Leprosy case definition

This document contains the case definitions for leprosy which is nationally notifiable within Australia. This definition should be used to determine whether a case should be notified.

Page last updated: 20 December 2012

(Effective 1 January 2013)

Reporting

Only a confirmed case should be notified.

Confirmed case

A confirmed case requires either laboratory definitive evidence OR laboratory suggestive evidence AND clinical evidence.

Laboratory definitive evidence

Detection of Mycobacterium leprae by nucleic acid testing from the ear lobe or other relevant specimens.

Laboratory suggestive evidence

Demonstration of characteristic acid fast bacilli in slit skin smears and biopsies prepared from the ear lobe or other relevant sites

OR

Histopathological report from skin or nerve biopsy compatible with leprosy (Hansen’s disease) examined by an anatomical pathologist or specialist microbiologist experienced in leprosy diagnosis.

Clinical evidence

Compatible nerve conduction studies

OR

Peripheral nerve enlargement

OR

Loss of neurological function not attributable to trauma or other disease process

OR

Hypopigmented or reddish skin lesions with definite loss of sensation.


Leprosy changes

In Reporting, changed 'only' confirmed cases to 'a' confirmed case.
  • Changed Confirmed case to 'either laboratory definitive evidence OR laboratory suggestive evidence AND clinical evidence'.
  • Changed 'Laboratory definitive evidence to Laboratory suggestive evidence'.
Redefined 'Laboratory definitive evidence – Detection of Mycobacterium leprae by nucleic acid testing from the ear lobe or other relevant specimens'.

Note
International reporting to the World Health Organization (WHO) is based on the WHO working definition: A person showing one or more of the following features, and who as yet has to complete a full course of treatment:
  • hypopigmented or reddish skin lesions with definite loss of sensation
  • involvement of the peripheral nerves, as demonstrated by definite thickening with loss of sensation
  • skin smear positive for acid-fast bacilli definition.
The difference in surveillance case definitions should be noted when reporting to the WHO.

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