Hansen's Disease

Hansen's disease is an infectious skin disease that is chronic which affects the peripheral nerves, nasal mucosa, skin, eyes and upper respiratory tract. Hansen's disease, also known as Leprosy an infectious disease causes severe skin sores that can be disfiguring and may also cause nerve damage in the arms and legs. The disease is assumed to spread via nasal droplets or through broken skin or through secretions from the infected person's body that may contain the bacteria. Hansen's disease is not contagious and does not spread by merely coming in contact with the infected person.

Hansen's disease has been reported since ancient times and each culture across the world had a different understanding of the condition. Indians, Chinese and the Egyptians felt it was a contagious disease that was incurable. The outlook towards the disease has changed in the recent past. If the condition is diagnosed at an early stage and treated, it is curable. Though not completely eradicated, the disease has become rare and the number of cases of leprosy have reduced. Reported cases are from parts of Africa, Asia and very few cases in America.

Hansen's disease cause

A slow growing bacterium called Mycobacterium Leprae causes the condition. Leprosy is also called Hansen's disease named after the scientist who discovered the bacteria that caused the condition.

Hansen's disease symptoms

The skin and the peripheral nerves (nerves outside the brain and spinal cord) are largely affected by this condition. The nasal mucosa, eyes and upper respiratory tract also get affected. It takes about 3-5 years for symptoms to appear from when the person has come in contact with the bacteria.

• Disfiguring skin sores that are pale in color
  
• Lumps or bumps on skin
  
• Thick, stiff and dry skin
  
• Numbness in affected part of the skin
  
• Eye problems like reduced blinking and dryness
  
• Nosebleeds
  
• Ulcers on sole of feet
  
• Enlarged nerves
  

Hansen's Disease Types

Depending on the number of skin sores and its type, leprosy can be classified into the following types:

Lepromatus: A severe form of the disease that has extensive skin bumps and rashes. Kidneys, nose and male reproductive organs get affected. Muscle weakness and numbness is also felt. This type is more contagious.

Tuberculoid: This is a mild form of leprosy; people with this type have flat and pale colored patches on the skin. The pale colored patches on the skin may feel numb due to the nerve damage beneath the skin. This type of leprosy is less contagious.

Borderline: People suffering from this type of leprosy have symptoms of both lepromatus and tuberculoid.

Mid-borderline: Asymmetrically distributed reddish plaques can be seen. Swollen lymph nodes may also be seen; they either regress or progress to other forms of leprosy.

Indeterminate: A few hypo-pigmented macules may be seen; they either heal or progress to become other forms of leprosy.

Hansen's disease diagnosis

Diagnosis is based on the clinical symptoms such as localized skin lesions and sensory loss. Skin biopsy is done. A skin smear test may also be done. Without taking proper treatment, this disease can cause severe complications like:

• Glaucoma or blindness
  
• Infertility in men
  
• Kidney failure
  
• Disfiguration of the face
  
• Nerve damage
  
• Muscle weakness
  
• Damage to nasal mucosa

Hansen's disease treatment

It is a myth that leprosy cannot be treated. For the past two decades, over 16 million people with leprosy have been treated. WHO offers free treatment for people suffering from leprosy. Treatment of leprosy depends upon the type. Treatment includes:

Hansen's disease Facts

• Hansen's disease progresses slowly - however progressively to affect the skin and nervous system.
  
• Leprosy is not contagious and is not acquired by sitting next to the affected person.
  
• Early symptoms of the disease begin in the cooler areas of the body (eyes, earlobes, nose) and later go on to cause loss of sensation.
  
• Leprosy can get very damaging if left untreated; it can disfigure the face too.
  
• Some people are genetically vulnerable to this disease.
  
• There is no commercially available vaccine that can prevent leprosy.
  
• 500,000 to 700,000 new leprosy cases are reported every year worldwide. Most of the cases are found in the tropics and the sub-tropics like Indonesia, Brazil, India.
  
• The incubation period of the disease may vary from 6 months to 40 years.
  
• Apart from humans chimpanzees, mangabey monkeys and nine-banded armadillos may also transmit the infection.
  
• More than 95% of the human population has a natural immunity to the disease.
  
• When treated at the right time, most cases of Hansen's disease respond to the treatment and become non-infectious within a short span of time.

Mantoux test

The Mantoux test or tuberculin sensitivity test is a diagnostic test for tuberculosis. This test, also known as Piquet Test is endorsed by the American Thoracic Society and Centers for Disease Control and Prevention (CDC). The other diagnostic tests for tuberculosis are Tine test and Heaf test. Since the Mantoux test makes use of purified protein derivatives (PPD), it is also referred to as PPD test. This tuberculosis test does not indicate how long the infection has been festering or if it is in the active stage. This tuberculosis test is prescribed for persons who have abnormal chest x-rays or symptoms such as weight loss and persistent cough for many months. A Mantoux test is not recommended for those suffering from any skin conditions or allergy. Women who are pregnant or breastfeeding must not be subjected to the Mantoux test.

This PPD test involves injecting a dose of TB antigens into the top layer of skin on the forearm. The dose includes 10 Tuberculin units (0.2 ml) as this exposes the person to enough bacteria to mount an immune reaction in the skin. A little bump (wheal) is noticed under the skin. This area is then observed for any reaction in then next 48 - 72 hours. Reactions such as fever or swollen lymph nodes in the armpit must be brought to the notice of health professionals immediately. The results of this test must be interpreted carefully. A positive result indicates tuberculosis. There may be cases of false positives or false negative results. The significance of the Mantoux test on those vaccinated with BCG is still controversial.

Pharyngitis

When the pharynx is inflamed, it is referred to as a sore throat or Pharyngitis. This condition is a common occurrence when there is any viral upper respiratory infection. In severe cases, Pharyngitis can also be indicative of diphtheria, gonorrhea or HIV. Pharyngitis is usually caused by micro organisms such as Streptococcus, Mycoplasma pneumoniae, Chlamydia pneumoniae, and Neisseria gonorrhoeae cause bacterial pharyngitis. This condition is contagious and is usually noticed in the winter months. Allergies, exposure to smoke and pollutants can cause sore throat and pharyngitis due to postnasal drip. If left untreated, pharyngitis can lead to rheumatic fever, scarlet fever, tonsillitis or pneumonia.

A person suffering from an upper respiratory tract infection such as pharyngitis will have sore throat and difficulty in swallowing. Accompanying fever, headache and swollen lymph nodes in the neck will also be noticed. Other symptoms of pharyngitis include cough, swollen tonsils and post nasal drip. There may be headache and earache. A physician will check the patient's eyes, throat and lymph nodes in the neck. A throat swab culture is done to diagnose the cause of infection. Bacterial infection or strep throat is treated with suitable antibiotics.

• Adequate rest
  
• Plenty of fluids
  
• Warm salt water gargle
  
• Avoid smoking and alcohol
  
• Adequate rest
  
• Plenty of fluids
  
• Warm salt water gargle
  
• Avoid smoking and alcohol