Leprosy

Description

Leprosy, also known as Hansen’s disease (HD), is a chronic disease caused by the bacteria Mycobacterium leprae and Mycobacterium lepromatosis.Named after physician Gerhard Armauer Hansen, leprosy is primarily agranulomatous disease of the peripheral nerves and mucosa of the upper respiratory tract; skin lesions are the primary external sign.Left untreated, leprosy can be progressive, causing permanent damage to the skin, nerves, limbs and eyes. Contrary to folklore, leprosy does not cause body parts to fall off, although they can become numb or diseased as a result of secondary infections; these occur as a result of the body’s defenses being compromised by the primary disease.Secondary infections, in turn, can result in tissue loss causing fingers and toes to become shortened and deformed, as cartilage is absorbed into the body.

Although the mode of transmission of Hansen’s disease remains uncertain, most investigators think that M. leprae is usually spread from person to person in respiratory droplets.Studies have shown that leprosy can be transmitted to humans by armadillos. Leprosy is now known to be neither sexually transmitted nor highly infectious after treatment. Approximately 95% of people are naturally immune and sufferers are no longer infectious after as little as 2 weeks of treatment.

Mode of Transmission

Airborne: inhalation of droplet/spray from coughingand sneezing of untreated leprosy patient

Signs and Symptoms

• long standing skin lesions that do not disappear with ordinary treatment
•  loss of feeling/numbness on the skin
• loss of sweating and hair growth over the skin lesions
• thickened and/or painful nerves in the neck, forearm, near elbow joint and the back of knees

Treatment

Multidrug therapy (MDT) is the cornerstone of the leprosy elimination strategy as it cures patients, reduces the reservoir of infection and thereby interrupts its transmission. MDT also prevents disabilities through early cure.

For purposes of treatment, leprosy is divided into two types :

1. Pauci-bacillary(PB) leprosy : 1-5 skin lesions – Regimen of two drugs – Rifampicin and Dapsone for 6 months;
2. Multi-bacillary(MB) leprosy : >5 skin lesions – Regimen of three drugs – Rifampicin,Clofazimine and Dapsone for 12 months;

Prevention and Control