title: Five-year experience with type 1 and type 2 reactions in Hansen disease at a US travel clinic.
abstract: 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.
authors.affiliation: Division of Infectious Diseases, Emory University, Atlanta, Georgia, USA. frs7@cdc.gov
authors.forename: Jesse T
authors.initials: JT
authors.lastname: Jacob
authors.forename: Phyllis
authors.initials: P
authors.lastname: Kozarsky
authors.forename: Roberta
authors.initials: R
authors.lastname: Dismukes
authors.forename: Vicki
authors.initials: V
authors.lastname: Bynoe
authors.forename: Lindsay
authors.initials: L
authors.lastname: Margoles
authors.forename: Michael
authors.initials: M
authors.lastname: Leonard
authors.forename: Ildefonso
authors.initials: I
authors.lastname: Tellez
authors.forename: Carlos
authors.initials: C
authors.lastname: Franco-Paredes
mesh_terms: D000328:Adult; D000368:Aged; D015331:Cohort Studies; D005260:Female; D006801:Humans; D007917:Leprostatic Agents / Q000627:therapeutic use; D007918:Leprosy / Q000150:complications* / Q000188:drug therapy* / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D014195:Travel; D014481:United States / Q000453:epidemiology
chemical_list: D007917:Leprostatic Agents