Hansen’s Disease 101: Causes, Symptom, Diagnosis & Treatment

Leprosy is a serious but uncommon chronic disease that affects the skin and nerves, especially the peripheral nerves that branch off from the central nervous system throughout the body. It produces a series of sores, bumps, or rashes across the skin and can produce other symptoms.

While the disease is now rare in Australia, some cases do occur in more tropical regions of the country. Leprosy is also common in many popular tourist destinations. Luckily, there is now a cure available for leprosy. However, treatment must happen as soon as possible to prevent further complications or permanent symptoms. Knowing the signs and symptoms of leprosy can help you identify it early and access medical support before the disease progresses too far.

We’ll explain what leprosy (also known as Hansen’s disease) entails, the causes, and the risk factors. We’ll also cover the symptoms and signs of leprosy, explore the treatment options available if you develop leprosy, and highlight important prevention and disease control strategies.

What is leprosy?

Leprosy, also known as Hansen’s disease, is a chronic bacterial infection of the skin and peripheral nervous system, especially the superficial nerves in the skin throughout your body. 

Leprosy is caused by a specific bacterium called Mycobacterium leprae. Leprosy, or Hansen’s disease, is more common in some subtropical and tropical areas of Asia, Africa, Central and South America, some parts of the Pacific region, and some of the United States.

Leprosy is now rare in Australia, and thanks to medical advancements in multi-drug treatment therapy, leprosy treatment is available and effective at curing the disease. 

Leprosy is categorised as a nationally notifiable disease. All cases must be reported to the Commonwealth Department of Health to maintain accurate records and trend data about how this disease affects Australians and ensure it remains rare and treatable. If you are diagnosed with leprosy, your doctor will be required to notify the appropriate regulatory bodies. No one else will be informed, and your privacy will be protected.

In Australia, there are only between 10 and 20 cases of leprosy reported each year. Most of these cases are diagnosed in Aboriginal and Torres Strait Islander individuals living in the Northern Territory or migrants who move to Australia from places where leprosy is more common. 

The main symptom of leprosy is sores or lesions, most often affecting the hands, feet, face, and nerves in the skin.

Types of leprosy

Leprosy has three different types. The form of leprosy diagnosed depends on the number of sores and the type of sores that develop. While all forms of leprosy are caused by exposure to the same type of bacteria, your immune system determines how well your body can fight off the disease. 

If you have a strong immune response to the disease, you may develop a milder form of the condition, producing only a few sores that may go away over time.

If your immune system cannot resist the bacteria, you may develop a more severe form of the disease, leading the bacteria to spread further rapidly throughout your nervous system. In severe cases, leprosy can lead to the development of many sores across your body. 

Without timely treatment, different symptoms can occur, including ulcers, sensation loss, vision, and damage to your limbs. 

The three types of leprosy

• Tuberculoid or paucibacillary leprosy

This is the mildest form. You may experience just one or two spots that heal over time. You should still seek treatment for this form of leprosy to ensure a full recovery.

• Multibacillary or lepromatous leprosy
  This is a more severe form of the disease that can develop many sores throughout your body. This form of leprosy can cause widespread bumps, sores, and rashes across the body and may affect the nose, kidneys, and male reproductive organs if not treated. Multibacillary leprosy is more contagious than tuberculoid leprosy.

• Borderline leprosy
  This is when people have some symptoms of both of the other two types of leprosy. It may be less severe than full lepromatous or multibacillary leprosy but more severe than mild tuberculoid leprosy.

What causes leprosy?

Leprosy is caused by an infection of the bacterium “Mycobacterium leprae”. Its alternative name, Hansen’s disease, is named after the scientist who discovered the bacterium that causes the disease in 1873. Without this discovery, scientists could not have created effective drug interventions that treat people with leprosy today.

The bacteria that causes leprosy is a slow-moving bacteria, so it is not easily spread between people through casual contact. While the exact cause of leprosy spreading between people is not fully understood, it is thought that droplets containing the bacteria can spread to nearby people when an infected individual coughs or sneeze, which are then breathed in by others.

Most people need prolonged, close contact with an infected person to develop leprosy. Most people with casual contact with someone with leprosy do not develop the disease themselves. Leprosy does not appear to be spread through sexual contact and cannot be spread from pregnant women to their unborn children.

Leprosy has a long incubation period, meaning that some people who become infected don’t develop symptoms for an extended period of between nine months to 20 years. The long period between infection and disease symptoms appearing makes it challenging to determine exactly when infection occurred.

What are the symptoms of leprosy?

Skin lesions, bumps, sores, or rashes are the most common type of symptom of leprosy. The sores are often pale or skin coloured and don’t go away on their own. Leprosy also affects the peripheral nervous system (PNS), including motor, sensory, and autonomic nerves. Other symptoms and signs of leprosy include the following:

• Sensory nerve damage

  Sensory nerves transmit feeling (sensation) from various parts of your body to the brain. When sensory nerves are damaged, your brain cannot register pain, making it difficult to know if medical treatment is required. People with damaged sensory nerves are at greater risk of burns and injuries to the extremities of the hands and feet. In severe cases or injuries, loss of toes, fingers, or extremities can occur.

