Hansen's disease, or known as leprosy, a chronic infectious disease, which involves primarily the skin and the peripheral nerves. Altough it's primarily a tropical disease, it has occurred as far North as Norway and Iceland.
The leprosy bacterium was first describe by the Norwegian physician, G. Armauer Hansen, in 1874. Its structure and characteristics is similar to the organism which causes tuberculosis. The bacteria are believed to be transmitted by direct contact.
Though it's not easily spread, but more than 5% of persons married to a person suffering from leprosy will become infected with the disease. The average period of incubation is five years or more.
The disturbances seen in leprosy are extremely variable. Skin is usually affected early while nerve damage appears later. There are many disabling phenomena result from nerve damage rather than infection.
The ulcers of the feet and the fingers are caused by damage resulting from of the infection along the nerves of the extremities. Facial disfigurement is seen only in advanced stages, when the infection is untreated.
Skin lesions vary from simple spots to thick infiltrations and nodule formation. The severity of the infections depends upon the type of leprosy. The most severe cases are caused by the lepromatous, which progresses steadily, and involves infiltration of the skin, producing nodular lesions.
The milder tuberculoid form usually improves spontaneously. In many instances, tuberculoid leprosy would be an unimportant skin condition were it not for the associated nerve involvement.
Leprosy is rarely fatal in itself. Death, when it occurs, usually results from complications, or a concurrent illness. The most serious complications are involvement of the nose and throat, which accompanies the advance disease. Trophic ulcerations of the feet with secondary infection, osteomyelitis (bone infection), and lesions of the inner structures of the eyes, which leads to blindness.
Since 1941, a group of drugs, called sulfones, which are related chemically to sulfonamides, have been widely used in the treatment of leprosy. Sulfones are highly effective in the milder types. Although they do not cure the lepromatous types, serious complications are usually prevented.
Because the similarity of the bacillus which caused leprosy, the sulfones were also tested against tuberculosis, but without success. Sulfones do not destroy, but surpress the leprosy bacillus, so that the patient's own defenses slowly overcome the disease.
Treatment failures are observed in approximately 5% of the cases, resulting from the development of drug-resistance by the leprosy bacteria. Although the sulfones act slowly, no better agents have been developed for control of leprosy.
Leprosy is being treated today with large-scale outpatient treatment programs. The U.S. operates a specialized hospital for the treatment of leprosy at Carville, La., and maintains clinics at hospitals, in New Orleans and San Francisco. Also two institutions in the state of Hawaii, to conduct a continuous program for the care of patients, and the control of spread of the disease.
Source : Encyclopedia International
U.S. Public Health Service Hospital, Carville, Louisiana.
Harold C. Neu, M.D., Columbia University.