Worth R M, Bomgaars M R
Int J Lepr Other Mycobact Dis. 1982 Sep;50(3):335-41.
The 140-year-old epidemic of leprosy among the people of Hawaii reached its peak at about the beginning of this century and has been subsiding ever since. A preliminary review of new cases in Hawaii in the past 15 years showed 49 among those born in Hawaii, plus 360 new immigrant cases (largely from the Philippines and Samoa), 130 of whom were of the borderline lepromatous or lepromatous (BL/L) form. Since 1970 all new cases have been treated as ambulatory patients in their home communities. A detailed review of all 95 new Hawaii-born cases in the past 21 years showed a continuing rapid decline in incidence among ethnic Hawaiian people, with a fall in the proportion of BL/L cases from its former plateau around 40% to only 20% in the last seven years. The new immigrant BL/L cases have apparently not caused a significant secondary outbreak among the Hawaiians but have caused a modest increase among groups. Among these recent non-Hawaiian secondary cases, the proportion of BL/L cases has also recently dropped so sharply that the risk of significant tertiary spread is minor. The possible role of improved nutrition in Hawaii as an influence on these recent leprosy patterns is suggested.
在夏威夷人群中流行了140年的麻风病，在本世纪初左右达到高峰，此后一直在消退。对夏威夷过去15年新病例的初步审查显示，夏威夷出生的有49例，另外还有360例新移民病例（主要来自菲律宾和萨摩亚），其中130例为界线类偏瘤型或瘤型（BL/L）。自1970年以来，所有新病例都作为门诊患者在其所在社区接受治疗。对过去21年夏威夷出生的所有95例新病例的详细审查显示，夏威夷族裔人群的发病率持续快速下降，BL/L病例的比例从之前约40%的稳定水平降至过去七年的仅20%。新移民的BL/L病例显然没有在夏威夷人中引发重大的二次爆发，但在其他群体中引发了适度增加。在这些近期的非夏威夷二次病例中，BL/L病例的比例最近也急剧下降，以至于发生重大三次传播的风险很小。有人提出，夏威夷营养状况的改善可能对这些近期的麻风病模式产生了影响。
