Volume 79, Issue 3
  • ISSN: 0002-9637
  • E-ISSN: 1476-1645


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.


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  1. Rinaldi A, 2005. The global campaign to eliminate leprosy. PLoS Medicine 2 : e341. [Google Scholar]
  2. Truman R, Kearney MT, Lea JW, 2006. A Summary of Hansen’s Disease in the United States—2005: National Hansen’s Disease Program HHS/HRSA/BPHC.
  3. Boggild AK, Keystone JS, Kain KC, 2004. Leprosy: a primer for Canadian physicians. CMAJ Canadian Medical Association Journal 170 : 71–78. [Google Scholar]
  4. Ranque B, Nguyen VT, Vu HT, Nguyen TH, Nguyen NB, Pham XK, Schurr E, Abel L, Alcais A, 2007. Age is an important risk factor for onset and sequelae of reversal reactions in Vietnamese patients with leprosy. Clin Infect Dis 44 : 33–40. [Google Scholar]
  5. Pocaterra L, Jain S, Reddy R, Muzaffarullah S, Torres O, Suneetha S, Lockwood DNJ, 2006. Clinical course of erythema nodosum leprosum: an 11-year cohort study in Hyderabad, India. Am J Trop Med Hyg 74 : 868–879. [Google Scholar]
  6. Lockwood DN, Vinayakumar S, Stanley JN, McAdam KP, Colston MJ, 1993. Clinical features and outcome of reversal (type 1) reactions in Hyderabad, India. Int J Lepr Other Mycobact Dis 61 : 8–15. [Google Scholar]
  7. Saunderson P, Gebre S, Byass P, 2000. ENL reactions in the multibacillary cases of the AMFES cohort in central Ethiopia: incidence and risk factors. Lepr Rev 71 : 318–324. [Google Scholar]
  8. Kumar B, Dogra S, Kaur I, 2004. Epidemiological characteristics of leprosy reactions: 15 years experience from north India. Int J Lepr Other Mycobact Dis 72 : 125–133. [Google Scholar]
  9. Bwire R, Kawuma HJ, 1993. Hospital-based epidemiological study of reactions, Buluba Hospital, 1985–89. Lepr Rev 64 : 325–329. [Google Scholar]
  10. Van Brakel WH, Khawas IB, Lucas SB, 1994. Reactions in leprosy: an epidemiological study of 386 patients in west Nepal. Lepr Rev 65 : 190–203. [Google Scholar]
  11. Manandhar R, LeMaster JW, Roche PW, 1999. Risk factors for erythema nodosum leprosum. Int J Lepr Other Mycobact Dis 67 : 270–278. [Google Scholar]
  12. de Carsalade GY, Wallach D, Spindler E, Pennec J, Cottenot F, Flageul B, 1997. Daily multidrug therapy for leprosy; results of a fourteen-year experience. Int J Lepr Other Mycobact Dis 65 : 37–44. [Google Scholar]
  13. Anderson H, Stryjewska B, Boyanton BL, Schwartz MR, 2007. Hansen disease in the United States in the 21st Century. Arch Pathol Lab Med 131 : 982–986. [Google Scholar]
  14. Ooi WW, Moschella SL, 2001. Update on leprosy in immigrants in the United States: Status in the year 2000. Clin Infect Dis 32 : 930–937. [Google Scholar]

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  • Received : 19 Feb 2008
  • Accepted : 20 May 2008

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