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2. CONTENT
 Introduction
 Background
 Causative agent
 Background
 Epidemiology
 Transmission
 Incubation Period
 Clinical features
 Types
 Diagnosis
 Treatment
 Preventive Measures
 WHO Response
 Strategic Pillars Set by WHO to Eliminate Leprosy
 Myths and misconceptions

3. WHAT IS LEPROSY?
• Leprosy is a chronic infectious disease,
also known as Hansen's disease, caused
by a type of bacteria, Mycobacterium
leprae.
• The disease predominantly affects the
skin and peripheral nerves. Left
untreated, the disease may cause
progressive and permanent disabilities.
• The bacteria are transmitted via
droplets from the nose and mouth
during close and frequent contact with
untreated cases.

4. BACKGROUND
• Hansen’s disease is
named after a
Norwegian
scientist, Gerhard-
Henrik Armauer
Hansen, who
discovered leprae in
1873

5. CAUSATIVE AGENT
• Mycobacterium leprae
• Acid fast, rod shaped
bacillus
• Stain with Ziehl Neelsen
carbol fuchsin.
• Cannot be grown in
bacteriological media or
cell cultures.
• Present intra and
extracellular, forming
characteristic clumps
called Globi.

6. BACKGROUND
• Leprosy has afflicted humanity, left
behind a terrifying image in history
and human memory of mutilation,
rejection and exclusion from
society.
• Lots of people have suffered its
chronic course of incurable
disfigurement and physical
disability.
• By G.A. Hansen in 1873.
• First bacterium to be identified as
causing disease in man.

7. CONT.
• Many countries in Asia, Africa and
Latin America with a significant
number of cases.
• About 1 – 2 million people disabled
due to past and present leprosy
who need to be cared for by the
community.

8. EPIDEMIOLOGY
• Leprosy is a neglected tropical
disease (NTD) which still occurs in
more than 120 countries, with more
than 2,00,000 new cases reported
every year.
• The reduction in the number of new
cases has been gradual, both
globally and in the WHO regions.

9. CONT.
• As per data of 2019, Brazil, India and
Indonesia reported more than 10 000
new cases, while 13 other countries
(Bangladesh, Democratic Republic of
the Congo, Ethiopia, Madagascar,
Mozambique, Myanmar, Nepal, Nigeria,
Philippines, Somalia, South Sudan, Sri
Lanka and the United Republic of
Tanzania) each reported 1000–10 000
new cases. 45 countries reported 0
cases and 99 reported fewer than
1000 new cases.

12. TRANSMISSION
 It’s unclear how Leprosy (Hansen’s disease)
transmits from person to person.
 Leprosy is likely transmitted via droplets,
from the nose and mouth, during close and
frequent contact with untreated cases
 Scientists believe it occurs when a person
with leprosy (Hansen’s disease) coughs or
sneezes and a healthy individual breaths in
the droplets containing pathogen.

13. CONT.
 It takes months of close
contact with an untreated leprosy
patient to contract the illness.
 Hansen’s disease cannot be
conveyed from a mother to her
unborn child during pregnancy, nor
can it be transmitted through
sexual contact.
 Identifying the source of infection
can be difficult due to the bacteria’s
slow growth rate and the time it
takes for symptoms to manifest.

14. INCUBATION PERIOD
The incubation period of leprosy is
5 years on an average.
However, symptoms may appear
within 1 years or as long as 20
years or more as well.

15. CLINICAL FEATURES
The disease manifests commonly through
skin lesion and peripheral nerve
involvement.
Leprosy is diagnosed by finding at least one
of the following cardinal signs:
(1)Definite loss of sensation in a pale
(hypopigmented) or reddish skin patch.
(2)Thickened or enlarged peripheral nerve,
with loss of sensation and/or weakness
of the muscles supplied by that nerve.
(3)Microscopic detection of bacilli in a slit-
skin smear.

17.  Discolored patches of skin
that are usually flat, numb,
and fading (lighter than the skin around)
 Skin growths (nodules)
 Thick, stiff, or dry skin
 Painless ulcers on the soles of the
Feet.
 Swelling or lumps on the cheeks or earlobes that aren’t
painful
 Loss of brows or eyelashes
 Numbness in the affected parts of the skin (especially
in the hands and feet)
 Enlarged nerves (particularly those around the elbow
and knee, as well as those on the sides of the neck)
 Blinding eye problems (when facial nerves are
affected).

18. TYPES
The quantity and type of skin lesions
determine the severity of leprosy. The
type of leprosy determines the
symptoms and treatment. The various
types of leprosy are:

19. 1. Tuberculoid
 Leprosy that is milder and less severe.
 This variety has only one or a few flat,
pale-colored patches on its skin
(paucibacillary leprosy)
 Because of nerve injury beneath the
skin, the affected area may feel numb.
 Tuberculoid is less contagious than
other types of leprosy.

