Hansen's Disease-Leprosy Information

The sources for the information in this document are the Florida Department of Health and the Centers for Disease Control and Prevention. For additional information about Hansen's disease, also known as leprosy, please visit http://www.cdc.gov/leprosy/.

What is Hansen's disease?

Hansen's disease, caused by Mycobacterium leprae, is an infectious disease that primarily affects the skin and the peripheral nerves. This disease, also known as leprosy, has been around for thousands of years, with the earliest descriptions recorded in India and China around 600 B.C. The disease was once feared as a highly contagious and devastating disease. Now, however, the disease is very rare and easily treated. Early diagnosis and treatment usually prevent disability related to the disease.

How is Hansen's disease transmitted?

Hansen's disease is caused by infection with bacteria. Evidence suggests that the bacteria that cause Hansen's disease can spread from person to person. This might happen when someone with the disease coughs or sneezes. This can release droplets into the air. It might also happen if you are exposed to other nasal fluids (also known as secretions). Droplets and other secretions can contain the bacteria that cause Hansen's disease. If you breathe these in, you can become sick with the disease.

What are the symptoms of Hansen's disease?

The bacteria that cause Hansen's disease grow very slowly. It may take 2-10 years before signs and symptoms appear. Symptoms mainly affect the skin, nerves, and mucous membranes (the soft, moist areas just inside the body's openings).

The disease can cause:

• Skin lesions that may be faded/discolored
• Growths on the skin
• Thick, stiff or dry skin
• Severe pain
• Numbness on affected areas of the skin
• Muscle weakness or paralysis (especially in the hands and feet)
• Eye problems that may lead to blindness
• Enlarged nerves (especially those around the elbow and knee)
• A stuffy nose
• Nosebleeds
• Ulcers on the soles of feet

Since Hansen's disease affects the nerves, loss of feeling or sensation can occur. When loss of sensation occurs, injuries (such as burns or fractures) may go unnoticed. You should always try to avoid injuries. But, if you experience loss of sensation due to Hansen's disease (or another cause), you may not feel pain that can warn you of harm to your body. So, take extra caution to ensure your body is not injured.

What is the incidence for Hansen's disease?

In the U.S., leprosy is rare. Around the world, as many as 2 million people are permanently disabled as a result of Hansen's disease.

You may be at risk for the disease if you:

• Live in a country where the disease is widespread. Such countries include:
  • Angola
  • Brazil
  • Central African Republic
  • Democratic Republic of Congo
  • Federated States of Micronesia
  • India
  • Kiribati
  • Madagascar
  • Mozambique
  • Nepal
  • Republic of Marshall Islands
  • United Republic of Tanzania
• Are in prolonged close contact with people who have untreated Hansen's disease. If they have not been treated, you could be exposed to the bacteria that cause Hansen's disease. As soon as patients start treatment, however, they are no longer able to spread the disease.

Most adults around the world, however, might face no risk at all. That's because evidence shows that 95% of all adults are naturally unable to get the disease, even if they're exposed to the bacteria that causes it.

Some armadillos in the southern United States are naturally infected with Hansen's disease. While it's possible for you to get the disease from an armadillo, the risk is low. Most people who come into contact with armadillos are unlikely to get Hansen's disease. But, if you decide to see a doctor because of your contact with an armadillo, make sure you provide a complete history of armadillo contact. Your doctor can determine whether or not you have the disease. In the unlikely event that you get Hansen's disease, your doctor can also help you get treatment. When possible, avoid contact with armadillos, so you'll be more certain you're not at risk for the disease.

Hansen's disease has been reported in Florida since 1921. Up until 1975, an average of four cases were reported each year, with 80% of the 226 cases occurring in persons residing in Monroe, Dade and Hillsborough counties at the time of onset. Another 82 cases were reported during the next two decades (1976-95).

What is the treatment for Hansen's disease?

Hansen's disease is easily treatable. It's treated for 6 months to 2 years with a combination of antibiotics.

If you are treated for Hansen's disease, it's important to:

• Tell your doctor about any potential nerve damage take extra care to prevent injuries that may occur (especially if you experience numbness or a loss of feeling in certain parts of the body).
• Take the antibiotics until your doctor says treatment is complete (otherwise you may get sick again).

In the U.S., people with the disease may be treated at special clinics run by the National Hansen's Disease Program.