Forgotten, But Not Gone: Leprosy Still Present in the U.S.

Long believed to be a disease of biblical times, leprosy, also known as Hansen's disease, continues to be seen in the United States.

"Approximately 150 cases are diagnosed each year with 3,000 people in the U.S. currently being treated for leprosy,” says James Krahenbuhl, PhD, director of the Health Resources Service Administration's National Hansen's Disease Program (NHDP) in Baton Rouge, La. "We believe there are more cases of leprosy not identified due to the lack of awareness about the disease among physicians in the U.S., which is leading to misdiagnosis and wrong treatments for patients who are left to suffer with the debilitating damage caused by this disease."

Although researchers do not clearly understand how leprosy is transmitted, they do know that it is a slow, chronic disease that attacks the peripheral nervous system and motor skills often leading to disability and disfigurement. According to the NHDP, the onset of infection and symptoms can take three to 10 years, making it difficult for researchers to find the origin of where or how people acquire the disease. As the disease progresses, patients lose their sense of touch in their fingers and toes leaving them open to repeated burns and cuts which then get infected. The effects of repeated damage will initiate bone absorption and motor nerve deterioration causing fingers to shorten and curve, resulting in a claw-like appearance. Although leprosy can be fully treated with medicine when diagnosed in early stages, once the disease has advanced nerve damage cannot be reversed.

Because many of the population in the U.S. affected by leprosy are immigrants in poor communities who primarily seek treatment in free clinics or emergency rooms, the NHDP says that many of those physicians are not familiar with the disease to make an accurate diagnosis. Therefore, many physicians mistake the skin lesions of leprosy for a fungus or ringworm and treat it with a topical cream. And, because leprosy is a slow-progressing disease, it can take months, if not longer, before the doctor or the patient realizes that the treatment isn't working – giving the disease enough time to start destroying the nervous system.

Leprosy is most prevalent in the tropics and third world countries where there are poor living conditions and limited access to medical care. Due to changes in immigrant relocation, leprosy is now being diagnosed throughout the U.S. The NHDP sees approximately 30 cases each year among residents in southern Louisiana and the Gulf Coast of Texas who were born in the U.S. and who have never visited an endemic country. "As we see leprosy move toward internal regions of the States, it becomes more urgent to reach those physicians to let them know about the symptoms of this disease," explains Krahenbuhl, who will lead a symposium at the American Society of Tropical Medicine and Hygiene meeting to raise awareness among physicians that leprosy is in the U.S. and assistance and treatments are available.