01910nas a2200253   4500000000100000008004100001653001900042653001200061653001400073653001800087100001200105700001600117700001500133700001400148700002200162700001100184700001400195245006200209856004600271300001100317490000700328520130700335022001401642       2014                            d10aHansen disease10aleprosy10aIncidence10aUnited States1 aNolen L1 aHaberling D1 aScollard D1 aTruman RW1 aRodriguez-Lainz A1 aBlum L1 aBlaney DD00aIncidence of Hansen's Disease - United States, 1994-2011.  uhttp://www.cdc.gov/mmwr/pdf/wk/mm6343.pdf  a969-720 v633 a<p>Hansen's disease (HD), or leprosy, is caused by the bacterium Mycobacterium leprae and is reportable in many states. It is a chronic disease affecting the skin and nerves, commonly presenting as pale or reddish skin patches with diminished sensation. Without treatment, it can progress to a severely debilitating disease with nerve damage, tissue destruction, and functional loss. An important factor in limiting HD morbidity is early diagnosis and prompt initiation of therapy. Because HD is rare, clinicians in the United States are often unfamiliar with it; however, HD continues to cause morbidity in the United States. To better characterize at-risk U.S. populations, HD trends during 1994-2011 were evaluated by reviewing records from the National Hansen's Disease Program (NHDP). When the periods 1994-1996 and 2009-2011 were compared, a decline in the rate for new diagnoses from 0.52 to 0.43 per million was observed. The rate among foreign-born persons decreased from 3.66 to 2.29, whereas the rate among U.S.-born persons was 0.16 in both 1994-1996 and 2009-2011. Delayed diagnosis was more common among foreign-born persons. Clinicians throughout the United States should familiarize themselves with the signs and symptoms of HD and understand that HD can occur in the United States.</p>  a1545-861X