The global prevalence of leprosy has decreased considerably from an estimated 600,000 cases in 2001 to approximately 190,000 cases at the start of 2011. This is due in part to a reduction in the treatment length from 24 months to 12 months, resulting in fewer people on treatment (and therefore classified with the disease) at any one time. The number of new cases of leprosy per year (incidence) also fell from approximately 720,000 in 2000 to about 300,000 in 2005. Since then this has stabilised, with an estimated 230,000 new cases reported in 2010. The highest numbers of new cases in 2010 were reported from India, Brazil, Indonesia, the Democratic Republic of Congo, and Ethiopia.
The World Health Organization (WHO) target of reducing leprosy to less than one case per 10,000 people globally was met in 2000. Given that leprosy can be clinically diagnosed, there is an effective multi-drug therapy, and the principal source of infection is untreated human cases, it is likely that a further reduction in leprosy burden is achievable.
Further information on the global epidemiology of leprosy is available from the World Health Organization [external link].
Leprosy became a notifiable disease in England and Wales in 1951 and a register of all cases was maintained, initially by the Ministry of Health and subsequently by the Department of Health and Social Security. In 1982, the national communicable disease surveillance centre in London, now part of Public Health England, as of 1 April 2013, has co-ordinated national surveillance of leprosy for the Department of Health.
Since 1951, a total of 1533 cases have been reported and the incidence has fallen from 373 cases notified in 1951-1960 to 129 cases in 2001-2010 (Figure). Between 1981 and 2010, 42.4% (127/299) of cases with known clinical features were diagnosed with lepromatous or borderline lepromatous leprosy. For cases with a recorded sex at notification, 64.5% (200/310) were male, and 62.7% (173/276) of those with a known age were aged 15-44, reflecting the reported higher risk of leprosy in men after puberty (6).
Since 1981, 59.9% (142/237) of cases with a recorded country of birth were born in South Asia, with the most common countries of India (81) and Pakistan (26). Since 1951, there have been no cases of confirmed transmission or acquisition in the UK.