A total of 137 cases were reported to the National Hansen’s Disease Registry (NHDR) in 2006. While this number represents a 20 percent decline from 2005 it is in keeping with the general trend of the last decade (Figure 1). Temporal variation in presentation is not uncommon with chronic diseases and can be influenced by a variety of factors. Declines in annual case registrations were seen coincident to relocation of our Program from Carville, Louisiana to its current Baton Rouge campus. Those annual numbers have increased steadily to this point in time and may now have stabilized.

The monthly number of cases registered in 2006 ranged from a low of 1 in December to a high of 25 in January (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. Comparing monthly registration trends over the last 10 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). Inspection of reporting records suggests there may be some confusion among State health departments and local practitioners with regards to the process of reporting HD cases. Some cases are reported to the CDC but not to the NHDP, and others go wholly unreported for several years. We are working with CDC personnel to resolve this issue.