Leprosy is a
chronic infectious disease that is caused by the bacterium
Mycobacterium leprae. It affects the
skin, mucosa of the upper
respiratory system and
eyes, peripheral
nerves, and some other structures. The
incubation period varies from three months to 40 years.
Transmission
Transmission is thought to occur through
inhalation of
bacteria-laden
dust particles.
Environmental factors such as unhygienic and crowded living conditions contribute to the spread of the disease.
Malnutrition and a weak
immune system also favor
infection.
Symptoms
Leprosy takes on two forms. Multibacillary leprosy occurs in patients with immune deficiencies. In this form,
patients have numerous
shiny, non-
itching reddish nodules,
tumours and raised patches with sloping edges. There is no
sensory loss in the affected parts of the body, but skin smears are always positive for bacilli. Unless treated with
multiple drug therapy, persons suffering from multibacillary leprosy constitute the
principal source of infection. In such persons the bacilli multiply almost unchecked.
The damage that the bacilli cause to the
peripheral nerves leads to
numbness,
muscle weakness or even
paralysis (with consequent
claw hand or foot drop), and dry skin. Because of the loss of
sensation the patient fails to notice an
injury. Injuries easily result in
infections which lead in turn to
ulcers that damage the dermal
tissues,
joints and
bones with the consequent loss of extremities (
toes and
fingers) or secondary deformities. This happens in an estimated 25% of cases that are not treated at an early stage of the disease.
The second form of the disease is paucibacillary leprosy, which occurs in those with a stronger immune system. This latter form is relatively
harmless and as a rule non-infectious. The most
frequent form of leprosy, it accounts for between 70 and 80 percent of all cases. The typical signs are flat or slightly raised patches on the skin - usually single but at most three, well demarcated, non-itching, and hypopigmented or reddish. Patients feel nothing in the affected area. This
sensory loss is very important for
diagnosis because bacilli are often undetectable in skin smears.
History
Leprosy has afflicted
humanity for
millennia. It once affected every
continent and it has left behind a terrifying image in history and human
memory - of
mutilation,
rejection and
exclusion from
society (and for the anti-socialites, yes, that last one is supposed to be a bad thing). Leprosy has struck fear into human beings for thousands of years, and was well recognized in the oldest civilizations of
China,
Egypt and
India. A
cumulative total of the number of
individuals who, over the millennia, have suffered its chronic course of
incurable disfigurement and physical disabilities can never be calculated.
The ancient
Greeks and
Romans learned painful lessons about leprosy after their armies returned
victorious from
Asia—unwittingly bringing back the previously unknown
affliction with their
plunder. In the
Middle Ages, sufferers had to wear special clothing, ring
bells to warn others that they were close, and walk on a
particular side of the road, depending on the direction of the
wind.
Dr. Armauer Hansen first discovered the leprosy bacillus in
Norway in 1873. He is credited with identifying one of the first bacteria known to be a human
pathogen. Today, leprosy is often called Hansen's disease.
Leprosy Today
Leprosy is still
extant today. Most cases are located in Asia. There are 700,000 new cases every year
worldwide, with 200 of those cases in the
United States. Rate of
occurrence has declined steadily over the past few decades. Leprosy is rarely the cause of death in a patient, but many patients die from
complications. The rate of
mortality for people suffering from leprosy is estimated to be about four times that of the normal
population.
Treatment
The current recommended course of treatment is rifampicin, clofazimine and dapsone for multibacillary leprosy (MB) leprosy patients and rifampicin and dapsone for paucibacillary leprosy (PB) patients. This is known as multi-drug treatment. MB patients are cured in 12 months, PB in six. Cases
resistant to treatment are extremely
rare.
Self-Assessment
Do you ever
wonder, "Do I have leprosy?" Now you can take this simple self-assessment test to determine whether you do!
1. Do you have red, raised patches on your
skin?
2. Have you ever
chewed through your
cheek at
breakfast because you couldn't feel anything? Is this a
recurring problem?
3. Has your
doctor performed a skin smear and come up with nothing? Did this self-same doctor rule out leprosy becuase of this? If so, you have an
idiot for a doctor. Be particularly worried if you're in an
HMO.
If you answer "yes" to the above three questions, you may have PB leprosy. Go see a non-HMO doctor immediately.
1. Are you covered with tumors?
2. Stick a finger or toe with the tumors into a
food processor. Did you feel anything? If so, you are in the early stages of the disease. If not, start fretting and check to see if you still have all of your limbs.
3. Did you catch your
dog burying one of your body parts in the
backyard last night?
4. Have you suddenly developed claw foot?
If you answered "yes" to one or more of the above questions, you may have MB leprosy. Go see your doctor immediately for a skin smear, which will detect the bacteria. Or, if you feel qualified, grab your high-powered
microscope, dab a swab from your skin beneath the lens, and look for the rod-shaped, red-stained leprosy bacilli.
This has been another public health service provided
free as in beer by
SueZVudu!