20. 2. Lepromatous
 An advanced stage of
the disease
 It causes extensive skin
lumps and rashes,
numbness, and muscle
weakness (multibacillary
leprosy)
 The nose, kidneys, and
male reproductive
systems may also be
affected.
 It is more infectious than
tuberculosis.

21. 3. Borderline- Its symptoms
are similar to both
tuberculoid and
lepromatous leprosy.
Doctors may also use the
following classification:
 Single lesion
paucibacillary (SLPB):
One lesion
 Paucibacillary (PB): Two
to five lesions
 Multibacillary (MB): Six or
more lesions

22. DIAGNOSIS
 Diagnosis of leprosy is most commonly
based on the clinical signs and symptoms.
 In an endemic country or area, an
individual should be regarded as having
leprosy if he or she shows ONE of the
following cardinal signs:
• Skin lesion consistent with leprosy and
with definite sensory loss, with or
without thickened nerves.
• positive skin smears.

23.  For patients presenting the symptoms,
a leprosy diagnosis is confirmed after
analysis of tissues biopsied from
infected sites.
 Typically, a stain for acid-fast bacteria
is performed.
 Additional steps may include-
• Culturing infected tissue to confirm
other bacteria are not involved-M.
leprae cannot be culture.
• Using PCR amplification to verify the
presence of DNA specific to M. leprae.

26. TREATMENT
 In 1995, the World Health Organization (WHO)
devised a multidrug medication to treat all
kinds of leprosy (Hansen’s disease). It’s
available for free all over the world.
 Several antibiotics are also used to treat
Hansen’s disease by destroying the
bacterium that causes it.
 These antibiotics are dapsone (Aczone),
rifampin (Rifadin), clofazimine (Lamprene),
minocycline (Minocin), and ofloxacin
(Ocuflux)

27. CONT.
 Anti-inflammatory drug such as
aspirin (Bayer), prednisone (Rayos),
or thalidomide (Thalidomide)
(Thalomid).
 The treatment will persist for
months, with the possibility of
lasting up to two years.

28. PREVENTIVE MEASURES
 Immunoprophylaxis
 Good coverage of BCG vaccine
 Chemoprophylaxis of chronic infectious
diseases.
 Education and awareness among the people
 Avoiding long-term, close contact with an
untreated person who has leprosy (Hansen’s
disease) is also the greatest way to prevent
it.
 However, in case if a person is affected with
leprosy, early diagnosis and prompt treatment
is the best way to prevent the spread of
leprosy.

29. WHO RESPONSE
 WHO published ‘WHO guidelines for the
diagnosis, treatment, and prevention of
leprosy 2018’ in, which recommended a three-
drug regimen (rifampicin, dapsone, and
clofazimine) for both paucibacillary and
multibacillary varieties of leprosy.
 In April 2021, WHO announced ‘Towards Zero
Leprosy – Global Leprosy (Hansen’s disease)
Strategy 2021-2030’ in line with NTD road
plan 2030, following extensive consultations
with countries, specialists in leprosy,
partners, and people affected by leprosy.

30. STRATEGIC PILLARS SET BY
WHO TO ELIMINATE LEPROSY
In all endemic nations, implement
coordinated, country-owned zero
leprosy roadmaps.
Increase leprosy prevention while
also incorporating active case
detection.

31.  Manage leprosy and its complications, as
well as the risk of new disabilities.
 Defeat stigma and ensure that human
rights are upheld
 For this strategic phase, the strategy
comprises a set of core research
priorities. To eradicate leprosy, global
and national research investments are
also required

32.  WHO issued a technical guide on
Leprosy/Hansen Disease treatment of
responses/prevention of disabilities in
2020 to provide hands-on information to
health workers on how to diagnose and
manage Lepra reactions early
 In 2020, the World Health Organization
published a technical guidance on
Leprosy Hansen disease contact tracing
and post-exposure prophylaxis.
 WHO has created e-learning modules to
help professionals at all levels improve
their knowledge and skills on issues
ranging from suspected referrals and
diagnosis through leprosy treatment and
disability management.

33. MYTHS AND MISCONCEPTIONS
Myth: Hansen's disease is very
contagious.
Fact: Hansen’s disease does not
spread easily from person to person.
You cannot get it through casual
contact such as shaking hands,
sitting next to, or talking to someone
who has the disease.
Resources- CDC Guidelines

34. Myth: There is no cure for Hansen's disease.
Fact: Hansen's disease is curable. People being
treated for Hansen's disease can live a normal
life among their family and friends and can
continue to attend work or school.
Myth: Hansen's disease makes your fingers and
toes fall off.
Fact: Fingers and toes do not “fall off” due to
Hansen's disease. The bacteria that cause the
disease attacks the nerves of the fingers and
toes, causing them to become numb. Burns and
cuts on numb parts may go unnoticed, which
may lead to permanent damage and
reabsorption.

35. THANK YOU