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Understanding leprosy

I WAS driving by the Leprosy centre the other day on my way to buy plants. It was a common disease in biblical times. Is it still common today?

Leprosy is also known as Hansen's Disease, after the man who discovered the bacteria that causes it (in 1873). It was the first bacteria ever identified to have caused disease in human beings.

It is common in many countries worldwide, especially subtropical and tropical countries. But today, the widespread thinking is that you don't have to isolate the patients anymore because effective medications exist everywhere.

According to global reports from 115 countries, there are 219,826 cases of leprosy worldwide in 2006. It has declined since 2005.

Leprosy has been eliminated in a lot of countries that previously had a high incidence. Countries that still have a lot of cases (these are called areas of "high endemicity") are India, Brazil, Nepal and a lot of African countries.

What is leprosy ?

Leprosy is actually an infectious disease. It has a very long history and has been extensively recorded in the Bible and the oldest civilizations of China. Egypt and India.

It is caused by the organism called Mycobacterium leprae. Now, contrary to myth, it is not a very contagious bacteria (it does not spread easily).

Children are more prone than adults to get- ting it.

Leprosy has terrified mankind for thousands of years, even though it is not very contagious, because of the physical mutilation it causes. It was taught to be a curse, or the culmination of one's sins. That's why lepers have been hunted and persecuted by society for millennia.

It was not until the 1940s that the cure for leprosy came about in the form of dapsone.

How is leprosy spread? I drove very near to the leper colony. Will I be afflicted?

No, you won't be afflicted. It is unclear to this day how leprosy is spread, but household and prolonged close contact is essential before you can get the disease.

The mycobacteria from the nose discharge of leprosy patients (when the patient coughs or sneezes) is postulated to enter through the nose and possibly through broken skin. It is not however spread through sexual contact or pregnancy.

But even though you may have been in contact with a leprosy patient, it takes a very long time for symptoms to appear. It usually takes about four years for tuberculoid leprosy to appear and eight years for lepromatous leprosy to appear.

In most cases, a leprosy patient will not infect others after three months of starting treatment Most of the patients in our leper colonies have been treated already.

How will I know if I have leprosy?

There are symptoms and signs you have to look out for, especially if you live in an endemic country.

There are two types of leprosy: tuberculoid and lepromatous. Both forms produce sores on the skin and will eventually cause peripheral nerve damage (meaning damage to the nerves of your limbs), which leads to loss of sensation in your skin and muscle weakness. The lepromatous form is the most severe and disfiguring.

Leprosy affects the skin and the nerves.

In the skin, the lesion can be single or multiple. The skin lesions are at first flat and red Then they enlarge, and have irregular shapes. They are paler than your surrounding skin in the centre but are darker around their edges. They can be raised or contain nodules. The characteristic feature is loss of sensation in that particular skin lesion to pain, heat and touch.

Thickened nerves, which can be felt below the skin, is also another feature of leprosy. There may be loss of sensation in the skin and weakness of muscles supplied by that affected nerve.

Patients who have leprosy for the long term may lose their hands or feet due to repeated injury resulting from lack of sensation. Inadequate care of wounds leads to gangrene, and the body tissues then die and become deformed.

Why do some people get tuberculoid leprosy and some get lepromatous leprosy? Is there a 'choice?

When the bacteria Mycobacterium leprae invades your body, one of two reactions can take place. In tuberculoid leprosy (which is milder), your body's immune system attempts to seal off the infection. This occurs in the deeper layers of the skin. As a result, there are skin lesions and enlarged nerves. About 70 - 80% of all leprosy belong to this type.

In lepromatous leprosy, the more contagious form, your body's immune system is unable to mount a strong response to the invading organism. The organism then multiplies freely in the skin. There are large nodules or lesions all over the body and face, sometimes involving the eyes, nose, and throat The face can appear like "a lion". This type of leprosy can lead to blindness and mutilation of the nose.

Leprosy can be treated and the drugs include dapsone, rifampicin and other antibacterial drugs.


Understanding leprosy

About leprosy

Leprosy susceptibility - 7 genes identified












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