Leprosy surveillance no. 1, January 1970
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Leprosy surveillance no. 1, January 1970

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    There were 1,820 cases of leprosy reported in the United States, including Puerto Rico, from the years 1949 to 1968; 89 percent of the cases (1,612) were reported from seven areas: California, Florida, Hawaii, Louisiana, New York City, Texas, and Puerto Rico. The largest number of cases (147) were reported in 1968 (incidence .073/100,000). The incidence has varied over the 20-year interval, reflecting the development of specialized state programs in Texas, California, Florida, and New York, and changes in national origin of the persons involved in Florida and Hawaii. With the emphasis on outpatient treatment, subsequent to a brief period of hospitalization for initiation of therapy, more cases are being reported. In addition, cases are diagnosed after briefer periods of illness.

    O f the 147 cases reported in 1968, 63 (43 percent) were born in the United States, including Puerto Rico, and 65 (43 percent) were born in the four countries of Mexico, Philippines, Cuba, and Samoa. Lepromatous and dimorphous leprosy was diagnosed in 78 (66 percent) of 118 patients whose clinical type was reported.

    Only 21 percent of cases reported in California were born in the United States; a larger percentage was born in Mexico, the Philippines, Samoa, and other foreign countries. In Florida, the majority of the recently reported cases are in persons born in Cuba. In Hawaii the majority of recently reported cases are in persons born in the Philippines and Samoa, and in New York City the majority of recently reported cases are in persons born in Puerto Rico and other Caribbean Islands. The largest number of cases of leprosy in persons born in the United States are reported in Puerto Rico and Texas. A large portion of the Texas cases are in persons with Spanish surname and/or of Mexican birth.

    Although in the early 1900's, there were cases of leprosy in immigrants from Scandinavia in the upper Mississippi Valley, only one case in a person of Scandinavian ancestry had been reported in the last 20 years. The patient was from Minnesota. Apparently this focus has disappeared.

    Only 755 of the 1,820 cases newly reported from 1949-1968 have been admitted to the USPHS Hospital at Carville. Other cases have been admitted to hospitals in Hawaii, Puerto Rico, and more recently to USPHS Hospitals in San Francisco and New York City. The majority of patients admitted to Carville have had lepromatous or dimorphous leprosy, possibly because outpatient facilities are used for treatment and care of patients with tuberculoid leprosy without complications.

    There were 346 Negroes admitted to Carville in the interval 1900-1968, the majority from Louisiana. Of 53 Negro patients with leprosy admitted after 1949, 31 (58 percent) had lepromatous leprosy, a frequency greater than might be expected on the basis of experience in Africa where tuberculoid leprosy is a higher percentage of the total.

    Leprosy was diagnosed in 187 persons who entered the military service after 1940 and were diagnosed before 1968. For various epidemiologic reasons, only 30 were considered to have had an almost definite exposure overseas. In these individuals, there was an average of 9 to 11 years between the exposure overseas and the diagnosis of lepromatousleprosy and an average of 3 to 5 years between exposure overseas and the diagnosis of tuberculoid leprosy.

    The State and Territorial Epidemiologists at a meeting in May 1969 requested: The reporting of leprosy on the weekly morbidity telegrams; a single form for reporting of leprosy; and modification of foreign quarantine regulations to allow entry into the country of persons with indeterminate and tuberculoid leprosy.


  • Content Notes:
    I. Summary -- II. Introduction -- III. General -- IV. Reports from the states -- V. Report from Carville -- VI. Leprosy in veterans -- VII. Reports on meetings -- VIII. Leprosy surveillance form.
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