Summary about Disease
Hansen's disease, also known as leprosy, is a chronic infectious disease caused by the bacterium Mycobacterium leprae. It primarily affects the skin, peripheral nerves, upper respiratory tract, eyes, and testes. It is curable with multidrug therapy (MDT). Early diagnosis and treatment are crucial to prevent disability.
Symptoms
Symptoms can develop slowly, sometimes over years. They may include:
Skin lesions: These are often discolored (lighter or darker than surrounding skin), flat, and numb. They may be single or multiple.
Numbness: Loss of feeling in the skin, particularly in the hands and feet.
Muscle weakness: Weakness in the hands and feet can lead to deformities.
Enlarged nerves: Peripheral nerves, especially those near the elbow and knee, may become enlarged and tender.
Eye problems: Can include dry eyes, reduced blinking, and even blindness if left untreated.
Nasal stuffiness/bleeding: Due to involvement of the nasal mucosa.
Causes
Hansen's disease is caused by the bacterium Mycobacterium leprae. It is believed to be spread via droplets, from the nose and mouth, during close and frequent contact with untreated cases. The exact mechanism of transmission is not fully understood, and prolonged, close contact is typically required.
Medicine Used
Multidrug therapy (MDT) is the standard treatment. The specific drugs and duration of treatment depend on the type of leprosy (paucibacillary or multibacillary). Common drugs used in MDT include:
Dapsone: An antibacterial drug.
Rifampicin: An antibiotic that kills M. leprae effectively.
Clofazimine: An antibiotic and anti-inflammatory drug.
Is Communicable
Yes, Hansen's disease is communicable, but not highly contagious. Transmission requires prolonged, close contact with an untreated individual. Most people have natural immunity to the disease. Once treatment begins with MDT, the person is no longer infectious.
Precautions
Early diagnosis and treatment: This is the most important precaution.
Screening of contacts: Individuals who have close contact with a person diagnosed with Hansen's disease should be screened for the infection.
Hygiene: General hygiene practices, such as handwashing, can help reduce the risk of transmission.
BCG vaccination: Provides some level of protection.
How long does an outbreak last?
Hansen's disease does not typically occur in outbreaks in the same way as other infectious diseases like influenza. New cases occur sporadically. The duration of illness in an individual lasts for as long as the infection remains untreated. With MDT treatment lasting for 6 months to 2 years the infection is eradicated and no longer a threat.
How is it diagnosed?
Diagnosis typically involves:
Clinical examination: Assessing skin lesions, nerve damage, and other symptoms.
Skin smear examination: A sample of skin tissue is examined under a microscope to identify M. leprae bacteria.
Skin biopsy: A small sample of skin is removed for microscopic examination and further testing.
Nerve biopsy: In some cases, a nerve biopsy may be performed.
PCR testing: May be used to detect M. leprae DNA.
Timeline of Symptoms
The incubation period (time between infection and symptom onset) is very long, ranging from several months to many years (typically 3-5 years).
Early stages: Subtle skin changes, such as discolored patches or areas of numbness.
Progressive stages: As the disease progresses, more noticeable skin lesions develop, nerve damage increases, and muscle weakness becomes apparent.
Late stages (without treatment): Permanent nerve damage, deformities, disabilities, and complications affecting the eyes, nose, and other organs.
Important Considerations
Stigma: Hansen's disease has historically been associated with significant stigma, which can delay diagnosis and treatment. Education and awareness campaigns are crucial to reduce stigma.
Treatment Adherence: Completing the full course of MDT is essential for curing the disease and preventing drug resistance.
Disability Management: Patients with nerve damage and disabilities may require rehabilitation services, including physiotherapy and occupational therapy.
Psychological Support: The diagnosis of Hansen's disease can be emotionally challenging. Psychological support and counseling can be beneficial.
Drug resistance: Drug resistance can occur but is rare due to the use of MDT.