What Is Leprosy Disease?

Prelude

This morning, my friend who is a survey manager for WHO, returned from her usual trip in a very unusual way. Most times, she would enter through the front door cheerfully describing the grasslands of Africa or the snowfall in Siberia. But today, on her return from Nepal, she was in tears. I panicked and kept questioning her. “Why are you crying, Leila?” She didn’t reply. Eventually, I calmed her down and she describes the havoc leprosy had wreaked in Nepal. It was my turn to cry. Lesions on the face, high fever, body pains, paralyzed nerves, damaged limbs. And the terrible stigma. Not only do leprosy patients suffer the crippling effects on their bodies but also their minds. The society rejects and isolates them making recovery far more difficult.

• Meaning
• Causes
• Symptoms
• Transmission
• Treatment
• Is Leprosy contagious?

Meaning Of Leprosy

Leprosy or Hansen’s disease is a serious infectious disease that targets the skin, mucous membranes, and peripheral nervous system. The causative agent is Mycobacterium leprae. It is characterized by skin lesions, claw hand and disfigurement of limbs. The bacterium infects a wide range of body parts. The patient suffers extensive sensory and motor damage. Chief nerves supplying the extremities are infected. Hence, the hands and feet start mutilating due to loss of sensation and pain.

Causes Of Leprosy

The causative agents of Leprosy are:

• Mycobacterium leprae
• Mycobacterium lepromatosis

We shall describe both these organisms in detail for better understanding.

Mycobacterium Leprae

Like TB, leprosy is caused by a bacterium. The bacterium is Mycobacterium Leprae. It was discovered by Armauer Hansen in Norway in 1873. This is why it is also called Hansen’s disease. Although its bacterial nature was known at the time, it was not considered infectious.

Mycobacterium Lepromatosis

Discovered in 2008, this bacterium is notorious for causing leprosy in some poor countries of the Americas. It was identified from a recent case of diffuse lepromatous leprosy.

Both these organisms are incapable of surviving outside of the host cell. Hence, they need the host to grow and multiply rapidly. Such microbes are called Obligate Intracellular Pathogens. It is not possible to culture them in the lab. Therefore, we can’t use the Germ Theory to analyze and study these creatures. As a result, other techniques like genetic engineering are used to establish the cause of illness.

Symptoms Of Leprosy

Its early signs and symptoms develop and intensify over the years, making it very hard to catch the disease in its early stages. Some notable clinical symptoms are listed below:

• Pinkish patches of insensitive skin
• Numbness especially in the extremities
• Skin lesions
• Skin deformities
• Tissue loss
• Absorption of cartilage into the body
• Sensation of pins and needles
• Reduced sensation of temperature
• Joint ache
• Reduced sensation of deep pressure
• Blisters and rashes
• Painless ulcers
• Progressive disfigurement (eyebrows loss)

Leprosy Transmission

Although clinicians employ the Multi drug therapy (MDT) to control its spread, it can still diffuse to caretakers and caregivers. Some scientifically proven modes of transmission are:

• Prolonged physical contact
• Airborne route
• Transmission via other species

Prolonged Physical Contact

One of the fastest modes of transmission is physical contact. Touching or living with a patient for years can increase your risk for it. Having close long-term contact with a patient can increase your chances five to eight times as compared to another member of the general population.

Airborne Route

The bacteria are well-known for their ability to travel through the air. So simple acts like wheezing, coughing, sneezing and even talking can disseminate microbes into the air. Now, another person breathing in the same air will most likely catch the disease. So we could say that it spreads by nasal secretions and droplets. Experiments proved that certain strains of M. Leprae caused leprosy when they were sprayed as aerosols onto mice. The mice exhibited the symptoms some days later suggesting a similar mechanism of transference for humans.

Transmission Via Other Species

Leprosy can also spread to humans via other neighboring and infected species. There is, for example, sufficient evidence in support of leprosy spreading to humans from Armadillos. In Britain, red squirrels are a threatened species and are a victim of leprosy. But they have never spread the infection to humans.

Treatment Of Leprosy

In case of timely diagnosis i.e. during the early stages, it doesn’t cause many complications. It can be cured. But serious complications can occur if therapy and treatment begin at the later stages of the disease. Unlike the past, it is completely curable by Multi drug therapy (MDT). 

• Multi-Drug Therapy
• Home Remedies

Multi-Drug Therapy (MDT)

This therapy involves the use of medications like Rifampicin and Dapsone. For treating multibacillary leprosy, doctors prescribe a drug plan of Rifampicin, Dapsone, and Clofazimine. The patient uses these drugs for a period of twelve months. These medicines termed as leprostatic agents and other antibiotics have the full potential to cure the patient entirely. The patients often don’t relapse after a few months or years. This program of three drugs is affable and effective. It makes up the MDT.  Also, the bacteria that cause it have not developed resistance against these drugs as in TB. The National Hansen’s Disease Program has clinics throughout the US to increase awareness about it.

Home Remedies For Leprosy

Often, there is no scientific proof in favor of home remedies. But they work. And that is why people use them.

• Cantella Asiatica, a mixture made from the neem plant Hydrocotyle shows some improvement among patients.
• Some patients also report that aromatherapy with frankincense also brings them relief.

We advise that you discuss with your doctor before using any home remedy. Such palliative cures are usually not based on scientific fact.

Is Leprosy Contagious?

The answer is a plain Yes! 

You can have leprosy if you care for and look after leprosy patients for many years. Although it is not the main route of dissemination, the bacterium can spread through regular physical contact. You are also at a higher risk if:

• You live in an area where the disease is widespread like Nepal, India, Egypt, and China. The incidence is especially high in Central Africa, Southeast Asia, and South America.
• You have an infected region q 25 on chromosome 6. Research shows that having this genetic code can make you more susceptible.
• Your job is looking after chimpanzees, armadillos, sooty mangabey, cynomolgus macaque or any other species capable of developing and transmitting leprosy.