Adult T-cell leukemia/
lymphoma (ATL), a rare outcome of
infection with
human T-lymphotropic
virus (
HTLV-I), is endemic in central Brooklyn, which has a large
Caribbean migrant population. Previous studies have suggested that
HTLV-I prevalence in central Brooklyn may be
similar to that recorded in the
Caribbean islands. We established a
pilot 1-year
surveillance program to identify cases of ATL in 7 of 10
hospitals serving the residents of 18 zip
codes of central Brooklyn with a combined
population of 1,184,670. Of the 6,198 in-
patient beds in the
catchment area, approximately 83 percent were covered. Twelve incident cases of ATL were ascertained, all among
persons of Afro-
Caribbean descent, indicating an annual
incidence in
African-Americans in this
community of approximately 3.2/100,000
person-years. Unexplained
hypercalcemia was the most useful
screening method, identifying 3 of 5
patients not referred for possible ATL by a local hematologist. The
femalemale ratio was 31. The age pattern was different from that reported in the
Caribbean Basin and closer to the pattern seen in
Japan. Our study supports evidence that
HTLV-I infection and ATL are endemic in central Brooklyn and suggests that a more intensive
surveillance program for this
disease coupled with intervention efforts to reduce
HTLV-I transmission are warranted.(Au)