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Am. J. Trop. Med. Hyg., 79(3), 2008, pp. 452-454
Copyright © 2008 by The American Society of Tropical Medicine and Hygiene

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SHORT REPORT


Five-year Experience with Type 1 and Type 2 Reactions in Hansen Disease at a US Travel Clinic

Jesse T. Jacob, Phyllis Kozarsky, Roberta Dismukes, Vicki Bynoe, Lindsay Margoles, Michael Leonard, Ildefonso Tellez, AND Carlos Franco-Paredes*
Division of Infectious Diseases, Emory University, Atlanta, Georgia; Emory TravelWell Clinic, Atlanta, Georgia; Hospital Infantil de Mexico, Federico Gomez, Mexico

 

ABSTRACT

Very few data have been reported on the epidemiology and clinical features of leprosy reactions in non-endemic settings. We performed a retrospective descriptive analysis to define the frequency and features of Type 1 and Type 2 leprosy reactions in a cohort of patients followed at a US travel and tropical medicine clinic in a 5-year period. We identified that leprosy reactions presented in 10/14 (71.4%) patients with leprosy seen at our clinic. We identified that leprosy reactions occur frequently among patients living in non-endemic areas and may occur before the initiation of multi-drug therapy (MDT), during MDT, or even years after completion of therapy and may produce significant neurologic sequelae. This group of patients needs long-term clinical monitoring even after completion of MDT because of the need to continue either anti-inflammatory therapy, presence of severe neurologic sequelae after reactions, or the potential occurrence of late leprosy reactions.

Received February 19, 2008. Accepted for publication May 20, 2008.

Financial support: This study was supported by the grant "Global Health without Travel" of the Global Health Institute of Emory University.

* Address correspondence to Carlos Franco-Paredes, Assistant Professor of Medicine, Division of Infectious Diseases, 550 Peachtree Street, MOT 7th Floor, TravelWell Clinic, Atlanta, GA 30308. E-mail: cfranco{at}sph.emory.edu

Authors’ addresses: Jesse T. Jacob, Phyllis Kozarsky, Roberta Dismukes, Vicki Bynoe, Lindsay Margoles, Michael Leonard, Ildefonso Tellez, and Carlos Franco-Paredes, Division of Infectious Diseases, 550 Peachtree Street, MOT 7th Floor, TravelWell Clinic, Atlanta, GA 30308, Tel: 404-686-5885, Fax: 404-686-4508, E-mails: frs7{at}cdc.gov, phyllis_kozarsky{at}emoryhealthcare.org, roberta_dismukes{at}emoryhealthcare.org, vicki_bynoe{at}emoryhealthcare.org, lmmargo{at}learnlink.emory.edu, mkleona{at}emory.edu, itellez{at}emory.edu, and cfranco{at}sph.emory.edu.






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Copyright © 2008 by the American Society of Tropical Medicine and Hygiene.