A total of 166 cases were reported to the National Hansen’s Disease Registry (NHDR) in 2005, representing a > 20% increase over the number of cases reported in the previous year (2004, n=131). This clearly reverses the declining trend in registered cases seen in recent years (Figure 1). Temporal variation in presentation is not uncommon with chronic diseases and can be influenced by a variety of factors. The decline in case registrations seen in the previous three years was coincident with the geographic relocation of our program from Carville, Louisiana to its current Baton Rouge campus, and it is possible that this programmatic disruption had some impact on case reporting.

The monthly number of cases registered in 2005 ranged from a low of 5 in December to a high of 33 in June (Figure 2). There is no pertinent epidemiological reason that a slow chronic disease might have variable reporting rates throughout the year, and these fluctuations in registration are probably the result of other operational issues. Among the operational concerns that might have influenced case registration in 2005 was transfer of our Registry data between incompatible computer platforms, which likely created some bottlenecks in recording. The Hansen’s Disease Registry is now available as a SAS dataset, making it much easier to compare reporting trends. Comparing monthly registration trends over the last ten years shows that registration reports tend to be returned at a fairly constant rate throughout the year, and there is no substantive intra-year temporal trend for reporting cases to the HD Registry (Figure 3).