• Eye nerve damage

  If leprosy affects the nerves in your eye, vision loss can occur.

• Motor nerve damage

  Motor nerves help your brain deliver messages to parts of your body, making them move. If your motor nerves are damaged, different types of paralysis can occur. These can include ‘dropped foot,’ ‘clawed hand,’ ‘dropped wrist,’ or lagophthalmos, where the eye cannot close.

• Autonomic nerve damage

  Your autonomic nerves regulate important bodily functions like blood pressure, heart rate, sweating, bowel and bladder emptying, and digestion. Damage to these nerves can lead to hair loss, inability to sweat and regulate temperature, and cracked or dry skin that is more prone to infections. 

• Muscle weakness or loss of sensation

  Muscle weakness or loss of sensation in the limbs can also result from nerve damage.

• A stuffy nose

  This can be a result of the lining of the nasal cavity being affected.

• Bleeding or inflammation of the eye.

Does leprosy cause loss of limbs?

Depictions of leprosy in fictional films and television shows have led some people to believe that leprosy causes arms and legs to rot or fingers or toes to fall off. This is a myth. In the past, some people experienced nerve damage that led to injuries and tissue damage that went untreated due to loss of sensation.

Now, leprosy can usually be detected early and treated well before serious tissue damage occurs. With modern treatment, the need to amputate any part of the body due to leprosy is extremely rare.

How is leprosy diagnosed?

In many cases, your doctor can diagnose you by observing your symptoms and looking at any sores or lesions on your skin. To confirm the diagnosis of suspected leprosy, your medical professional may also take a sample of your skin or nerve (a skin or nerve biopsy) to test for the bacterium that causes leprosy. In some cases, they may also test the sample to rule out other potential diseases that could cause symptoms similar to those of leprosy. 

How is leprosy treated?

Since the early 1980s, leprosy has been curable with a combination of drugs that attack and kill the bacteria that cause leprosy. Before this time, the disease could only be controlled and slowed. Fortunately, recovery rates are very good for leprosy today. Leprosy can now be cured using a combination of two to three types of antibiotics. Treatment courses for leprosy can last between six months to two years, and most people can manage their own treatment at home without needing to stay in the hospital. 

The two types of antibiotics used to treat leprosy are dapsone and rifampicin, and clofazimine is added for some types of the disease. Using multiple drugs attacks the bacteria more effectively, helping to reduce symptoms and kill the disease-causing microorganisms quicker. 

Once you begin treatment, you are no longer considered contagious and do not need to isolate from others. To ensure the disease is completely eliminated, you must take all your medications as prescribed and not stop taking them early, even if you notice an improvement in your symptoms. Proper medical intervention can prevent further nerve damage or limb deformities from occurring.

In severe cases, some people may undergo surgery to improve the appearance or function of damaged limbs or extremities. While undergoing treatment for leprosy, it’s extremely important to tell your doctor if any of the following symptoms occur.

• Numbness or sensation loss in any skin patches, extremities, or other parts of your body.
  This can be a sign of nerve damage. If this occurs, you must take extra care to avoid any injuries, burns, or cuts to avoid infections and limb deformities.
• The patches of skin or bumps become red, swollen, or painful, or you have nerve pain or fever.
  These symptoms may indicate secondary complications resulting from leprosy, which might require additional medical intervention to prevent serious or permanent damage. 

How is leprosy prevented?

There is no vaccine specifically formulated to prevent acquiring leprosy. However, the BCG vaccine, which protects people from getting tuberculosis (TB), called the BCG vaccine, appears to offer some protection against leprosy. This is because the organism that causes leprosy is closely related to the one that causes TB. However, having a TB vaccine does not mean you cannot get leprosy.

The prevention of leprosy is primarily achieved by avoiding close contact with people infected with the disease. People who live with or have prolonged, close contact with someone with leprosy should check for symptoms and seek medical treatment if they suspect an infection has occurred.

How Homage can support people with leprosy

If you or someone close to you has been diagnosed with leprosy, Homage is here to help. Our team of highly trained, compassionate, and professional Care Pros can support you or a close friend or relative to manage their treatment journey from the comfort, privacy, and safety of your own home.

Staying home while you receive leprosy treatment is a great way to reduce the risk of spreading the disease to others. It is also preferable to stay in a safe and comfortable environment where you are at a lesser risk of acquiring injuries or other types of infections while your immune system fights off the disease.

All of Homage’s home nursing providers are qualified Australian nurses who understand disease prevention and treatment protocols, including minimising the risk of spreading the disease. We can help you to manage your medication and treatment journey while following the highest standard of infection control procedures to keep you and your loved ones safe.

If you are struggling to stay on top of your usual chores and responsibilities while you recover, our team of warm and friendly Home Care Pros can assist with food preparation, transport to and from medical appointments personal care like bathing or dressing. We can even support you with tasks around the home while you focus on recovering. Some people experience muscle weakness or fatigue when recovering from leprosy, so getting some help with your usual tasks of daily living can be a huge relief. We pride ourselves on matching you with the perfect Care Pro for your unique situation, needs, symptoms, and preferences, so reach out today for an obligation-free discussion about how we can best support your recovery with peace of mind.