Understanding the Impact of Hansen’s Disease (Leprosy) on Immigration Medical Exams

Hansen’s disease, commonly known as leprosy, is an infectious chronic bacterial illness primarily affecting the skin and peripheral nerves, characterized by specific skin lesions. Despite being one of the oldest diseases in recorded history, it remains a significant concern due to its potential for severe deformity and impairment if left untreated. Consequently, the CDC has established stringent guidelines for screening immigrants for Hansen’s disease during medical examinations.

The Link Between Hansen’s Disease and Immigration

According to the US Centers for Disease Control and Prevention, approximately 200,000 cases of leprosy are identified annually worldwide. However, in the United States, only 150 to 250 cases are diagnosed each year, with immigrants constituting the majority of these cases. Many countries in South Asia, South Africa, and South America report over 1,000 cases annually. Given the significant influx of immigrants from these regions to the United States, there is an increased risk of Hansen’s disease entering the country.

Transmission of Leprosy

Hansen’s disease is caused by the bacterium Mycobacterium leprae and is believed to spread through contact with infected individuals’ mucosal secretions. Transmission typically occurs when an individual with Hansen’s disease coughs or sneezes. However, the disease is not highly contagious, and prolonged, close contact with an untreated individual is usually required for transmission to occur.

There have been concerns about the role of armadillos in Hansen’s disease transmission. Some armadillos in the southern United States are naturally infected with Mycobacterium leprae, raising the possibility of transmission to humans. However, the risk posed by armadillos is considered minimal.

Who Is at Risk?

While Hansen’s disease is rare in the United States, it affects up to 2 million individuals worldwide. Overall, the likelihood of contracting the disease is low, as over 95% of people possess natural immunity against it.

However, individuals residing in regions where the disease is prevalent face a higher risk. Between 2011 and 2015, several countries in Africa, Asia, and the Americas reported over 1,000 new cases of Hansen’s disease to the World Health Organization (WHO). Additionally, individuals in prolonged close contact with untreated individuals with Hansen’s disease are at risk of transmission, though the risk diminishes once treatment is initiated.

Understanding the Impact for Immigration

Immigrants from regions where Hansen’s disease is endemic are subject to thorough medical examinations to detect and prevent the spread of the disease within the United States. These examinations play a crucial role in ensuring public health and safety while facilitating the immigration process for individuals from affected regions.


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