| Clinical
Features |
This chronic infectious disease
usually affects the skin and peripheral nerves but has a wide
range of possible clinical manifestations. Patients are classified
as having paucibacillary or multibacillary Hansen's disease.
Paucibacillary Hansen's disease is milder and characterized
by one or more hypopigmented skin macules. Multibacillary
Hansen's disease is associated with symmetric skin lesions,
nodules, plaques, thickened dermis, and frequent involvement
of the nasal mucosa resulting in nasal congestion and epistaxis. |
| Etiologic
Agent |
A bacillus, Mycobacterium leprae,
that multiplies very slowly and mainly affects the skin, nerves,
and mucous membranes. The organism has never been grown in
bacteriologic media or cell culture, but has been grown in
mouse foot pads. |
| Incidence |
In 1999, the world incidence of
Hansen’s disease was estimated to be 640,000; and in 2000,
738,284 cases were identified. In 1999, 108 cases occurred
in the United States. In 2000, WHO listed 91 countries as
endemic, with India, Myanmar, and Nepal having 70% of cases. |
| Sequelae |
Worldwide, 1-2 million persons are
permanently disabled as a result of Hansen's disease. However,
persons receiving antibiotic treatment or having completed
treatment are considered free of active infection. |
| Transmission |
Although the mode of transmission
of Hansen's disease remains uncertain, most investigators
think that M. leprae is usually spread from person
to person in respiratory droplets. |
| Risk
Groups |
Close contacts with patients with
untreated, active, predominantly multibacillary disease, and
persons living in countries with highly endemic disease. |
| Surveillance |
Hansen's disease is nationally notifiable
in the United States. |
| Trends |
Incidence/prevalence has remained
relatively stable in the United States. Decreasing numbers
of cases worldwide with pockets of high prevalence in certain
countries. |
| Challenges |
The main challenges for Hansen's
disease elimination efforts are to reach populations that
have not yet received multidrug therapy services, improve
detection of disease, and provide patients with good quality
services and free drugs. |
| Opportunities |
Hansen's disease in the Western
Pacific is a particular problem and opportunities exist for
participation in Hansen's Arial, Helvetica" size="-1">This page last reviewed
March 08, 2001
Centers
for Disease Control and Prevention
National
Center for Infectious Diseases
Division
of Bacterial and Mycotic Diseases
|
