• 1

    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.

  • 2

    U.S. Department of Health and Human Services, CDC, 2001. Summary of notifiable diseases, United States, 1999. MMWR Morb Mortal Wkly Rep 48 :1–101.

    • Search Google Scholar
    • Export Citation
  • 3

    World Health Organization, 1998. World Health Organization Expert Committee on Leprosy. Seventh Report. World Health Organ Tech Rep Ser 874.

  • 4

    Sehgal VN, Jain S, Charya SN, 1996. Persisters, relapse (reactivation), drug resistance and multidrug therapy (MDT): uniform diagnostic guidelines for leprosy are needed. J Dermatol 23 :905–907.

    • Search Google Scholar
    • Export Citation
  • 5

    Girdhar BK, Girdhar A, Kumar A, 2000. Relapses in multibacillary leprosy patients: effect of length of therapy. Lepr Rev 71 :144–153.











View More View Less
  • 1 Brooke Army Medical Center, Fort Sam Houston, Texas; National Hansen’s Disease Programs, Baton Rouge, Louisiana; Medicine Specialty Services, University of Texas at Tyler, San Antonio, Texas

Areas of low endemicity of Hansen’s disease, such as Texas, California, and Hawaii, exist due to immigration and rare autochthonous infections. Managing this disease in these areas of low endemicity is difficult, especially in observing for relapse. The accurate diagnosis of relapse is imperative so that appropriate therapy can be promptly reinstituted and unnecessary treatment can be avoided. To assess treatment failures in an area of low endemicity, we retrospectively evaluated 113 patients with Hansen’s disease treated in southern Texas. Of 57 patients who completed therapy, 11 were later restarted on medications for this disease for presumed relapse. However, nine of the 11 were found not to have true relapses of Hansen’s disease. The accurate diagnosis of relapse of this disease is essential not only in the individual patient but also for prospective treatment trials to establish best practices.

Author Notes

Reprint requests: Clinton K. Murray, Department of Medicine, Infectious Diseases Service, Brooke Army Medical Center, 3851 Roger Brooke Drive, Fort Sam Houston, TX 78234-6200, Telephone: 210-916-5554, Fax: 210-916-0388, E-mail: Clinton.Murray@AMEDD.ARMY.MIL.