Leprosy

Hansen disease

Leprosy is caused by the bacteria Mycobacterium leprae. It is not very contagious and has a long incubation period (time before symptoms appear), which makes it hard to know where or when someone caught the disease. Children are more likely than adults to get the disease.

Experts believe that the bacteria spread when a person breathes in tiny airborne droplets released when someone with leprosy coughs or sneezes. The bacteria may also be passed on by coming into contact with the nasal fluids of a person with leprosy. Leprosy has 2 common forms: tuberculoid and lepromatous. Both forms produce sores on the skin. However, the lepromatous form is more severe. It causes large lumps and bumps (nodules).

Leprosy is common in many countries worldwide, and in temperate, tropical, and subtropical climates. About 100 cases per year are diagnosed in the United States. Most cases are in the south, California, Hawaii, and U.S. islands, and Guam.

Most people who come in contact with the bacteria don't develop the disease. This is because their immune system is able to fight off the bacteria.

Drug-resistant Mycobacterium leprae and an increased numbers of cases worldwide have led to global concern for this disease.

Symptoms include:

• Skin lesions that are lighter than your normal skin color
• Lesions that have decreased sensation to touch, heat, or pain
• Lesions that do not heal after several weeks to months
• Muscle weakness
• Numbness or lack of feeling in the hands, arms, feet, and legs

Tests that are done include:

• Skin lesion biopsy
• Skin scraping examination

The lepromin skin test can be used to tell the 2 different forms of leprosy apart, but the test isn't used to diagnose the disease.

Several antibiotics are used to kill the bacteria that cause the disease. These include dapsone, rifampin, clofazamine, fluoroquinolones, macrolides, and minocycline. More than 1 antibiotic is often given together.

Aspirin, prednisone, or thalidomide is used to control inflammation.

Diagnosing the disease early is important. Early treatment limits damage, prevents a person from spreading the disease, and reduces long-term complications.

Health problems that may result from leprosy include:

• Disfigurement
• Muscle weakness
• Permanent nerve damage in the arms and legs
• Loss of sensation

People with long-term leprosy may lose the use of their hands or feet due to repeated injury because they lack feeling in those areas.

Call your health care provider if you have symptoms of leprosy, especially if you have had contact with someone who has the disease. Cases of leprosy in the United States are reported to the Centers for Disease Control and Prevention.

People on long-term medicine become noninfectious. This means they do not transmit the organism that causes the disease.