Leprosy is an infection caused by bacteria called Mycobacterium leprae. It is also known as Hansen disease.

Leprosy or Hansen disease can affect the nerve, eyes, skin and the nasal mucosa. Leprosy causes severe, disfiguring skin sores and nerve damage in the arms, legs and skin and around the body.

Brief History of Leprosy

Leprosy is an ancient disease that has been in existence since at least 4000 BC. Leprosy was present and described in the ancient civilization of China, India and Egypt.

The first known written reference of leprosy was on Egyptian Papyrus dated back at about 1550 BC. This disease was believed to be brought to Europe by the Romans and the Crusaders and later the Europeans brought it to the Americans, for centuries, leprosy has remained a poorly understood disease characterized by human suffering and social isolation.

Countries in which leprosy is more commonly found include Angola, Bangladesh, Brazil, China, Central African Republic, Ethiopia, India, Indonesia, Madagascar, Myanmar, Nepal, Nigeria, Philippines, Sudan, South Sudan, Sri Lanka, Democratic Republic of the Congo, and Mozambique.

In 1873 a Norwegian scientist named Gerhard Armauer Hanseen discovered the bacteria causing the infectious disease and the first medication breakthrough occurred in the 1940s with the development of the drug ‘Dapsone’ and it was later discovered that the bacteria causing leprosy was more effectively killed using multiple medications.

Some Common misconception and myth associated with leprosy

There are some common misconceptions and myth associated with leprosy which has continually caused confusion, stigma and discrimination in the society.

Myths: Leprosy is as a result of sin:

Facts:  Leprosy is not as a result of sin, curse or behavioural defect. It is caused by slow-growing bacteria called Mycobacterium leprae.

Myths: You can get leprosy when sitting next to someone who has the disease.

Facts: You cannot get leprosy through casual contact such as shaking hands, sitting next to or talking to someone who has the disease.

Myths: People who have leprosy need to live in special houses isolated from healthy people.

Facts: People with leprosy who are being treated with antibiotics can live a normal life among their family and friends and can continue to attend work or school.

What are the forms of Leprosy?

Tuberculoid: this type of leprosy is mild and less severe. People who suffer from this type of leprosy have only one or few patches of flat, pale coloured skin (Paucibacillary leprosy). This type of leprosy is less contagious than other forms

Borderline: people with this type of leprosy have symptoms of both the tuberculoid and lepromatous forms of leprosy.

Lepromatous: lepromatous leprosy is a more severe form of the disease. It is more contagious than tuberculoid leprosy and has widespread skin bumps and rashes, numbness, and muscle weakness. The nose, kidney and male reproductive organ may also be affected.

How is Leprosy Transmitted?

The precise mechanism of transmission of leprosy is unknown but however researchers suggest that M. leprae spreads from person to person by nasal secretions or droplets from the upper respiratory tract and nasal mucosa. However, leprosy is not highly contagious like the flu.

What are the Symptoms of leprosy?

 The following are the major signs and symptoms of leprosy:

Numbness

Loss of temperature sensation 

Touch sensation reduced

Pins and needles sensations

Joint pain

Nerve injury

Weight loss

Eye damage (dryness, reduced blinking)

Large ulcerations

Loss of digits

Facial disfigurement

How do healthcare providers diagnose leprosy?

Leprosy can be recognized by appearance of patches of skin that may look lighter or darker than the normal skin.

The healthcare provider or doctor will take a sample of the skin or nerve to examine the bacteria using a microscope and may also do tests to rule out other skin disease.

How is leprosy treated?

According to world health organization(WHO) leprosy is curable with a combination of drugs known as multi-drug therapy(MDT), as the treatment of leprosy with only one anti-leprosy drug (mono-therapy) will result in the development of drug resistance to that drug. The combination of drugs used in the multi-drug therapy (MDT) depends on the classification of the disease. Rifampicin, which is the most important anti-leprosy medicine, is included in the treatment of both types of leprosy.

What is the Current Control Strategy?

Since the transmission of leprosy is poorly understood, and according to World Health Organization (WHO) policy majorly focuses on the early detection of new cases and rapid treatment rather than prevention of transmission. Treating leprosy early both limits the transmission of the disease and also the deformity that long-term infection can cause. The World Health Organization (WHO) “final push” strategy towards elimination emphasizes the expansion of multi drug therapy to health centers in endemic areas, aims to reduce stigma so that individuals that are infected will report for treatment, and encourages all patients to complete their full course of treatment.

How can leprosy be prevented?

Avoiding contact with droplets from nasal and other secretions from patients with untreated M. leprae infection is currently the most effective way to avoid leprosy. Treatment of patients with appropriate antibiotics stops the person from spreading the disease. People who live with individuals who have untreated leprosy are about eight times as likely to develop the disease, because researchers speculate that family members have close proximity to infectious droplets. Leprosy is not hereditary, but recent findings suggest susceptibility to the disease may have a genetic basis.

Reviewed on 10/04/2020

REFERENCES
https://www.who.int/lep/disease/treatment/en/

WHO (2010). Global Leprosy Situation, 2010. Weekly Epidemiological Record 35

WHO. The “Final Push” strategy for elimination.