Abstract
Dear Editor,
We read with great interest the Professional Practice article “An Employee With Undiagnosed Leprosy: Are Other Employees at Risk?” by Lurati (2017). The author described a case of leprosy and highlighted questions raised by coworkers regarding transmission. We suggest some valid points that will add to occupational health nurses’ understanding of this forgotten, stigmatized disease. From the case description, the patient was diagnosed with multibacillary leprosy; clinical findings of multiple skin lesions and nerve involvement were described. In view of these findings, the worker was treated with the World Health Organization (WHO) multibacillary regimen of three medications, namely, Rifampicin, Dapsone, and Clofazimine for a period of 12 months (WHO recommended MDT regimens, n.d.). The U.S. recommendation for therapy is similar to the WHO recommendation (U.S. Recommendations for Multidrug Therapy, Health and Human Resources Administration, n.d.). In addition, workers should also be advised of possible adverse reactions during treatment.
The author clearly described the low risk of transmission so coworkers may be at the workplace without anxiety about contracting Hansen’s Disease. If the worker began treatment with rifampicin, transmission is unlikely because a single dose of rifampicin kills 99.9% of leprae bacilli (WHO Effectiveness of MDT: FAQ, n.d.). However, the occupational health nurse should be aware that a source may be found in the community. Close contacts of the janitor, including his household contacts, should be screened at the workplace or health department to detect early signs of leprosy. Screening is particularly important in India (163 districts in 20 states); 34,000 undiagnosed cases of Hansen’s Disease were identified between March 2016 and February 2017 by means of the Leprosy Case Detection Campaign (LCDC; Leprosy case detection campaign data, 2016).