Leprosy

Leprosy is a chronic bacterial disease of the skin and nerves in the hands and feet and, in some cases, the lining of the nose. It is caused by a bacteria similar to that which causes tuberculosis. Because of the visible disfigurement in untreated people, with leprosy have long been feared and shunned by others. Multibacillary Hansen's disease is associated with symmetric skin lesions, nodules, plaques, thickened dermis, and frequent involvement of the nasal mucous resulting in nasal congestion and pistachios. Because the organism grows best at lower temperatures the leprosy bacillus has a preference for the skin, the mucous membranes and the nerves.The World Health Organisation (WHO) estimates there are 830,000 cases of the disease worldwide. It is most prevalent in poverty-stricken areas of in Asia, Africa and Latin America. However, one way the disease is likely passed from person to person is through droplets expelled from the nose and mouth of an infected person and breathed in or touched by an uninfected person. About 95% of people who are exposed to Mycobacterium leprae do not develop leprosy because their immune system fights off the infection. In people who do develop the disease, the infection can range from mild (tuberculoid leprosy) to severe (lepromatous leprosy). The tuberculoid form of leprosy is not contagious.

Leprosy is a painful condition which, although curable, can leave sufferers deformed and crippled if left untreated. Although leprosy is not highly contagious, does not cause death, and can be effectively treated with antibiotics, the disease still causes widespread anxiety. Its victims were often shunned by the community, kept at arm's length, or sent to a leper colony. Many people still have misconceptions about the disease. Health care workers often work for many years with people who have leprosy without contracting the disease. Almost all cases of leprosy in the United States involve people who emigrated from developing countries. The infection can start at any age but most commonly begins in the 20s and 30s. Other potential sources of Mycobacterium leprae are soil, armadillos, and possibly bedbugs and mosquitoes. The third type is known as borderline or dimorphous leprosy, and is has characteristics of both other forms. Contrary to popular belief, it is not highly communicable and is extremely slow to develop. Household contacts of most cases and the medical personnel caring for Hansen's disease patients are not at particular risk. It is very curable, although the treatment is long-term, requiring multiple medications.

Causes of Leprosy

The common Causes of Leprosy :

• Leprosy is a chronic disease caused by a bacillus, Mycobacterium leprae;
• M. leprae multiplies very slowly and the incubation period of the disease is about five years. Symptoms can take as long as 20 years to appear;
• Exposure to the nasal discharge of those that remain untreated for years is thought to be the main cause of infection. Transmission is not completely understood
• Leprosy is not highly infectious. It is transmitted via droplets, from the nose and mouth, during close and frequent contacts with untreated cases.
• HIV infection is not a risk factor for acquiring leprosy, nor does it increase the clinical symptoms or virulence of leprosy.

Symptoms of Leprosy

Some common Symptoms of Leprosy :

• Leprosy mainly affects the skin and nerves;
• Skin lesions that do not heal after several weeks to months
• If untreated, there can be progressive and permanent damage to the skin, nerves, limbs and eyes.
• Numbness or absent sensation in the hands and arms, or feet and legs
• Local skin numbness.
• muscle weakness resulting in signs such as foot drop (the toe drags when the foot is lifted to take a step)

Treatment of Leprosy

• Medications used to eliminate the microorganism and to reduce symptoms like dapsone, rifampin and clofazimine.
• Ethionamide
• Patients with leprosy should be treated by a doctor who has experience with the disease. Treatment is with multiple drugs for six months to two years.
• WHO and US treatment regimens for paucibacillary and multibacillary disease are listed below. Therapy for single-skin lesions is not universal, as 80% of single-skin lesions heal spontaneously. Therefore, only the WHO has a recommended treatment.
• Aspirin, prednisone, or thalidomide are used for the control of inflammation, that may occur with therapy.
• Treatment consists of antimicrobial therapy using sulfones, primarily oral dapsone, which may cause hypersensitivity reactions

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