Page 202 - ירושלים: גיליון רפואי

Medical File No. 008

Name of disease: Hansen’s disease (leprosy)

Cause and Hansen’s disease is an infectious disease caused by Mycobacterium leprae, which
transmission enters the body through the respiratory system, and multiplies slowly in the cold
areas of the body – the skin, peripheral nerves and the mucous membranes of the
upper respiratory tract. Bacteria are transmitted via the air from the upper respiratory
tract of an infected person to others nearby through talking, sneezing, or coughing.
Most people (over 95%) are able to develop efficient natural immunity immediately
after infection, thus preventing the development of the disease. The disease is named
after the Norwegian physician Armauer Hansen, who discovered the bacteria in 1873.
Although in Hebrew Hansen’s disease is called tzara’at - the biblical term requiring
exclusion - all researchers agree that Hansen’s disease is not the biblical leprosy. The
signs of leprosy as described in the Old Testament differ significantly from those
of Hansen’s disease. In particular, the Bible does not mention the serious physical
disabilities which accompany the disease we know today as Hansen’s disease.

Symptoms The incubation period, from the initial exposure to the bacteria until clinical signs
and of the disease appear, may last a few months and up to many years (40 years), the
progression average being 3-5 years. Symptoms of Hansen’s disease may appear on the skin and
the extremities. The first is usually dermatological – a reddish patch on light skin
or light areas on dark skin. These skin patches may appear anywhere on the body
and usually disappear following treatment. The second symptom is a change in the
function of hands, feet, and face. The multiplication of the bacteria in the peripheral
nerve sheaths leads to inflammation of the sensory, motor, and autonomic fibers. This
manifests itself in symptoms of muscle weakness or paralysis as well as changes in
sensation to heat, cold, touch, pressure and pain, and dryness of the skin. The lack of
this basic protective mechanism, may result in injuries and serious disabilities.

Treatment To this day there is no laboratory test that reliably diagnoses Hansen’s disease,
and therefore clinical examination is required for this purpose. There is no immunization
medications against Hansen’s disease; however, contemporary treatment allows healing and
continuation of everyday life. The goals in overall treatment of Hansen’s disease
are to eliminate the bacteria, reduce the inflammation in the peripheral nerves and
prevent disabilities. Treatment includes medication and introduction of precautions
to prevent injuries and disabilities. The medications are effective immediately and
they render patients non-infectious.

Notes An estimated 10–12 million people worldwide suffer from Hansen’s disease or its
Name of outcomes, mainly in East Asia, Africa, and South America. However, Hansen’s disease
practitioner sufferers can be found all over the world, including Europe, the United States, and
Israel. Despite effective medications, provided free of charge by the World Health
Organization, new Hansen’s disease patients are still diagnosed every year.
In the past, people with Hansen’s disease were treated in isolated institutions;
however, today the trend globally is to integrate their care in the framework of the
general health system, ensuring their rights and their dignified role in society.

Ruth Wexler, R.N., B.S.N., M.P.A. Signature
Head nurse, Hansen Government
Hospital, 1988–2009

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