Hansen’s Disease (HD) specialists believe that the bacteria spread via the respiratory or airborne route. Approximately 95% of the world’s population has a natural protection against or resistance to the bacteria that causes HD. People with this resistance will not get HD if they're exposed. For unknown reasons, there are a few people (approximately 5% of the world’s population) who have little or no protection. The susceptible person can get the disease on exposure to an untreated person with Hansen’s disease.

Even for the small percentage of people who have no protection from the disease, it is still difficult to get HD. The disease does not spread easily and is not spread through casual contact. In most cases, there may be only one person in a family who develops this disease.

HD is not passed on from a mother to her unborn baby. It is also not transmissible through sexual contact.

Early signs or symptoms include:

• A rash on the trunk of the body and/or extremities

• Reddish or pale-colored skin patches that do not itch and which may have lost some feeling

• Skin patches that get larger or do not go away despite medical treatment

• Bumps and thickening of the skin, especially on the face, ears, and the extremities

• Loss of feeling or weakness of the fingers or toes

• A painful nerve or weak muscles of the lower arm or leg

Your doctor can make the diagnosis by doing a test called a biopsy.

The bacteria affect the skin, mucous membranes, and nerves. It causes dryness and stiffness of the skin. In some cases, the affected nerves can swell, causing pain. There may be loss of feeling and weakness in the muscles of the hands or feet. If left untreated, there can be progressive and permanent damage to the skin, limbs, and eyes. Early treatment can prevent these disabilities.

Numbness in the hands and feet can cause injuries to the fingers and toes. If there is a loss of feeling, the fingers and toes become more vulnerable to repeated injury and infection. Infection can lead to bone absorption, which can alter the appearance of the digit(s), making them shorter. Digits never just “fall off”. Early detection and treatment are key to avoiding these problems.

Certain specific antibiotics treat an infection. Treatment, generally with three drugs, takes from six months to two years. With treatment, even the most severe cases are non-infectious within a few days or weeks of treatment. Early treatment can prevent the disabilities associated with HD. The disease is curable and a person with HD can continue to work and lead an active life.

We have a contract with the National Hansen’s Disease Program (offices located in Baton Rouge, Louisiana), to provide treatment for individuals in Texas. Four clinic sites in Texas receive funding through this contract.

For more information on Hansen’s disease and available services in Texas, please call 800-252-8239, and press option 5. You can also contact the DSHS Hansen's Disease Program by fax at 512-989-4010.

In 1994, it was estimated that there were 2.4 million cases of HD worldwide. A total of 1.7 million registered cases received treatment. The largest numbers of cases are in Southeast Asia and Central Africa. Smaller numbers exist in South and Central America. There are about 200-250 newly diagnosed cases reported to the national registry each year. The largest number of cases in the U.S. reside in California, Texas, Louisiana, Florida, New York, Hawaii, and Puerto Rico.

The origins of the stigma come from fear and the disease as it appeared hundreds of years ago. People have passed down this stigma for generations worldwide. It has persisted in cultural ways, including figures of speech, art, religion, and recently, movies and television. The images and information passed down over time are not consistent with the Hansen’s disease of today. Hansen’s disease continues to be studied by expert and knowledgeable researchers. Hansen's disease is one of many communicable diseases diagnosed and treated with success. This stigma, which continues to cause trauma and emotional pain, has no place in today’s society.

Hansen’s Disease Service Delivery Work Plan

NHDP Guide to the Management of Hansen's Disease

Texas Law and Administrative Code requires doctors, hospitals, schools, and labs to inform the Texas Department of State Health Services (DSHS) if they think someone has a notifiable condition.

You may obtain paper reporting forms by calling your local health authority. You can also download reporting forms in portable document format (PDF):

• Epi-2 - For detailed single-case medical care provider reports

• Epi-1 - For less detailed multiple reports

To report confirmed or suspected Hansen’s Disease, please call 800-252-8239 or 737-255-4300. Access other related forms.

NOTE: Communicable disease reporting is exempt from HIPAA (Health Insurance Portability and Accountability Act of 1996).

• National Hansen's Disease Program
  Ambulatory care, clinical services, clinical lab, and social services relating to HD
• World Health Organization

City of Amarillo Department of Public Health
1000 Martin Road
Amarillo, TX 79107
Phone: 806-378-6312
Fax: 806-378-6306
Physician: Scott Bell, MD
Nurse: Catrina Wright, RN

Denton County Public Health

www.dentoncounty.gov/643/Public-Health

Denton and Lewisville
Project Director: Ashley Ray, MPH, MPA, CHES
Phone: 940-349-2922
Public Health Nurse: Soila Gomez, RN
Phone: 940-349-5896

Denton Office
535 S. Loop 288, Ste 1003
Denton, TX 76205

Lewisville Office
190 N. Valley Parkway
Lewisville, TX 75067

DSHS Public Health Region 11 Headquarters
601 W. Sesame Drive
Harlingen, TX 78550
Phone: 956-423-0130
Fax: 956-444-3298
dshs.texas.gov/regional-local-health-operations/texas-public-health-region-11

Texas Center for Infectious Diseases
2303 S. E. Military Drive
San Antonio, TX 78223
Phone: 210-531-4576
Public Health Nurse: Trista Reglein, ACNE
dshs.texas.gov/tcid/