What Is Hansen's Disease?

Hansen's Disease has been a dreaded condition since the beginning of man's recorded history. Learn more about this illness by reading this article.

Hansen's disease, commonly referred to as leprosy, is a chronic infectious disease caused by the mycobacterium leprae bacteria. This disease can cause severe deformity of the feet, hands and face. The bacteria that cause leprosy thrive in cool areas of the body such as the skin, nerves near the skin surface and in oral and nasal mucus membranes. The infection leads to a loss of sensation in the affected areas.

Leprosy was once a widespread disease but is now generally classified as a tropical disease, with the larger numbers of cases concentrated in Brazil, India, Nigeria, Indonesia, Bangladesh and Myanmar. Only about five percent of the people who are infected with the bacteria actually develop the disease. The immune system generally prevent the development of leprosy. However, it has been found that some people are naturally more susceptible to the infection, while others carry a natural immunity. When an individual does develop symptoms, they are usually mild. The disease is only fatal in rare cases or in cases where other complications have taken hold.

Hansens's disease has two forms-tuberculoid (paucibacillary Hansen's disease) and lepromatous (multibacillary Hansen's disease).



Tuberculoid Hansens's disease is the milder form of leprosy in which bacteria live in a few small, symmetrical skin lesions. Symptoms are caused by the body's immune response to this particular bacteria. After exposure, it usually takes about four years for tuberculoid leprosy symptoms to appear.

Lepromatous Hansen's disease is the severe form in which skin lesions are numerous and larger in size. There are more bacteria present in the lesions and the skin may become very thick. As this type of leprosy advances, nodules may form on both sides of the body. Thick skin folds form on the face and the entire nose may collapse. With lepromatous leprosy, it may take as long as eight years for symptoms to appear after exposure.

Both forms of Hansen's disease may result in permanent nerve damage. Burns and injuries may go untreated and unnoticed because of the loss of sensation associated with leprosy. This can cause unnecessary injuries which may become infected with tissue-damaging bacteria. Damaged foot and hand nerves often cause fingers and toes to stiffen and curl inward, making grasping objects and walking difficult or impossible for some individuals. Fingers may also become shorter and stiff. Both types of leprosy may also result in blindness.

The first drug developed to treat Hansen's disease was promin. This drug was administered by injection and was, for a long time, a very successful treatment. Later, promin was replaced with the antibiotic dapsone, which could be taken orally. In the 1980's, problems arose when the bacteria became resistant to dapsone. At that point, a multi-drug treatment was devised, combining dapsone with clofazimine and rifampin. This treatment has proven to be the most effective treatment for many years. In treating the tuberculoid leprosy, the multi-drug treatment must be followed for approximately six months, while in the case of lepromatous leprosy, the treatment can last as long as two years. These drugs prevent the disease from being contagious as well as stopping the progression of the disease. They cannot, however, reverse any of the nerve damage or deformity that occured prior to treatment.

It is still not known exactly how leprosy is transmitted from one person to another. It is believed that the disease is spread through respiratory droplets but this has not been proven. Preventing the spread of Hansen's disease is, for the present, limited to treating individuals after they contract the disease. Some of the vaccines used to treat tuberculosis may offer some hope in this area since the bacteria that cause Hansen's disease are similar to those that cause tuberculosis.

Even after treatment and the infection is cured, there may still be disability and disfigurement. It is recommended that annual examinations be done for at least five years after the last contact with any person who is infectious.

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