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
Children are more prone than adults to get-
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
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
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
Why do some people get tuberculoid leprosy
and some get lepromatous leprosy? Is there a
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