Leprosy & Related Diseases

A germ, or bacteria, called Mycobacterium leprae. It causes an infection that affects the skin, destroys nerves and can also cause problems in the eyes and nose.

The medical name for leprosy is Hansen’s disease. Norwegian doctor Armauer Hansen was the first to view the bacillus under a microscope in 1873.

No. The bacteria attack nerve endings and destroy the body’s ability to feel pain and injury. Without feeling pain, people injure themselves and the injuries can become infected, resulting in tissue loss. Fingers and toes become shortened and deformed as the cartilage is absorbed into the body. Repeated injury and infection of numb areas in the fingers or toes can cause the bones to shorten. The tissues around them shrink, making them short.

Early signs include spots on the skin that may be slightly red, darker or lighter than normal skin. The spots may also become numb and have lost hair. Often they appear on the arms, legs or back. Sometimes the only sign may be numbness in a finger or toe. If left untreated, hands can become numb and small muscles are paralyzed, leading to curling of the fingers and thumb. When leprosy attacks nerves in the legs, it interrupts the communication of sensation in the feet. The feet can then be damaged by untended wounds and infection. If the facial nerve is affected, a person loses the blinking reflex of the eye, which can eventually lead to dryness, ulceration and blindness. Bacteria entering the mucous lining of the nose can lead to internal damage and scarring which in time causes the nose to collapse. Untreated, leprosy can cause deformity, crippling and blindness.

M. leprae is transmitted primarily through coughing and sneezing. In most cases, it is spread through long-term contact with a person who has the disease but has not been treated. Scientists don’t fully understand how leprosy is spread.

Most people will never develop the disease even if they are exposed to the bacteria. Approximately 95% of the world's population has a natural immunity to leprosy.

Leprosy can be cured with multi-drug therapy (MDT), a combination of three antibiotics: rifampin, clofazimine and dapsone. Treatment can take from six months to a year, sometimes longer. People are no longer contagious after about one week of MDT.

Dapsone: Some people may have mild anemia. Very rarely, other blood problems have been reported. Rifampin: Sometimes it will cause abnormal liver tests, but the problem clears when the medication is stopped. It may cause a harmless orange color in the urine, sweat or tears. Clofazimine: It has virtually no side effects except some darkening of the skin which slowly fades when the medication is stopped.

Approximately 5,000 people in the U.S. are cured but suffer from the effects of leprosy and continue to receive care through outpatient clinics and private physicians. Between 150-225 people are diagnosed with leprosy each year in the U.S.

Most women with leprosy have normal pregnancies and deliver healthy babies. Patients on treatment do not transmit leprosy to their babies.

In some states along the Gulf Coast in the southern U.S., nine-banded armadillos have been found to carry a certain strain of the M. leprae bacteria. Nine-banded armadillos are the only non-human animal known to carry the bacteria. Scientific studies suggest that humans can get the bacteria from armadillos.

Patients taking Multi-Drug Therapy do not spread the disease. When a person is placed on medication, most of the bacteria are killed within a few days. Within one week of starting the medicine, there is no risk of spreading the disease to anyone else. It is not necessary to isolate a person with leprosy at any time. Also, it is not transmitted through sexual contact or pregnancy.

A trained health worker diagnoses leprosy through a skin biopsy. In this test, a small piece of skin is taken and sent to a laboratory where it is examined for the bacteria. Skin smears are another test that can be used. This is done by making a small incision into the skin. A small amount of tissue fluid is obtained and examined in the laboratory for the bacteria. There are no blood tests for leprosy.

No. For centuries leprosy has been viewed with horror and the word leper has come to mean outcast. The word leper reinforces the already strong stigma against leprosy and contributes to the heartbreaking ostracism sufferers face. Using the word leper today is considered an offense to the hundreds of thousands affected by this disease. The terms “person affected by leprosy” and “Hansen’s disease” are used instead.

Reaction is the body’s response to the dead bacteria in the body. When patients begin taking Multi-Drug Therapy (MDT) the bacteria are killed quite rapidly. Sometimes it takes years for the dead bacteria to be completely cleared from the body. During this time the body may react against these dead bacteria. This can cause pain and swelling in the skin and nerves and other parts of the body. Fever and muscle aches may also occur. The eyes could be red and painful. During reactions there is an increased risk of damage to nerves in the eyes, hands and feet. Treating reactions quickly can prevent nerve damage.

Up to half of all people with leprosy have reactions. A reaction does not mean the disease is getting worse or that the medication has stopped working. It is not an allergic reaction to the medication. It means that the body is reacting or fighting against the dead bacteria. These bacteria may have been killed by the body’s resistance to the bacteria or by the medication. This is why some people develop reactions before they even start MDT.

If medications that kill bacteria were not given, the bacteria would begin growing again.

Some reactions can be treated with medicine such as aspirin or Tylenol. In some cases, medications such as prednisone or thalidomide may be required to prevent nerve damage during reaction. Episodes of reaction may occur off and on for a period of time.