LEPROSY
(HANSEN’S DISEASE)
Wisconsin Division of Public Health Disease Surveillance Manual (EpiNet, February 2005)
I. IDENTIFICATION
A. CLINICAL DESCRIPTION: A chronic bacterial infection caused by Mycobacterium leprae. Majors forms of the disease are:
- Tuberculoid : One or a few well-demarcated, hypopigmented, and anesthetic skin lesions, frequently with active, spreading edges and a clearing center; peripheral nerve swelling or thickening may also occur. Cell mediated immune responses are intact.
- Lepromatous : A number of erythematous papules and nodules or an infiltration of the face, hands and feet with lesions in bilateral and symmetric distribution that progresses to thickening of the skin. Cell mediated immunity is greatly diminished.
- Borderline (Dimorphous): Skin lesions characteristic of both tuberculoid and lepromatous forms.
- Indeterminate : Early lesions, usually hypopigmented macules, without developed tuberculoid or lepromatous features.
B. REPORTING CRITERIA: Laboratory confirmation.
C. LABORATORY CRITERIA FOR CONFIRMATION:
- Demonstration of acid-fast bacilli in skin or dermal nerve, obtained from the full thickness skin biopsy of a lepromatous lesion.
D. WISCONSIN CASE DEFINITION: A clinically compatible case that is laboratory confirmed.
II. ACTIONS REQUIRED / PREVENTION MEASURES
A. WISCONSIN DISEASE SURVEILLANCE CATEGORY II: Report to the patient's local health officer on an Acute and Communicable Disease Case Report (DPH 4151) or other means within 72 hours of the identification of a case or suspected case.
B. EPIDEMIOLOGY REPORTS REQUIRED:
1. Acute and Communicable Diseases Case Report (DPH 4151).
2. Leprosy Surveillance (CDC 52.18).C. PUBLIC HEALTH INTERVENTIONS:
- Source investigation by LHD.
- Contacts of infectious patients should be examined at 12-month intervals for at least five years following the last exposure.
III. CONTACTS FOR CONSULTATION
A. BCDP / COMMUNICABLE DISEASE EPIDEMIOLOGY SECTION: (608) 267-7321.
B. REGIONAL STAFF: See Epinet Introduction: “REGIONAL OFFICE CONTACTS”.
C. WSLH / MYCOBACTERIOLOGY UNIT: (608) 262-1618.
IV. RELATED REFERENCES
1. "Leprosy" DPH Disease Fact Sheet Series: View a list of all current Communicable Disease Fact Sheets
2. Heymann DL, ed. LEPROSY. Control of Communicable Diseases Manual. 18 th ed. Washington , DC : American Public Health Association, 2004:302-306.
3. Pickering LK, ed. Leprosy. In: Red Book: 2003 Report of the Committee on Infectious Diseases. 26 th ed. Elk Grove Village , IL : American Academy of Pediatrics, 2003:401-403.
V. DISEASE TRENDSThe incidence of leprosy in Wisconsin is low. Two cases have been reported between 1999 and 2003.