In Brazil there is a law that prohibits the use of the term "leprosy" officially. The disease is known as "leprosy" or Hansen's disease. They say this prevents the rejection of people who have it. Carlos da Costa Ribeiro in 1921, notes that leprosy in Ceará is concentrated in the part closest to the shore, during the rainy season is almost submerged. The high sul sertão and half of the state have no cases. Ribeiro draws attention to the fact that the return of people suffering from leprosy, working in the rubber industry in the interior of Amazonas and were linked to the boom of the cotton plantations, spread leprosy in some cases and other cases no. Consider as an active focus Ipu characterized by the large trade with the Amazon.