What you should know about Hansen's Disease (Leprosy))

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Thousands of years ago, as we studied through history, anyone who had leprosy was banished far away from other humans and left in the forest for isolation and eventual death, the first time I heard about leprosy, I was really curious about if such a disease still existed till date and to my surprise, I read through research published by World Health Organization (WHO), that leprosy exists up till date, and it is as common as 208,000 people still having it on a yearly basis. 1.

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Hansen's disease is another name for leprosy, it is an infectious ancient disease that exists up till date, when detected on time and treated, curing the disease is a great possibility. The disease is caused by the bacteria, Mycobacterium leprae, these bacteria can affect the skin, eyes, the nerves and even the mucous membrane, when the bacteria affect any of these areas, it creates disfiguring sores and damaged nerve. Unlike the days when those with leprosy were segregated, there is now an effective treatment for the disease and there is no need for segregation anymore.

The spread of Hansen's disease is spread through sneezing or coughing of a person who has the disease, while it isn't a highly contagious disease, constant close contact for a long period would result in an eventual contact of the disease. The bacterium responsible for the disease, which is Mycobacterium leprae, multiplies slowly, with an average incubation period of five years. In some cases, symptoms may not even appear until over 20 years.
[Incubation period means, the time between when infection occurs and the first appearance of the symptom].

Before going further into the description of the disease, let's go through a brief history on the existence of the disease, The first break out of the disease was in the 1940s, that was when the medicine dapsone was developed, but it took years for the disease to be treated, in most cases, it took the entire lifespan of the person. In the early 1960s, rifampicin and clofazimine were also added to the medicine catalogs, they were labelled as multidrug therapy. However, in 1981, World Health Organization (WHO) recommended MDT, which consist of medicines like; dapsone, rifampicin and clofazimine, this was a better treatment option that took six months for the cases of pauci-bacillary and 12 months for the cases of multi-bacillary, the drug kills the pathogen and then cures the patient. MDT brought about a massive reduction in leprosy cases as the medicine was given freely, donation done through a standing agreement with Norvartis, this agreement has been in existence from 2000 up until 2025. Lots of countries, as a matter of reported accuracy, up to 45 countries have reported no case of leprosy at all. 2
Leprosy comes in three(3) major forms;

Tuberculoid Leprosy: Another name for tuberculoid leprosy is paucibacillary leprosy, those with this form of leprosy usually experience mild symptoms, they usually have only a few sores, the occurrence of the few sores is usually as a result of a good immune system.

The sores are characterized by solitary skin lesions, these skin lesions are distributed asymmetrically alongside demarcated edges. The lesions often heals simultaneously. 3

Lepromatous Leprosy: This form of leprosy give people widespread lesions and sores, another name for it is, multibacillary leprosy, the lesions and sores affects the skin, the organs and even the nerves. With an attack of lepromatous leprosy on the body, the immune system responds in a poor manner, the disease as well becomes more contagious. Those with lepromatous leprosy, have skin lesions that lack granulomatous response, as well as showing significant amount of organisms. 4

Borderline Leprosy: This type of leprosy has symptoms of lepromatous and tuberculoid leprosy combined, another name for borderline leprosy is dimorphus leprosy. Even if is characterized by skin lesions that look like that of tuberculoid leprosy, they are in a more numbered form and could also be accompanied by satellite lesions found around large lesions. Boderline leprosy are unstable, until there is a provided solution.
Clinically, borderline leprosy is characterized with a few scattered hairless plaque.5

Physical examination is conducted to look out for telltale symptoms and signs of the disease, a biopsy is also carried out to remove smaller pieces of the skin or the nerve, it is then sent for testing in the laboratory.

In order to determine the type of Hansen's disease it is, a lepromin skin test is carried out, which involves injecting a small amount of Hansen's disease causing bacterium which has initially been deactivated, into the skin, in most cases it is on the upper forearm. At the site of injection, the result would come out positive, when there is a presence of Hansen's disease.

Several types of antibiotics can be used to kill the bacteria causing Hansen's disease, the antibiotics include; dapsone, rifampin, clofazimine, minocycline and ofloxacin. Doctors may also recommend anti-inflammatory drugs like; aspirin, prednisone and thalidomide, the treatment for this disease could last for one year or even two years.

Certain complications could arise from the delayed treatment of Hansen's disease, as mentioned earlier, the best thing about this disease, is to identify it on time and begin treatment immediately, when there is a delayed treatment it could result in;

Weakness of the muscle: This is the lack of muscle strength, when this happens, the muscles may be unable to move or contract as easily as they use to before. In this case, claw-like hands are created or inability to flex your feet.
Permanent damage to the nerve's in the legs and in the arms: The nervous system has everything to do with the body's activities, it involves body and breathing regulations to the control of muscles, it goes as far as sensing cold and heat. Since nerves are extremely essential to all body activities, nerve damage and nerve pain can affect the quality of one's life. 6
Loss of hair, particularly the hair on the eyebrows and the eyelashes.
Total disfigurement.
Serious nasal congestion.
Bleeding of the nose and eventual collapse of the nasal septum.
Blindness.
Infertility.
Erectile dysfunction.
Iritis.
Glucoma.
Kidney failure.

The best way to ensure that you and your family never have hansen's disease, is through avoiding close long-term contanct with a person who has it and has not been treated, little wonder they were sent into exile in those days. However, since we have modernized medical instruments and medications to help treat the disease, once the disease has been treated, you no longer have to fear going close to the person who was formerly with the disease. Although, even after treatment, the patient must visit the doctor for more proper test in order to ascertain the presence of any form of residue.7