What’s happening about leprosy?

With World Leprosy Day around the corner, find out if we are ready to get rid of this long dreaded disease for good

By Dr Parul R Sheth

Over 100 countries celebrate the 56th annual World Leprosy Day on January 31, 2010. Leprosy also known as the Hansen’s disease is one of the oldest diseases from biblical times, earlier recognized in the ancient civilizations of China, Egypt and India. Being a chronic infectious disease throughout history the sufferers have been ostracized by their families and community people.

The culprit

Bacteria Mycobacterium leprae causes leprosy. These bacteria multiply very slowly and have a long incubation period of about five years. Since the symptoms can take as long as 20 years to appear it makes it difficult to diagnose the time and place of the disease.  

Leprosy can occur at all ages ranging from early infancy to very old age although children may be more susceptible to contracting the disease than adults. “Leprosy is not as rampantly infectious as they once believed; it is not easy to catch and has recently been attributed to genetic predisposition along with infection”, says Dr Pankaj Maniar, consultant dermatologist and Vice President, Alert India, an NGO.


G. H. A. Hansen, discoverer of M. leprae
The disease is transmitted via droplets, from the nose and mouth, during close and frequent contacts with untreated cases. 

Unpleasing signs

The two common forms of the organism – tuberculoid and lepromatous produce sores on the skin. The lepromatous form is severe and it produces large, disfiguring lumps and bumps or nodules. The initial skin lesions are lighter than the normal skin; they have decreased sensation to touch, heat or pain and they do not heal for a long time.

The disease affects the nerves and may cause muscle weakness. Progressive and permanent damage to the skin, nerves, limbs and eyes can occur if left untreated. In people with long-term leprosy, due to the nerve damage in the arms and legs, there is a loss of sensation resulting in repeated injury leading to loss of hand or feet use.

Diagnosis of leprosy is most commonly based on the clinical signs and symptoms. The signs can be recognized using Lepromin skin test, which helps distinguish between the two types of leprosy. Skin scraping and skin lesion biopsy, are other tests. If you notice the symptoms of leprosy or you have been in close contact with someone who has the disease, seek medical help.  

Early recognition helps

Early diagnosis and treatment limits the damage by the disease, makes the person non-infectious and allows you to live a normal lifestyle. This can also prevent you from developing complications such as cosmetic disfigurement and permanent nerve damage.

Antibiotics help in killing the bacteria while aspirin, prednisone or thalidomide helps in controlling inflammation. With effective medications available, isolation of those with leprosy is unnecessary. WHO has recommended Multi-Drug Therapy (MDT) consisting of three drugs - dapsone, rifampicin and clofazimine. MDT, which is available in a convenient monthly pack kills the bacteria and cures the person.  

People on long-term medications do not transmit the bacteria; they become non-infectious. You can prevent the disease by avoiding close physical contact with untreated people. 

Eradicating the stigma

According to Jeyakumar Daniel, director of the Leprosy Mission Trust, India, an NGO, while medical science had helped India to eradicate leprosy up to 95 percent, the disease is still widely treated as a social stigma. People with leprosy are living in self-settled colonies in miserable conditions, far away from the cities and begging is their only sustenance.

The age-old stigma results in hiding the disease and not reporting it makes it difficult for an early treatment. In an environment where people with leprosy are accepted without being ostracized, an early diagnosis would become easy and the disease can be cured. Antibiotics with good skin care can prevent the disease from damaging the body. There is no vaccine as yet for leprosy however, earlier research studies using BCG vaccine (vaccine used for tuberculosis) was found to be effective.

Pic: Wikipedia.org


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