Leprosy (Hansen’s Disease)

Overview

What is leprosy?

Leprosy (also called Hansen’s disease) is an infectious disease caused by the bacteria Mycobacterium leprae (my-co-bak-TEER-ee-um LEP-pray). It can affect your eyes, skin, mucous membranes and nerves, causing disfiguring sores and nerve damage. Leprosy has been around since ancient times. For centuries, people isolated and shunned those with leprosy because the disease wasn’t understood. Today, effective treatment is available, and there’s no need to quarantine people with leprosy.

Does leprosy still exist?

Yes. Although it’s rare, leprosy still exists today. According to the World Health Organization, approximately 208,000 people have leprosy (Hansen's disease) around the globe, with most cases found in Asia and Africa. In the United States, about 100 people receive a leprosy (Hansen's disease) diagnosis every year.

Who does leprosy affect?

While leprosy can affect people of all ages, it’s most common in people aged five to 15 or those over 30. Research suggests that over 95% of people infected with Mycobacterium leprae don’t actually develop leprosy because their bodies fight off the infection.

What are the three types of leprosy?

There are three main types of leprosy, including:

  1. Tuberculoid leprosy. Someone with this type of leprosy usually has mild symptoms, developing only a few sores. This is because of a good immune response. Tuberculoid leprosy is also called paucibacillary leprosy.
  2. Lepromatous leprosy. People with this type of leprosy have widespread sores and lesions affecting nerves, skin and organs. With lepromatous leprosy, the immune response is poor and the disease is more contagious. Lepromatous leprosy is also called multibacillary leprosy.
  3. Borderline leprosy. This type of leprosy involves symptoms of both tuberculoid and lepromatous leprosy. Borderline leprosy is also called dimorphus leprosy.

Symptoms and Causes

What are the 3 main symptoms of leprosy?

The three main symptoms of leprosy (Hansen's disease) include:

  1. Skin patches that may be red or have a loss of pigmentation.
  2. Skin patches with diminished or absent sensations.
  3. Numbness or tingling in your hands, feet, arms and legs.
  4. Painless wounds or burns on the hands and feet.
  5. Muscle weakness.

Additionally, people with leprosy (Hansen's disease) may develop:

When the disease is in the advanced stages, it can cause:

  • Paralysis.
  • Vision loss.
  • Disfigurement of the nose.
  • Permanent damage to the hands and feet.
  • Shortening of the fingers and toes.
  • Chronic ulcers on the bottom of the feet that don’t heal.

Once infected with Mycobacterium leprae bacteria, it takes about three to five years for leprosy symptoms to appear. In some cases, it can even take up to two decades. For this reason, it’s difficult for health providers to determine when and where the infection took place.

What is the main cause of leprosy?

Coming into close contact with the bacteria Mycobacterium leprae causes leprosy (Hansen's disease).

Is leprosy (Hansen's disease) contagious?

Although it is not highly contagious, leprosy (Hansen's disease) can spread from person to person. Experts don’t fully understand how the disease spreads from one person to another, but the bacterium is likely transmitted through airborne droplets when an infected person coughs or sneezes. When bacterium is released into the environment, other people can inhale it. Hansen's disease can’t be spread through hugging, shaking hands, sitting next to an infected person or even sexual contact.

It’s important to note that most people have natural immunity to Mycobacterium leprae. In fact, only 5% of all people are truly vulnerable to leprosy (Hansen's disease).

Do armadillos carry leprosy?

Yes, some do. Mycobacterium leprae only grows in living hosts, including certain types of armadillos. Research has confirmed that a species of armadillo native to the southern United States and Mexico can carry leprosy (Hansen's disease) and spread it to humans.

Diagnosis and Tests

How is leprosy diagnosed?

If your healthcare provider thinks you might have Hansen's disease (leprosy), they’ll perform a skin biopsy. During this procedure, they’ll take a small sample of tissue and send it to a lab for analysis.

Management and Treatment

Is there a cure for leprosy today?

Yes. Thanks to modern medicine and the discovery of antibiotics, leprosy (Hansen's disease) is curable. Over the past 20 years, over 16 million people have beat the disease.

How is leprosy treated?

Leprosy (Hansen's disease) is treated with multidrug therapy (MDT), an approach that combines different types of antibiotics. In most cases, your healthcare provider will prescribe two to three different kinds of antibiotics at the same time. This helps prevent antibiotic resistance, which occurs when bacteria mutate (change) and fight off the antibiotic drugs that usually kill them. Common antibiotics used in the treatment of Hansen's disease include dapsone, rifampin and clofazimine.

Antibiotics can’t treat the nerve damage that may occur as a result of Hansen's disease. Your healthcare provider may also prescribe anti-inflammatory drugs, such as steroids, to manage any nerve pain.

How long does it take to recover from leprosy treatment?

On average, leprosy (Hansen's disease) treatment takes one to two years to complete. During this time, your healthcare provider will monitor your progress.

Prevention

How can I prevent leprosy (Hansen's disease)?

While the chances of getting Hansen's disease are quite low, there are still things you can do to reduce your risk. For example, if you’re around an infected person, avoid contact with airborne droplets from their nose or mouth.

Outlook / Prognosis

What can I expect if I have Hansen's disease?

If you’ve been diagnosed with Hansen's disease (leprosy), it’s important to seek treatment immediately. The sooner you begin antibiotics, the less severe your symptoms will be. Your healthcare provider will find the right combination of antibiotics for your situation and they’ll continue to monitor you over the next couple of years.

Living With

When should I see my healthcare provider?

Anytime you develop skin sores, numbness or muscle weakness, it’s important to schedule an appointment with your healthcare provider. They can determine if your symptoms are due to leprosy or another health condition.

A note from Cleveland Clinic

Leprosy (Hansen's disease) was shrouded in mystery for centuries. Today, we understand it as a curable disease. If you think you might have leprosy, visit your healthcare provider right away. Prompt treatment is your first step toward healing and a better quality of life.

Last reviewed by a Cleveland Clinic medical professional on 05/18/2022.

References

  • Bhandari J, Awais M, Robbins BA, et al. Leprosy. (https://www.ncbi.nlm.nih.gov/books/NBK559307/) [Updated 2021 Nov 20]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Accessed 5/18/2022.
  • Centers for Disease Control and Prevention. Hansen’s Disease (Leprosy). (https://www.cdc.gov/leprosy/index.html) Accessed 5/18/2022.
  • National Library of Medicine. Leprosy. (https://medlineplus.gov/genetics/condition/leprosy/) Accessed 5/18/2022.
  • National Organization for Rare Diseases. Leprosy. (https://rarediseases.org/rare-diseases/leprosy/) Accessed 5/18/2022.
  • World Health Organization. Leprosy (Hansen’s disease). (https://www.who.int/health-topics/leprosy#tab=tab_1) Accessed 5/18/2022.

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