September 01, 2011
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Hansen’s disease on the rise among US Micronesian, Marshallese patients

Woodall P. Emerg Infect Dis. 2011;17:1202-1207.

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The number of Micronesian or Marshallese origin patients with Hansen’s disease has risen in the United States during the past decade, according to a study.

“[Hansen’s disease] has been present in the United States for more than a century; the number of patients has remained relatively constant at 150-200 per year,” researchers wrote. “The US National Hansen’s Disease Program has noted an increasing number of cases among US-resident Marshall Islanders and Micronesians, including several persons with advanced disease.”

National Hansen’s Disease Program surveillance and clinical records were used to find demographic and disease-related data from January 1990 to October 2009 cases that identified patients as either from the Marshall Islands or Micronesia.

Clinical data were available for 49 patients. Of these patients, 37 had leprosy reaction, neuropathy or other complications. Of Micronesian patients, only two were aged younger than 40 years; 42 (76%) had multibacillary disease; 10 (18%) were female; and six (10%) were children. Of Marshallese patients, only one was aged younger than 40 years; 25 (76%) had multibacillary disease; 11 (33%) were female; and three (10%) were children. Of Marshallese patients living in northwestern Arkansas, all were aged younger than 40 years; 15 (88%) had multibacillary disease; five (30%) were female; and none were children.

“With the goal of decreasing health disparity and preventing disability, case-finding and case-management interventions are needed in US-resident Marshallese and Micronesian communities that are integrated into general health services and avoid the stigma of leprosy-labeled activities,” researchers wrote. “Special efforts may be necessary to increase case detection among women and children.”

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