[Epidemiological survey of leprosy conducted in metropolitan France between 2009 and 2010]. / Enquête épidémiologique sur la lèpre en France métropolitaine en 2009 et 2010.

BACKGROUND: There is no official leprosy register in France. The last epidemiological survey on leprosy in metropolitan France was done between 1995 and 1998. We performed a new epidemiological study of leprosy in metropolitan France in 2009 and 2010. PATIENTS AND METHODS: We contacted 85 dermatology and infectious disease units by e-mail or by telephone in order to determine the number of leprosy patients either being followed up or newly diagnosed in 2009 and 2010. RESULTS: The response rate was 87%. In 2010, 127 patients were being followed up in metropolitan France, mostly at dermatology units (78%). Seventy-five patients were on anti-bacillary treatment and the prevalence was 0.011/10,000. There were 39 new cases diagnosed in 2009 and 2010 (mean 19 cases/year) (low case-detection rate: 0.003 per 10,000 inhabitants). Among the new cases, seven patients (18%) were of French origin, with two from metropolitan France and five from French overseas territories. DISCUSSION: Our study confirms the persistence of imported leprosy in France and shows no significant decrease in the number of new cases since 1998 (19 vs. 18 new cases/year) or in disease prevalence (0.013 vs. 0.011 per 10,000 inhabitants). This prevalence is very far removed from the one per 10,000 inhabitants proposed by the World Health Organization as the criteria for endemic disease. Most patients in our survey were immigrants (82%). Lepromatous forms (46%) were more frequent than the tuberculoid forms (33%). All patients had either travelled to or lived in areas of high leprosy prevalence, including metropolitan subjects. CONCLUSION: Leprosy remains present in metropolitan France, and it is still important to continue teaching about it at medical faculties in order to ensure diagnosis of new patients as early as possible.

Prevalence of human T cell lymphotropic virus (HTLV) types I and II and human immunodeficiency virus type 1 infections among persons with Hansen's disease in New York City.

One-hundred seven consecutive patients attending a New York Hansen's disease clinic from November 1990 through June 1991 were tested for retroviruses. This cohort included 58 patients diagnosed with Hansen's disease after the onset of the AIDS epidemic, 54 of whom immigrated to the United States before diagnosis of Hansen's disease (median, 7 years). The overall rate (1.9%) of human T cell lymphotropic virus (HTLV) type I infection was low. Two (3.6%) of 55 Caribbean-born patients had polymerase chain reaction (PCR)-documented HTLV-I infection, but this incidence was not higher than expected in persons without Hansen's disease. No patient had PCR-documented evidence of either HTLV-II or human immunodeficiency virus (HIV) type 1 infection. The low rate of HIV-1 among those studied was likely related to an absence of classic HIV risk behavior because about half of the cohort could have incubated Mycobacterium leprae for a prolonged period while infected with HIV-1.

An epidemiologic evaluation of leprosy in New York City.

Leprosy is a transmissible disease that is propagated from human to human. At the US Public Health Service hospital, New York City, the number of new leprosy cases per year during the 1970s was about three times greater than in the previous decade. This review of our 100 most recent leprosy patients shows that 60% were of the lepromatous and borderline lepromatous type. Ninety-nine of the patients were foreign born, originating in more than 26 countries. This emphasizes that, at this time, the leprosy problem in New York City is almost exclusively a reflection of immigration patterns. The majority of the patients were asymptomatic at the time of entering the United States. The average latent period from entering the United States until onset of symptoms was 4.8 years, with a range of 0 to 38 years. These figures emphasize the need for physicians to be aware that leprosy can occur as long as five to 40 years after emigration from endemic areas. For all types of leprosy, the average lag from the onset of symptoms to the time of diagnosis was 29.0 months (range, 0 to 245 months). Our experience indicates that a program of urban leprosy treatment using available drugs and supportive care is feasible.

An epidemiologic evaluation of leprosy in New York City

Leprosy is a transmissible disease that is propagated from human to human. At the US Public Health Service hospital, New York City, the number of new leprosy cases per year during the 1970s was about three times greater than in the previous decade. This review of our 100 most recent leprosy patients shows that 60% were of the lepromatous and borderline lepromatous type. Ninety-nine of the patients were foreign born, originating in more than 26 countries. This emphasizes that, at this time, the leprosy problem in New York City is almost exclusively a reflection of immigration patterns. The majority of the patients were asymptomatic at the time of entering the United States. The average latent period from entering the United States until onset of symptoms was 4.8 years, with a range of 0 to 38 years. These figures emphasize the need for physicians to be aware that leprosy can occur as long as five to 40 years after emigration from endemic areas. For all types of leprosy, the average lag from the onset of symptoms to the time of diagnosis was 29.0 months (range, 0 to 245 months). Our experience indicates that a program of urban leprosy treatment using available drugs and supportive care is feasible.