Leprosy was long feared as a highly contagious, devastating disease. It is neither easy to catch nor incurable: it spreads with difficulty, antibiotics cure it, and people with it can lead active lives during and after treatment. Each year up to 225 people in the United States and 250,000 worldwide are diagnosed with it.
Image from CDC's page on leprosy.
What it is
Leprosy, also called Hansen's disease, is caused by two slow-growing bacteria, Mycobacterium leprae and Mycobacterium lepromatosis. It can affect the nerves, skin, eyes and the lining of the nose. Some parts of the body may lose their sense of touch and pain, making cuts, burns and other injuries more likely.
Although the disease is hard to catch and completely curable, stigma persists. People who have it often face isolation and discrimination, especially where it is more common.
Symptoms
Because the bacteria grow so slowly, signs can take up to 20 years to appear after exposure. Symptoms mainly involve the skin, nerves and nasal lining. Left untreated, or treated late, leprosy can cause serious complications and disability.
Where it occurs
Leprosy is rare in the United States, and most people diagnosed here were infected in a country where it is more common. In 2023, according to World Health Organization data:
| New cases reported | Countries |
|---|---|
| More than 10,000 | Brazil, India, Indonesia |
| 1,000–10,000 each | Bangladesh, Democratic Republic of the Congo, Ethiopia, Madagascar, Mozambique, Myanmar, Nepal, Nigeria, the Philippines, Somalia, Sri Lanka, United Republic of Tanzania |
How it spreads — and how it doesn't
- Only through long, close contact. Catching it takes prolonged, close contact over many months with someone whose leprosy is untreated. It likely spreads when a sick person coughs or sneezes and someone else breathes in the droplets again and again over a long time.
- Most people are immune. About 95% of people cannot get leprosy because their immune systems fight off the bacteria.
- Not through sex or pregnancy. It is not sexually transmitted and does not pass to a fetus.
- Not through casual contact. Shaking hands with, sitting beside or talking to someone with leprosy will not spread it.
- Armadillos. Some armadillos in the southern United States carry the bacteria naturally and may be able to pass it to people, but the risk is very low; most people who handle armadillos are unlikely to get leprosy.
Diagnosis
A healthcare provider examines the skin for patches lighter, darker or redder than the person's usual skin, and checks whether those patches have lost feeling. To confirm the diagnosis, they take a skin or nerve sample and look for the bacteria under a microscope, and may run tests to rule out other skin diseases.
Treatment
Leprosy is treated with a combination of antibiotics, usually for one to two years, and is cured if the full course is taken as prescribed. People being treated can keep working or going to school and live normally among family and friends.
In the United States, the National Hansen's Disease Program runs specialized clinics, and federally supported outpatient clinics operate across the continental United States and in Puerto Rico (HRSA's clinic list).
Do fingers and toes fall off?
No. The bacteria attack the nerves in fingers and toes and make them numb. Burns, ulcers and cuts on numb skin can go unnoticed and lead to permanent damage or infection, which can cost a finger or toe. Sometimes nerve damage weakens the muscles so much that the body reabsorbs muscle and bone, making the digits look shorter.
Sources
Based on "About Leprosy (Hansen's Disease)," Centers for Disease Control and Prevention; a work of the United States government in the public domain.
Licence: CC0 1.0 (public domain) · Adapted from www.cdc.gov
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