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Leprosy (Hansen's Disease)

Old scourge can be cured

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Updated June 12, 2014

A leprosy patient at the Mawlamyine Christian Leprosy Hospital in Mawlamyine, Burma.
Stephen J. Boitano/Lonely Planet Images/Getty Images
It was 1873, and Dr. Armauer Hansen of Norway had astounding news for the world: leprosy was caused by a bacterium (Mycobacterium leprae). Until then, the disease was thought to be from a curse or sinful ways.

Leprosy, known as Hansen's disease, still exists. According to the World Health Organization (WHO), the global registered prevalence of leprosy at the beginning of 2008 stood at 212,802 cases, while the number of new cases detected during 2007 was 254,525 (excluding the small number of cases in Europe).

Leprosy Is Not Very Contagious

Modern medicine tells us that leprosy is spread when an untreated infected person coughs or sneezes (but not by sexual contact or pregnancy). However, leprosy is not very contagious; approximately 95% of people have natural immunity to the disease. People with leprosy who are treated with medication do not need to be isolated from society. Historically, people with leprosy were sent to 'leper colonies,' also called 'leprosariums,' on remote islands or in special hospitals.

Signs and Symptoms of Leprosy

The earliest sign of leprosy is commonly a spot on the skin that may be slightly redder, darker, or lighter than the person's normal skin. The spot may lose feeling and hair. In some people, the only sign is numbness in a finger or toe.

If left untreated, leprosy can progress to cause serious effects on the body, including:

  • Hands and feet - Leprosy bacteria attack the nerves in the hands and feet and cause them to become numb. A person may get cuts or burns on the numb parts and not know it, leading to infections which cause permanent damage. Fingers and toes may be lost to infection. Serious infections in the feet may require amputation. Paralysis may cause the fingers and toes to curl up permanently.

  • Eyes - Leprosy bacteria attack the nerves around the eyes, causing the loss of blinking reflex (which protects the eye from injury and moistens the surface). The eyes become dry and infected, and blindness may result. Because of numbness of the eye, the person cannot feel debris in or scratches on the eye.

  • Face - Damage to the internal lining of the nose causes scarring and eventual collapse of the nose.

Leprosy Diagnosis

Leprosy is diagnosed by taking a skin sample (biopsy) and examining it under the microscope, looking for leprosy bacteria. Another test used for diagnosis is a skin smear. A small cut is made in the skin and a small amount of tissue fluid is taken. This is examined under a microscope for the presence of leprosy bacteria.

Treatment Available

The good news is that leprosy is curable. In 1981, the WHO recommended the use of a combination of three antibiotics -- usually dapsone, rifampin, and clofazimine -- for treatment, which takes six months to a year or more. Certain cases may be treated with two antibiotics, but rifampin is a key component of either regimen. Since 1995, the WHO has provided these drugs free of charge to all leprosy patients worldwide.

During the course of treatment, the body may react to the dead bacteria with pain and swelling in the skin and nerves. This is treated with pain medication, prednisone or thalidomide (under special conditions).

A Hopeful Outlook

Before treatment was available, a diagnosis of leprosy meant suffering and pain and being shunned by society. Today, antibiotics and good skin care will prevent the disease from destroying the body. Perhaps in the future a vaccine will eliminate this ancient scourge altogether.

Source:

"About leprosy: The basics." Get Informed. American Leprosy Missions. 29 Apr 2009

"Leprosy Today." Programmes and projects. World Health Organization. 29 Apr 2009

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