Of the 137 reported cases, 116 (85 percent) recorded a location other than the United States as their place of birth. Collectively, national origin of the cases reported in 2006 could be associated with a total of 26 different countries or territories (Table 2). Of the 26 total birth countries reported, the majority of cases (68 percent) presented from the Philippines (22), United States (21), Mexico (20), Brazil (4), and India (9) respectively. Another 23 cases arose from among the Trust Territories (11), Micronesia (5) or American or Western Samoa (1), or Viet Nam (6) . These same patterns are generally reflected in the 10 year summary trend, except notably fewer cases are now being registered among persons immigrating from Cuba or Viet Nam (Table 3).

The WHO and allied non-government organizations (NGO’s) have sponsored global campaigns for the “Elimination of Leprosy as a Public Health Problem” for some 25 years now – the primary aim being to reduce national prevalence to less than 1:10,000 persons by providing antibiotic therapy for the disease. Through these massive efforts, thousands of individual cases have been cured. In 2006 the WHO reported that only 259,017 new cases were registered worldwide, representing a greater than 60 percent decline in annual new case numbers registered since 2001. Unfortunately, nearly all of this reduction has been observed within countries in Southeast Asia, a region which contributes fewer than 10 percent of the cases we encounter in the United States. New Case presentation rates in the rest of the global community appear to be relatively steady.