It is just a “matter of time” before a leprosy outbreak hits homeless populations in the U.S., a doctor has warned in an opinion piece published in The Hill on Monday. 

Dr. Marc Siegel of New York University’s Langone Health said the combination of poor hygiene, a lack of shelter and inaccessible medical treatment among the homeless creates a “perfect cauldron” for the bacterial disease.

He cited Los Angeles County, with almost 60,000 homeless people, as being particularly at risk. LA also experienced earlier this year another disease, as Siegel put it, “not commonly seen since the Middle Ages,” a typhus outbreak.

Siegel said exacerbating the problem is that three quarters of LA’s homeless population lack medical treatment.

Left untreated, leprosy can cause blindness or permanent disability, which the doctor called a “sure recipe for instant public panic.”

Leprosy affects 250,000 people worldwide annually, according to the Center for Disease Control and Prevention, including about 150 in the US.

Siegel wrote that two-thirds of these cases are in India, which is home to one third of the world’s poorest population.

Central and South America have more than 20,000 new incidences a year, with a few cases coming across the U.S. southern border undetected, he said.

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