RESUMO
Autochthonous leprosy has been reported in New York City, where there are no wild armadillos. Recent autochthonous cases also have been reported in Georgia and Florida and blamed on armadillos, including cases with no known armadillo exposure. International migration needs to be considered as a cause of autochthonous leprosy.
Assuntos
Transmissão de Doença Infecciosa , Hanseníase/transmissão , Mycobacterium leprae/isolamento & purificação , Florida/epidemiologia , Georgia/epidemiologia , Humanos , Hanseníase/epidemiologia , Hanseníase/microbiologia , Cidade de Nova Iorque/epidemiologiaRESUMO
We report an indigenous case of leprosy in New York City in an immunocompetent patient who was infected with a Mycobacterium leprae genotype that is consistent with an exogenous origin. Physicians in the eastern United States should be alerted that, although most patients who develop leprosy in the United States are foreign born, native-born Americans are also susceptible to the infection.
Assuntos
Doenças Endêmicas , Hanseníase/epidemiologia , Hanseníase/microbiologia , Mycobacterium leprae , Polimorfismo de Nucleotídeo Único/genética , DNA Bacteriano/análise , DNA Bacteriano/isolamento & purificação , Humanos , Masculino , Mycobacterium leprae/classificação , Mycobacterium leprae/genética , Mycobacterium leprae/isolamento & purificação , Cidade de Nova Iorque/epidemiologia , Reação em Cadeia da Polimerase/métodos , Pele/microbiologiaRESUMO
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.