Hansen's disease


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leprosy

 [lep´ro-se]
an inflammatory disease caused by Mycobacterium leprae, manifested in various ways, depending on the host's ability to develop cell-mediated immunity. It is a chronic communicable disease characterized by the production of granulomatous lesions of the skin, mucous membranes, and peripheral nervous system. Not readily contagious, it often results in severe disability but is rarely fatal. Called also Hansen's disease. adj., adj lep´rous.
Frequency and Transmission. Leprosy is essentially a tropical disease, although it has occurred in every country in the world. According to the World Health Organization, the number of leprosy patients in the world was less than 600,000 at the beginning of 2001. Its control remains a problem in six countries: Brazil, India, Madagascar, Mozambique, Myanmar, and Nepal.

Leprosy is not inherited, but the actual means of transmission have not yet been established. It is known that the source of infection is the discharge from lesions of persons with active cases. It is believed that the bacillus enters the body through the skin or through the mucous membranes of the nose and throat. Leprosy is considered one of the least contagious of infectious diseases; only 3 to 5 per cent of those exposed to it ever contract it.
Symptoms. The average incubation period of leprosy is 3 years. Initially, the infection is confined to the sheaths of nerves in the dermis. The disease progresses by spreading up the nerve sheath, resulting in loss of sensation, or by forming subcutaneous nodules and skin lesions.

In the lepromatous type, open sores later appear on the face, earlobes, and forehead, with tests showing large numbers of bacilli in the discharge from these lesions. If progress of the disease is not checked by treatment, the fingers and toes disintegrate and there may be other disfiguring due to trauma to the insensitive extremities. Death may occur in extreme cases of this type, but more often it is due to a secondary infection, such as tuberculosis or pneumonia.

In the tuberculoid type, there is loss of sensation on sections of the skin and atrophy of muscles. This often results in contraction of the hand into a claw.

Leprosy is further classified as either paucibacillary or multibacillary according to whether there are fewer or more than five lesions or patches present.
Treatment. Leprosy is most effectively and inexpensively treated with sulfone medications, such as dapsone, developed around 1950. In cases of sulfone resistance, the drug clofazimine (Lamprone) may be prescribed. A semisynthetic antibacterial, rifampin, is very effective in killing leprosy bacilli rapidly, so that patients receiving it may be considered minimal public health risks within a few days after treatment is begun. However, these drugs are expensive, have serious side effects, and are not readily available in many countries.

Treatment continues for several years at least, and sometimes indefinitely. In addition to specific medical therapy, adequate rest, diet, and exercise are provided. Physical therapy is employed to retrain affected muscles. Psychiatric help, not only for leprosy patients but for their close contacts and those who only imagine they have been exposed, is invaluable in relieving the anxieties arising from the age-old misconceptions about the disease.
Prevention. Preventive measures include establishment of clinics and hospitals for diagnosis and treatment. Early diagnosis and prompt treatment with multidrug therapy are key to prevention. Many patients return to their homes completely free of symptoms and are able to resume normal lives. Cure has been most successful in cases that were diagnosed and treated at an early stage, especially among the young.

Among the public health measures used to prevent leprosy are the laws in most countries requiring that all cases be reported to the local authorities and that all discharged leprous patients be examined at six-month intervals. Most countries also refuse entry to immigrants known to be infected. In the United States, information about leprosy, as well as treatment, can be obtained from the Gillis Long Hansen's Disease Center, Carville, LA 70721, telephone 800-642-2477.
Miller-Keane Encyclopedia and Dictionary of Medicine, Nursing, and Allied Health, Seventh Edition. © 2003 by Saunders, an imprint of Elsevier, Inc. All rights reserved.

Hansen's disease

(hăn′sənz)
n.
The American Heritage® Medical Dictionary Copyright © 2007, 2004 by Houghton Mifflin Company. Published by Houghton Mifflin Company. All rights reserved.

Hansen's disease

Leprosy. An infection of the skin and the nerves, caused by the slowly replicating organism Mycobacterium leprae . Infectivity is low and the incubation period of the disease is from 2–5 years. Untreated Hansen's disease may cause loss of fingers and toes due to trauma to anaesthetized parts, and severe facial disfigurement and blindness. In the lepromatous form the body's immune reaction is poor and tissue destruction is great. In the tuberculoid form there is a good immune response and the disease is milder and non-infectious. Treatment with the drug dapsone is now less effective because of bacterial resistance and this has been replaced by drugs such as rifampicin, clofazimine and ethionamide, used in combination. Thalidomide is also valuable in the treatment of Hansen's disease.
Collins Dictionary of Medicine © Robert M. Youngson 2004, 2005
References in periodicals archive ?
Also, pain and sequelae could be avoided if early diagnoses increase: more than three million cases of Hansen's disease go unnoticed in the world.
Araujo); National Hansen's Disease Programs, Baton Rouge, Louisiana, USA (D.L.
Fairley, "Delayed diagnosis, leprosy reactions, and nerve injury among individuals with Hansen's disease seen at a United States clinic," Open Forum Infectious Diseases, vol.
Sensing that a study with high quality and high-level of evidence would be welcome, we convened an expert group of peripheral nerve surgeons, reconstructive surgeons, and immunologists who have extensive experience with Hansen's Disease. The first meeting occurred during November 11-14, 2015 in Denver, Colorado, USA with support from the Association of Extremity Nerve Surgeons.
Number and rate * of new Hansen's disease diagnoses among foreign-born persons, by region of birth-United States, 2007-2011 Region No.
Although the advent of sulfone drugs helped treat Hansen's disease in the 1940s, segregation laws isolating the sick weren't lifted until 1969.
Fortunately, Hansen's disease is not an epidemic threat.
Hansen's disease or leprosy is a contagious infection pathology produced by an alcohol-acid resistant bacillus, known as Hansen's bacillus or Mycobacterium leprae.
Boogie Kahilihiwa, who has Hansen's disease and has lived in Kalaupapa for nearly 60 years, told me in a deep throaty voice that physical pain and a lack of resources were manageable, but "the most painful part of leprosy is the separation from your mom and dad--from the ones you love."
We reported our patient's case of leprosy to the Texas Department of Health as well as the National Hansen's Disease Center.
"Leprosy" or "Hansen's Disease" (the proper terminology) played a role in the history of disease and illness worldwide.
However, the topical gel form appears to be much safer, free from the hemolysis, hemolytic anemia, and peripheral neuropathy that can result from oral administration of the drug for Hansen's disease or serious skin disorders, said Dr.