The term Hansen disease instead of leprosy is now preferred by some experts, because of it being less perjorative. Hansen disease was named in honor of the Norwegian physician, Gerhard Armauer Henrik Hansen, who in 1873 discovered the bacillus Mycobacterium leprae, the first microbe found to be the causative agent of a human disease. Hansen’s discovery demonstration of the bacterial cause of anthrax by 3 years. Hansen’s research helped to establish fundamental principles in microbiology, immunology, and public health.
Hansen disease, is a chronic infectious disease with a wide range of clinical manifestations. It is a chronic granulomatous disease of the skin, mucous membranes, nerves, lymph nodes, eyes, and internal organs such as the liver, spleen, and testicles. Hansen disease and is one of the oldest known diseases of mankind. It is curable but if untreated can lead to severe deformities.
Causes
Hansen’s disease in an attempt to eliminate the centuries-old stigma, is transmitted generally by direct, person-to-person contact, usually repetitive, over a prolonged period of time. However, it is one of the least contagious of all communicable diseases, and only about four to five percent of the world’s population is even susceptible to it.
The most common cause of hammertoe is a muscle/tendon imbalance. This imbalance, which leads to a bending of the toe, results from mechanical (structural) changes in the foot that occur over time in some people
Symptoms
Hansen’s disease attacks the nerves in the hands and feet and cause them to become numb. A person may get cuts or burns on the numb parts and not know it, leading to infections which cause permanent damage. Fingers and toes may be lost to infection. Serious infections in the feet may require amputation. Paralysis may cause the fingers and toes to curl up permanently.
Hansen’s disease can cause a wide variety of skin abnormalities, including spots or areas which are thicker than normal and have lighter skin color than normal. These spots may have increased, lessened or missing touch and/or temperature sensation. Hansen’s disease can also involve the interior nasal surfaces , causing nasal congestion and nosebleeds. Long-term complications may include loss of digits, facial changes and secondary infection.
Once infected with the mycobacteria, the average incubation period is two to three years, but it can range from 6 months to 40 years or longer. In 90% of patients the first sign of the disease is a feeling of numbness, which may precede skin lesions by a number of years. Temperature is the first sensation lost, followed by light touch, pain and then deep pressure. Sensory loss usually begins in the extremities (toes and fingertips).
Treatment
The best way to prevent the spread of leprosy is the early diagnosis and treatment of people who are infected. For household contacts, immediate and annual examinations are recommended for at least five years after last contact with a person who is infectious.
Dapsone is the first effective drug against Hansen’s disease but the bacteria developed resistance against the drug. Hence in 1970s the scenario shifted from monotherapy to Multiple Drug Therapy (MDT). The drugs used in WHO-MDT are a combination of rifampicin (600mg once a month), clofazimine (300 mg once a month and 50mg daily) and dapsone (100mg daily) for one year for Multibacillary (MB) leprosy patients and rifampicin (600mg once a month),and dapsone (100mg daily) for six months for Paucibacillary leprosy patients.
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