February 01, 2009
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Leprosy rare but remains, even in the United States

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Contrary to many people’s suppositions, leprosy is not an eradicated disease. Although leprosy, also known as Hansen’s disease, is often associated with the distant past, cases are reported throughout the world, including the United States.

A symposium here was focused on the risk for contracting leprosy and treatments for the disease. James Krahenbuhl, PhD, director of the Health Resources Service Administration’s National Hansen’s Disease Program in Baton Rouge, La., led the symposium. Krahenbuhl said although leprosy is rare, it still exists. “Approximately 150 cases are diagnosed each year and there are about 3,000 people in the United States currently being treated for leprosy,” he said in a press release.

Krahenbuhl added that there may be even more cases of leprosy that remain undiagnosed. He said lack of awareness about the disease may contribute to cases being misdiagnosed or undiagnosed. “We believe there are more cases of leprosy not identified due to the lack of awareness about the disease among physicians in the United States, which is leading to misdiagnosis and wrong treatments for patients who are left to suffer with the debilitating damage caused by this disease,” he said.

Also adding to the diagnosis difficulties is the fact that leprosy is often a slow, chronic disease. According to Krahenbuhl, the onset of symptoms can take three to 10 years. Krahenbuhl also said that much remains unknown about the disease; it is still not clearly understood how leprosy is transmitted.

Early diagnosis is important for patients with leprosy. The disease can be fully treated with medicine when diagnosed in early stages. However, once the disease has advanced, nerve damage cannot be reversed.

Prevalence

Today, leprosy is most common in tropical climates and in developing countries.

According to data from the National Hansen’s Disease Program, an average of 30 cases per year have been recorded in the past few years in southern Louisiana and the Gulf Coast of Texas.

Krahenbuhl said many patients with leprosy in the United States are poor and often seek treatment in free clinics or emergency rooms. Because of this, they are often treated by physicians who are not familiar with the disease and who may misdiagnose the symptoms. Krahenbuhl said the skin lesions of leprosy have often been mistaken for a fungus or ringworm and doctors have prescribed treatment with topical creams.

“As we see leprosy move toward internal regions of the United States, it becomes more urgent to reach those physicians to let them know about the symptoms of this disease,” Krahenbuhl said.

Presented at: ASTMH 57th Annual Meeting; Dec. 7-11, 2008; New Orleans.