Understanding Hansen’s disease

Hansen’S disease (also known as leprosy) is an infection caused by slow-growing bacteria called Mycobacterium leprae. It can affect the nerves, skin, eyes, and lining of the nose (nasal mucosa). With early diagnosis and treatment, the disease can be cured. People with Hansen’s disease can continue to work and lead an active life during and after treatment.

Leprosy was once feared as a highly contagious and devastating disease, but now we know it doesn’t spread easily and treatment is very effective. However, if left untreated, the nerve damage can result in crippling of hands and feet, paralysis, and blindness.

How do people get Hansen’s disease?
It is not known exactly how Hansen’s disease spreads between people. Scientists currently think it may happen when a person with Hansen’s disease coughs or sneezes, and a healthy person breathe in the droplets containing the bacteria. Prolonged, close contact with someone with untreated leprosy over many months is needed to catch the disease.

You cannot get leprosy from a casual contact with a person who has Hansen’s disease like: Shaking hands or hugging, sitting next to each other on the bus, sitting together at a meal.Hansen’s disease is also not passed on from a mother to her unborn baby during pregnancy and it is also not spread through sexual contact.Due to the slow-growing nature of the bacteria and the long time it takes to develop signs of the disease, it is often very difficult to find the source of infection

How is the disease diagnosed?
Hansen’s disease can be recognized by appearance of patches of skin that may look lighter or darker than the normal skin. Sometimes the affected skin areas may be reddish. Loss of feeling in these skin patches is common. You may not feel a light touch or a prick with a needle.

To confirm the diagnosis, your doctor will take a sample of your skin or nerve (through a skin or nerve biopsy) to look for the bacteria under the microscope and may also do tests to rule out other skin diseases.

How is the disease treated?
Hansen’s disease is treated with a combination of antibiotics. Typically, two or three antibiotics are used at the same time. These are dapsone with rifampicin, and clofazimine is added for some types of the disease. This is called multidrug therapy. This strategy helps prevent the development of antibiotic resistance by the bacteria, which may otherwise occur due to length of the treatment.

Treatment usually lasts between one to two years. The illness can be cured if treatment is completed as prescribed.
Sign and symptoms Symptoms mainly affect the skin, nerves, and mucous membranes (the soft, moist areas just inside the body’s openings).

The disease can cause skin symptoms such as:
Discolored patches of skin, usually flat, that may be numb and look faded (lighter than the skin around), growths (nodules) on the skin, thick, stiff or dry skin, painless ulcers on the soles of feet, painless swelling or lumps on the face or earlobes, loss of eyebrows or eyelashes.

If left untreated, the signs of advanced leprosy can include: paralysis and crippling of hands and feet; shortening of toes and fingers due to reabsorption; chronic non-healing ulcers on the bottoms of the feet; blindness; loss of eyebrows; and nose disfigurement.Other complications that may sometimes occur are: painful or tender nerves; redness and pain around the affected area; and burning sensation in the skin.
*Dr. Anthony Nwaoney is an epidemiologist