An Epidemiologic Evaluation of Leprosy in New York City

Autochthonous Leprosy without Armadillo Exposure, Eastern United States

“…In 1982, we reported that leprosy in New York City occurred exclusively among foreign-born persons ( 1 ). In 1991, Mastro et al reported that leprosy was an epidemic phenomenon without secondary transmission ( 2 ).…”

Autochthonous leprosy in the eastern United States is from international migration, not from armadillos

“… 2 We reported autochthonous leprosy cases in New York City, 3 including proof with molecular techniques. 4 In our original epidemiologic evaluation of leprosy in New York City, we found an average lag from onset of symptoms to diagnosis of leprosy of 4.8 years with some cases going undiagnosed for more than 30 years, 5 findings that tend to confirm the lower incidence than expected in the Ramos study. Although the transmission of leprosy is still poorly understood, it stands to reason that the international migration of patients with leprosy is playing a role in what has been identified as a secondary attack of leprosy in New York City, and New York City is well above the armadillo belt.…”

Endemic Leprosy in New York City

“…A 1982 epidemiologic report of leprosy in New York City showed 99 of 100 of the most recent leprosy cases at the former USPHS (United States Public Health System) Hospital on Staten Island, NY were foreign born (4). There were cases of leprosy in foreign born patients who had been in the U.S. for as long as 38 years, raising the question of acquiring the infection in some of NYC’s immigrant communities.…”