gaurish: Hi doctor, we keep hearing that leprosy is no longer a threat it use to be, but there are still beggers on the road that have the disease and use the disease to ask for money. what are the chances to contracting the disease from them ?

DrGanapati: This is an eternal question raised by all. The beggars on the roadside are "arrested" cases and are not infectious. Deformity does not necessrily mean infectivity. As such one cannot get infected from such "ex-patients". Infection lurks in the society and such patients may not be identifiable so easily. Please do not encourage such beggars by giving charity.

gaurish: are there any tests that one should take on a regular basis to test for the disease?

DrGanapati: The only method is to get a clinical examination done by any experienced doctor or para-medical worker trained in leprosy. One should look for any discoloured patch / patches on the skin. Clinical test consists of eliciting loss of sensations. Rarely disease may start with shiny oily skin with tiny nodules. In such cases skin clippings are examined for the causative organisms under the microscope.

altaf: Hello Sir, is leprosy spread by touch ? how contagious is it ?

DrGanapati: Leprosy may not necessarily spread by skin to skin contact. It is believed to spread by aerial means ie. "droplet infection", in the same manner as tuberculosis. But very few develop infection, as human beings are blessed with strong IMMUNITY.

Meeeeeee: Hi, is leprosy heridatary?

DrGanapati: No. It is not hereditory. The infection is acquired by exposure to the germs present in the environment. However, the defence mechanism providing immunity to fight the disease is very high in human beings. Not all those who are exposed to the germ develop leprosy.

altaf: what does the bombay leprosy project do for leprosy patients in bombay?

DrGanapati: We indentify patients by creating awreness among doctors, paramedics in municipal health centers and the public and encourage self reporting. Dermatologists refer patients for expert opinion and treatment of complications. Treatment is offered free of charge by reaising donations. Deformities are attended to by experts. Rehabilitation of selected patients is given by job opportunities like training computers etc

Meeeeeee: How does the disease manifest itself? What are first symptoms?

DrGanapati: First symptom is generally a disolouration of skin in the form of a whitish or reddish patch with loss of sensation to touch, pain .

altaf: does the government provide aid in treatment for leprosy the way it does for TB?

DrGanapati: Yes. Basic treatment with standard drugs is provided in Primary Health Centers free of charge only if patients report voluntarily due to govt's awreness campaigns. However, expertise in the mangement of complications is poor. Many NGOs assist the govt inthis.

Meeeeeee: There are several organisations that are working towards the elimanation of leprosy? How successful are these? Presuming that we achieve 100% success - as in manage to eliminate the disease completely, are there chances of the disease recurring? If yes, how can that be prevented?

DrGanapati: Prevalence rate has come down satisfactorily, though new case are reporting in large numbers especially from some urban and rural pockets. Expertise in managing complications and offering disability care gigantic problems. Total eradication will take several more years.