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Articles » Hansen's Disease (Leprosy): DBMD

Hansen's Disease (Leprosy): DBMD

Article title: Hansen's Disease (Leprosy): DBMD

Conditions: Hansen's Disease (Leprosy)

Source: DBMD

Hansen's Disease (Leprosy)

Clinical Features This chronic infectious disease usually affects the skin and peripheral nerves but has a wide range of possible clinical manifestations. Patients are classified as having paucibacillary or multibacillary Hansen's disease. Paucibacillary Hansen's disease is milder and characterized by one or more hypopigmented skin macules. Multibacillary Hansen's disease is associated with symmetric skin lesions, nodules, plaques, thickened dermis, and frequent involvement of the nasal mucosa resulting in nasal congestion and epistaxis.
Etiologic Agent A bacillus, Mycobacterium leprae, that multiplies very slowly and mainly affects the skin, nerves, and mucous membranes. The organism has never been grown in bacteriologic media or cell culture, but has been grown in mouse foot pads.
Incidence In 1999, the world incidence of Hansenís disease was estimated to be 640,000; and in 2000, 738,284 cases were identified. In 2000, 91 cases occurred in the United States. In 2000, WHO listed 91 countries as endemic for leprosy, with India, Myanmar, and Nepal having 70% of cases.
Sequelae Worldwide, 1-2 million persons are permanently disabled as a result of Hansen's disease. However, persons receiving antibiotic treatment or having completed treatment are considered free of active infection.
Transmission Although the mode of transmission of Hansen's disease remains uncertain, most investigators think that M. leprae is usually spread from person to person in respiratory droplets.
Risk Groups Close contacts with patients with untreated, active, predominantly multibacillary disease, and persons living in countries with highly endemic disease.
Surveillance Hansen's disease is nationally notifiable in the United States.
Trends Prevalence has remained relatively stable in the United States. Decreasing numbers of cases worldwide with pockets of high prevalence in certain countries.
Challenges The main challenges for Hansen's disease elimination efforts are to reach populations that have not yet received multidrug therapy services, improve detection of disease, and provide patients with good quality services and free drugs.
Opportunities Hansen's disease in the Western Pacific is a particular problem and opportunities exist for participation in Hansen's disease elimination activities in endemic-disease countries, and in the Republic of the Marshall Islands.

December 2001


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