Leprosy (Hansen's Disease)

Leprosy is a chronic bacterial infection caused by the bacteria mycobacterium leprae, classically involving the skin, nasal passages, peripheral nerves and testes.

Where does it occur?

It occurs primarily in developing countries with 90% of cases in 2002 reported from Brazil, India, Madagascar, Mozambique, Nepal, and Tanzania. In the United States cases have been seen in California, Texas, Louisiana, Hawaii, and Puerto Rico.

How is it transmitted?

It is transmitted through contact of nasal droplets from an infected person to another person’s skin or respiratory tract. One may also contract it from soil infected by armadillos.

Is it contagious from person to person?

It is contagious from person to person through nasal secretions.

What is the risk for travelers?

The risk is generally very low.

How soon after exposure will I develop symptoms?

Symptoms usually develop 5-7 years after exposure, but can take up to 40 years.

What are the signs and symptoms?

Signs and symptoms commonly involve the skin, nasal passages and nerves.

 Involvement of the skin is manifested either as diffusely thickened skin, thickened plaques, nodular to irregular raised lesion or as a flat patch of lightly discolored skin with associated numbness.

Involvement of the nasal passages is characterized by chronic congestion and bloody nasal discharge with subsequent collapse of the central cartilage leading to a “saddle nose”.

Involvement of the nerves is manifested with loss of sensation of touch, hot and cold sensitivity and pain. Damage to nerves at elbow can result in bending of 4th/5th fingers resulting in a “claw hand” or atrophy of muscles between fingers.

Are there any lab tests to diagnose the illness?

Skin lesions can be smeared for mycobacterium leprae on special acid fast stains.

Is there any treatment?

Antibiotics like dapsone + rifampin + clofazamine are effective if treated for 12-24 months.

What preventive measures can be taken?

Reduce contact with known leprosy patients.

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