Every year on the last Sunday of January, World Leprosy Day is observed. It coincides with the death anniversary of Mahatma Gandhi. This year the day will be observed on 29th of January 2023. The goal of commemorating World Leprosy Day is to raise awareness about the stigma caused by the disease. Awareness is raised by informing the general public that it is a bacterial infection that can be easily treated.
Were you aware of the fact that India runs the largest leprosy elimination programs in the world?
The National Leprosy Eradication Program (NLEP) ensures strict contact tracing of leprosy patients with an aim to completely eradicate the disorder from the country. However, the government has had to shift its focus to other concerning areas, owing to the COVID epidemic. The frontline workers have had to shift their efforts to the vaccination drive and this could have impacted the NLEP.
The country is now dealing with new treatment complications: Some former patients who received multidrug therapy in the past are now experiencing relapses, while others are not responding to the standard drugs. From 2019 to 2022, the Leprosy Mission India identified over 100 such cases in India. Drug resistance has developed in half of them, and they are not responding to treatment or medication.
Another reason for India's continued struggle with leprosy is stigma, which, like the bacterium, persists with painful consequences. Disease-related disfigurement has long resulted in isolation and ostracism. Superstitions and rumors about being cursed spread alongside the disease and these superstitions need to be eliminated by educating the rural population about the cause, symptoms, and treatment options. Let’s understand what leprosy is before we look into the details of the disorder.
What is Leprosy?
Leprosy is a disease that causes severe, scarring skin sores and limb nerve damage. Every country has been affected by the leprosy disease. Leprosy is not particularly contagious, but it spreads when a healthy person has frequent and close contact with mouse droplets and leprosy patients. This disease affects children more than adults. Nearly 180000 people worldwide are infected with leprosy. The peripheral nerves, skin, upper respiratory tract, and eyes are the primary targets of leprosy disease. The most common mode of transmission is through the respiratory tract. Leprosy can also be spread by insects. Let us take a closer look at leprosy disease, different types of leprosy, leprosy causes, symptoms, and treatment.
What Causes Leprosy?
Mycobacterium leprae, a slow-growing type of bacteria, causes leprosy (M. leprae). Hansen's disease, named after the scientist who discovered M. leprae in 1873, is another name for leprosy. It is unclear how leprosy is transmitted. When a person with leprosy coughs or sneezes, droplets containing the M. leprae bacteria are spread and breathed in by another person. To transmit leprosy, close physical contact with an infected person is required. It is not spread through casual contact with an infected person, such as shaking hands, hugging, or sitting next to them on a bus or at a meal table. Pregnant women who have leprosy cannot pass it on to their unborn children. It is also not transmitted via sexual contact.
Types of Leprosy
The types of leprosy are defined by the number and type of skin sores present anywhere on the body. Also, the symptoms and treatment options depend on the type of leprosy. Following are some of the types of leprosy;
Tuberculoid Leprosy - Leprosy that is milder and less severe. This type has only one or two patches of flat, pale-colored skin (paucibacillary leprosy). Because of nerve damage beneath the skin, the affected area of skin may feel numb. Tuberculoid leprosy is not as contagious as other types.
Lepromatous Leprosy – This type of leprorsy is a more severe manifestation of the disease. It causes widespread skin bumps and rashes, numbness, and muscle weakness (multibacillary leprosy). The nose, kidneys, and male reproductive organs are all at risk. It spreads faster than tuberculoid leprosy.
Borderline Leprosy - This type of leprosy manifests symptoms of both tuberculoid and lepromatous leprosy.
There can also be other classifications such as:
Single lesion paucibacillary (SLPB) – This could be referred to one lesion
Paucibacillary (PB) – This could mean that the patient has between two to five lesions
Multibacillary (MB) - This could mean that the patient has either six or more lesions
What are the Symptoms of Leprosy?
Leprosy begins with the skin and progresses to the peripheral nerves, which are located outside the brain and spinal cord. Although it takes three to five years for these symptoms to appear after coming into contact with the bacteria, symptoms can appear up to 20 years after infection. The incubation period is the time between being exposed and the appearance of symptoms. If this period lengthens, doctors will have a much more difficult time diagnosing the disease.
Some of the symptoms of leprosy are as follows:
How is Leprosy Diagnosed?
If you have a leprosy-like skin sore, the doctor will take a small sample and send it to a lab to be examined. This is known as a skin biopsy. A skin smear test may also be performed by your doctor. There will be no bacteria in the test results if you have paucibacillary leprosy. There will be presence of bacteria if you have multibacillary leprosy.
A lepromin skin test may be required to determine the type of leprosy you have. The doctor will inject a small amount of inactive leprosy-causing bacteria just beneath the skin of your forearm for this test. They'll check the area where you were shot three days later and again 28 days later to see if you have a reaction. You may have tuberculoid or borderline tuberculoid leprosy if you have a reaction. This test has no effect on people who do not have leprosy or have lepromatous leprosy.
Treatment of Leprosy
Treatment for leprosy is entirely dependent on the type of leprosy that the patient has. Doctors can then proceed to treat the infection with antibiotics. Long-term treatment includes two or more antibiotics for 6 months to a year. People with severe leprosy may need to take antibiotics for a longer period of time. However, these antibiotics are ineffective in treating nerve damage. Some anti-inflammatory medications are used to treat nerve pain and severe damage caused by leprosy.
Any medical information referred to in or through our blog is provided as information only and is not intended:
Leprosy can be cured and this can be done with a combination of antibiotics and this is known as Multi Drug Therapy (MDT). This type of treatment is usually free across the world to prevent and treat leprosy. Let’s join hands to raise awareness on this disease and act now to completely end leprosy-related disorders and the stigma associated with it.