diseases specialist Matteo Bassetti told RaiNews.
Should we fear leprosy in France?
After these two attacks in Europe, should we fear a resurgence of this disease? On this subject, Dr Gérald Kierzek remains pragmatic:
“It is a disease associated both with extreme poverty and lack of access to diagnosis and care. In this sense, imported cases are not impossible.”
A 2017 study also reported 160 cases in France between 2001 and 2015. The specialist, however, sees no reason to panic.
“First of all, it must be remembered that leprosy is not very contagious. It is transmitted by droplets and nasal secretions from infected people. But it is a contagion which requires several contacts, which is late and which can take years to appear. Then, it is a condition that can be treated, with antibiotics. There is no reason to panic.”
On its website, the Pasteur Institute specifies: “The treatment recommended by the WHO since 1981 makes it possible to cure patients and, if administered early, to avoid disability. This is a polychemotherapy (PCT), which consists of the administration of three antibiotics (dapsone, rifampicin and clofazimine). Paucibacillary leprosy can be cured in 6 months and multibacillary leprosy in 12 months. In addition, patients are no longer infectious from the first dose of PCT, and their ability to transmit leprosy is therefore interrupted.
Leprosy, classified by the World Health Organization among the twenty neglected tropical diseases, remains rare in Europe but present in more than 120 countries. Its long incubation period, from six months to ten years, complicates the identification of cases. The bacillus attacks the skin and peripheral nerves, causing skin lesions, loss of sensitivity and, if treatment is delayed, physical deformities. Transmission occurs through respiratory droplets after repeated close contact, which limits its contagiousness. According to the World Health Organization, this disease “is curable and treatment at an early stage helps prevent disability“. Recent data shows 172,717 new cases worldwide in 2024 compared to 182,815 in 2023, a drop of 5% in diagnoses.