U.S. sees increase in leprosy

0 Comments | Deseret News (Salt Lake City), Feb 18, 2003 | by Sharon Lerner New York Times News Service

NEW YORK -- In the United States, leprosy is usually regarded as a plague of the past, a disease relegated to biblical times or to poor and distant countries. But, as cases of leprosy have been declining worldwide in recent years, the infection has been on the rise in the United States.

While there were some 900 recorded cases in the United States 40 years ago, today more than 7,000 people have leprosy, or Hansen's disease, as it is now called. "And those are the ones we know about," said Dr. William Levis, attending physician at Bellevue Hospital's Hansen's Disease Clinic. "There are probably many, many more."

There is no sign on the door announcing Bellevue's clinic, even though it has almost 500 people receiving regular outpatient care and is one of only 11 federal Hansen's disease centers. On a recent morning, a sampling of patients said they were loath to tell others about their diagnoses.

A Queens man tells his friends that the bumpy patches on his arms are allergies, and a college student has kept her infection secret from everyone but her grandmother. A 61-year-old Staten Island man who is being treated for a recurrence of leprosy he contracted 40 years ago says he still has not told his wife of 33 years.

Most of those infected in this country are immigrants from global leprosy hot spots, like Brazil, India and the Caribbean. But, in the past six years, Levis and his colleagues have proved that a handful of his patients -- including a 73-year-old man from Queens who had never been out of the country and an elderly Jewish man from Westchester County -- have contracted leprosy here.

As a result, the disease is now officially endemic to the Northeastern United States for the first time ever. The bacteria are thought to be passed through the respiratory droplets of an infected person.

With a standard regimen of multiple drugs, a vast majority of people with leprosy cease to be contagious within three months and become free of the bacteria that cause it in two to five years. Without treatment, the disease can be spread and untreated infections can also result in serious complications, including the loss of toes or limbs.

That is what happened to a 47-year-old father of four who was born in Guyana. As Levis ran a swab over his patient's legs testing for numbness, the man from Guyana reflected on his appreciation for his doctor.

"When he started explaining things to me, I thought he was crazy," the patient said.

But after 15 years in which his doctor first cleared the leprosy- causing bacteria from his body and tried to alleviate the numbness, limping and severe case of claw hand, the patient changed his mind. "He's the only one who was able to help me with all this stuff," the patient said, "so I guess he's not crazy after all."