02307nas a2200361   4500000000100000008004100001260002100042653001400063653001400077653002200091653002600113653001200139100001300151700001300164700001300177700001300190700001500203700001300218700001300231700001200244700001200256700001100268700001200279700001200291700001300303700001300316245010400329856006700433300001100500490000700511520141300518022001401931       2026                            d  c08/2026bMDPI AG10aAwareness10aDiagnosis10aImported diseases10aMycobacterium leprae 10aleprosy1 aBriciu V1 aLupşe M1 aBaican A1 aFetica B1 aIonică AM1 aCoroiu G1 aFlonta M1 aJodal A1 aFilip V1 aStan O1 aMarcu D1 aLazar A1 aVarodi C1 aBaican C00aThe First Cases of Imported Leprosy in Romania After More than Four Decades of Absence of New Cases  uhttps://www.mdpi.com/2414-6366/11/8/217/pdf?version=1785740039  a1 - 120 v113 a<jats:p>Although in Romania an increase in migrant population has been reported in the last years, there are no screening programs for infectious diseases implemented for migrants. We report the first two cases of leprosy (Hansen’s disease) since 1981 and the first imported ones in Romania, in two sisters originating from Indonesia, employed as massage therapists at a SPA center. Case one was diagnosed with multibacillary Hansen’s disease of mid-borderline type, and case two with paucibacillary Hansen’s disease borderline tuberculoid form based on epidemiological, clinical, histopathological and molecular diagnosis. Both patients have started multidrug therapy with dapsone, rifampicin and clofazimine provided by WHO. Both patients developed dapsone induced anemia under therapy, even though no G6PD deficiency was present, and dapsone was stopped. The clinical evolution of skin lesions was favorable under therapy, and the haemoglobin level started to increase after dapsone was stopped. This publication underlines the risk of importing rare diseases in Romania and in other European countries and the delay in diagnosis due to insufficient awareness among occupational medicine doctors. Improved strategies are needed at national level in order to increase awareness on rare imported infectious diseases and introduce screening programs in migrant population from high-risk areas.</jats:p>  a2414-6366