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Relapse of Leprosy in American Samoa

The incidence of known leprosy in American Samoa was 5.3 per thousand. There were 24 open cases. Of old, outpatient, lepromatous cases, 25% had undergone frank clinical and histological relapse, and 41.7% were bacteriologically positive. Only 9% of old tuberculoid cases showed histological evidence of activity.

Lepromatous leprosy exhibits a strong tendency to relapse when suppressive sulfone chemotherapy is discontinued, even if the patient has previously received chemotherapy for as long as 5 years. Tuberculoid leprosy, on the contrary, tends to undergo arrest of activity, even when chemotherapy has been of brief duration and long since discontinued. Neglect of patient follow-up results in rapid deterioration of leprosy control.

^* Formerly Chief of Medical Service, Hospital of American Samoa. Present address: 2101 Travis St., Amarillo, Texas.