Hansen’s Disease (Leprosy): General Information

Epidemiology:

• cause: mycobacterium leprae
• reservoir in humans, (and a few animals such as the nine-banded armadillo)
• transmission by inhalation (respiratory) (also by skin contact)
• Development of the disease through T-cell mediated response
• Less than 5% of people are infected in an affected group (attack rate) less than 5%, death is lower than 0.1%
• Incubation period is on average 2-5 years (up to 20)
• Geographic spread is worldwide, 200000 new leprosy patients yearly worldwide

Areas with higher prevalence: Sudan, Brazil and South Pacific Islands.  Also present in Africa, South America and the Indian Sub-Continent (India, Bangladesh…)

Classifcation (WHO):

• paucibacillary (tuberculoid according to the Ridley and Jopling Classification), multibacillary (lepromatous)
• Leprosy apart from the skin has a consequence on the peripheral nerves nerves, acute & chronic manifestations as well as social stigma.

Tuberculoid Leprosy

Treatment: MDT (Multidrug Therapy)

• PB (Paucibacillary): rifampicin (monthly) et dapsone (daily) for 6 months,
• MB (Multibacillary): riafampicin(monthly), clofazimine (daily), dapsone (daily)  for 12months

Contributors:

Dr Christophe HSU – dermatologist. Geneva, Switzerland

Source of information: Richardus JH. Chemo- and Immunoprophylactic Strategies in Leprosy Control. 2012 (02) – 20th Regional Conference of Dermatology (RCD) – Manila, Phillipines

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