Leprosy

Leprosy is an infectious disease that causes severe, disfiguring skin sores and nerve damage in the arms and legs. The disease has been around since the beginning of time, often surrounded by terrifying, negative stigma and tales of leprosy patients being shunned as outcasts. At one time or another outbreaks of leprosy have affected, and panicked, people on every continent. The oldest civilizations of China, Egypt, and India feared leprosy was an incurable, mutilating, and contagious disease. 

However, leprosy is actually not highly contagious. You can catch it only if you come into close and repeated contact with nose and mouth droplets from someone with untreated, severe leprosy. Children are more likely to get leprosy than adults. 

Today, more than 200,000 people worldwide are infected with leprosy, according to the World Health Organization, most of them in Africa and Asia. About 100 people are diagnosed with leprosy in the U.S. every year, mostly in the South, California, Hawaii, and some U.S. territories. 

Leprosy is caused by a slow-growing type of bacteria called Mycobacteriumleprae (M. leprae).Leprosy is also known as Hansen’s disease, after the scientist who discovered M. leprae in 1873.

Approximately 1 to 2 million people worldwide are permanently disabled because of leprosy.

Symptoms

  • Leprosy primarily affects the skin and the nerves outside the brain and spinal cord, called the peripheral nerves. It may also strike the eyes and the thin tissue lining the inside of the nose.
  • The main symptom of leprosy is disfiguring skin sores, lumps, or bumps that do not go away after several weeks or months. The skin sores are pale-colored.
  • Leprosy can permanently damage your skin, nerves, arms, legs, feet, and eyes.
  • Loss of feeling in the arms and legs and Muscle weakness

Complications of leprosy can include:

  • Blindness or glaucoma.
  • Erectile dysfunction and infertility in men.
  • Kidney failure.
  • Muscle weakness that leads to claw-like hands or an inability to flex the feet.
  • Disfiguration of the face (including permanent swelling, bumps, and lumps).
  • Permanent damage to the peripheral nerves, the nerves outside the brain and spinal cord, including those in your arms, legs, and feet.
  • Permanent damage to the inside of the nose, which can lead to nosebleeds and a chronic, stuffy nose.
  • Nerve damage can lead to a dangerous loss of feeling. A person with leprosy-related nerve damage may not feel pain when the hands, legs, or feet are cut, burned, or otherwise injured.

It takes a very long time for symptoms to appear after coming into contact with the leprosy-causing bacteria. Some people do not develop symptoms until 20 or more years later. The time between contact with the bacteria and the appearance of symptoms is called the incubation period. Leprosy’s long incubation period makes it very difficult for doctors to determine when and where a person with leprosy originally got sick.

Approximately 1 to 2 million people worldwide are permanently disabled because of leprosy.

Resources

Resources

  • Holden (2009). “Skeleton Pushes Back Leprosy’s Origins”. ScienceNOW. Retrieved 2010-01-31.
  • WHO (1995). “Leprosy disabilities: magnitude of the problem”. Weekly Epidemiological Record 70 (38): 269–75. PMID 7577430.
  • Japan repealed its “Leprosy Prevention Laws” in 1996 but former patients still reside in sanatoriums. “Koizumi apologises for leper colonies”. BBC News. May 25, 2001. and Ex-Hansen’s disease patients still struggling with prejudice Japan Times June 7, 2007.
  • Radan S, Hutt A (2001-11-06). “Europe’s last leper colony lives on”. BBC News. Retrieved 2010-01-31.
  • “Leprosy”. WHO. 2009-08-01. Retrieved 2010-01-31.

Treatments

Enough synthetic pharmaceuticals that are effective against leprosy have by now been identified, and support a flexible choice of treatments. The WHO Study Group’s report on the Chemotherapy of Leprosy in 1993 recommended two types of standard MDT regimen be adopted.[68] The first was a 24-month treatment for multibacillary (MB or lepromatous) cases using rifampicin, clofazimine, and dapsone. The second was a six-month treatment for paucibacillary (PB or tuberculoid) cases, using rifampicin and dapsone. At the First International Conference on the Elimination of Leprosy as a Public Health Problem, held in Hanoi the next year, the global strategy was endorsed and funds provided to WHO for the procurement and supply of MDT to all endemic countries.

Between 1995 and 1999, WHO, with the aid of the Nippon Foundation (Chairman Yōhei Sasakawa, World Health Organization Goodwill Ambassador for Leprosy Elimination), supplied all endemic countries with free MDT in blister packs, channelled through Ministries of Health. This free provision was extended in 2000 and again in 2005 with donations by the MDT manufacturer Novartis through WHO. In the latest agreement signed between the company and WHO in October 2010, the provision of free MDT by WHO to all endemic countries will now run until at least the end of 2015. At the national level, non-government organizations (NGOs) affiliated to the national programme will continue to be provided with an appropriate free supply of this WHO supplied MDT by the government.

MDT remains highly effective, and patients are no longer infectious after the first monthly dose. It is safe and easy to use under field conditions due to its presentation in calendar blister packs.[8] Relapse rates remain low, and there is no known resistance to the combined drugs. The Seventh WHO Expert Committee on Leprosy, reporting in 1997, concluded that the MB duration of treatment — then standing at 24 months — could safely be shortened to 12 months “without significantly compromising its efficacy.”

 

 

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